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NURS 201 > LEC 9: Cultural Safety & Cultural Competence > Flashcards

LEC 9: Cultural Safety & Cultural Competence Flashcards

1
Q

Can you ever truly be competent in another’s culture?

A

No, you will never truly know what someone’s view and beliefs are
- Need to take a client based approach

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2
Q

Why cultural competence and safety?

A
  1. Increasing number of minority populations
    - 19.1% if Canadiens identify as members if visible minorities (Statistics Canada, 2015)
    - 8.4% of Canadian nurses graduated from an international program (CNA, 2010)
  2. Notable health disparities for minority porpulations
  3. Despite efforts to develop CC policies, strategies, and interventions, culturally unsafe care persist
  4. Cultural issues are intertwined with socio-economic and political issues
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3
Q

What is culture?

A
  • Culture is the processes that happen between individuals and groups within organizations and society that confer meaning and significance (CNA, 2010)
  • Cultures and cultural norms are not discovered, rather they are constructed (Allen, 1999)
  • We all belong to many different cultures at once, we never really belong to one culture
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4
Q

Cultural Competence (CC)

A
  • The application of knowledge, skills, and personal attributes to maximize respectful relationships with diverse populations of clients and co-workers (CNA, 2010)
  • Congruent behaviours, attitudes, and policies that align in a system or agency enabling providers to work effectively in cross-cultural care (CNA, 2010)
  • Shown to lead to improve health outcome
  • CC is supported by cultural diversity
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5
Q

What are key values in cultural competence (CC)?

A
  • Inclusivity
  • Respect
  • Valuing differences
  • Equity
  • Commitment
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6
Q

What can cultural diversity catalyze?

A

Cultural diversity can catalyze new:

  • Ideas
  • Knowledge
  • Creativity
  • Productivity
  • Partnership
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7
Q

Cultural Safety (CS)

A
  • Action to protect from danger and reduce risks to health and well-being hazards (Racine, 2014)
  • Action or inaction that does not respect the cultural background of a client is considered cultural unsafe care (Racine, 2014)
  • Fostering cultural safety (CS) is addressing root causes of health inequities
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8
Q

What is situated vulnerabilities?

A

Everyone is in a place of vulnerability since we have all felt excluded at some point in our lives

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9
Q

Cultural Competence & Safety in Practice

A
  • Expression of cultural Intolerance persist within health disciplines
  • The same level of safety and proficient care is provided for individuals from any type of cultural or ethnic background
  • Employers must create environments that value diversity
  • Clients are responsible for choosing the information they share that will impact their healthcare
  • CC is an expected standard for all professional interactions
  • RNs must engage in critical self-reflection and critique of structures, discourses, power relations, and assumptions
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10
Q

Why do health professions struggle with being culturally competent?

A
  • How we understand culture can be problematic
  • Unease with the unknown
  • It’s not prioritized
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11
Q

Since CC and CS is not prioritized- what does the system value?

A
  • System is set up based on a biomedical approach
  • Desire measurable outcomes
  • Structural contraints/ violence
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12
Q

What are some cultural approaches RNs can take?

A
  • Getting an interpreter
  • Using client centered care approach; finding out what the client’s goal is
  • Being sensitive with how you are promoting health care to others
  • Co-ordinate with other traditional healers
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13
Q

What is structural violence?

A
  • Policies we have in place that do not make it easy for everyone to access
  • Its about looking at the system as a whole and where the disadvantage effect different people
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14
Q

Why we don’t teach about “culture”

A
  • Medical anthropology
  • Nursing in Canada, it’s not what we do
  • Culture is very individualized to the person and group
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15
Q

Medial Anthropology

A

The study of how culture and society organizes/ influences health and health care

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16
Q

How is culture very individualized to the person and group?

A
  • May be variations across groups of same “culture”
  • May be variations across individuals within a group
  • May be different levels of practice or understanding/belief
  • Do NOT assume that because you “know” about culture, you “know” about your client’s culture
17
Q

US: What can RNs do?

A

Focus on “Transcultural Nursing” which originally was influence by medical anthropology

  • Still has more “anthropology” feel to it
  • US textbook: cultural “information” which may be stereotyped, inaccurate, or not accepted by individuals
18
Q

Canada: What can RNs do?

A

Use cultural competency and cultural safety

  • Models that can apply to anyone in any setting
  • Not “culture” (ethnicity) specific knowledge but more general approaches to client care encounters
19
Q

What are the five things that Campinha-Bacote’s Model of Care focuses on?

A
  1. Awareness
  2. Knowledge
  3. Skill
  4. Encounters
  5. Desire
20
Q

Campinha-Bacote’s Model of Care: Awarness

A

Self-examination of your own background and biases

- Avoid cultural imposition

21
Q

Campinha-Bacote’s Model of Care: Knowledge

A

Seek knowledge from the client and family

22
Q

Campinha-Bacote’s Model of Care: Skill

A
  • What information is relevant to providing care?

- Are there assessments you can do?

23
Q

Campinha-Bacote’s Model of Care: Encounters

A

Interactions with clients without judgment

24
Q

Campinha-Bacote’s Model of Care: Desire

A

The WANT to be culturally competent to improve quality of care

25
Q

Campinha-Bacote’s Model of Care: Key Points

A
  1. Developments of Cultural Competence is a process which takes time and place
  2. Key stating point is to look at our own assumptions, biases, values, and prior experiences with others
    - Have we had negative experiences? If so work through these
  3. Start with the client and work out from there
  4. Use additional resources as “guidelines not gospel”
    - May or may not be right for/used by your client
26
Q

What are the six things that Griger & Davidhizar’s Transcultural Assessment Model focuses on?

A
  1. Communication
  2. Space
  3. Social
  4. Time
  5. Environment control
  6. Biology
27
Q

Griger & Davidhizar’s Transcultural Assessment Model: Communication

A

Verbal and non-verbal communication

28
Q

Griger & Davidhizar’s Transcultural Assessment Model: Space

A

Personal space preferences and/or needs

29
Q

Griger & Davidhizar’s Transcultural Assessment Model: Social

A

Social roles, family, culture, and religion values

30
Q

Griger & Davidhizar’s Transcultural Assessment Model: Time

A

Time orientation may impact on health practices

31
Q

Griger & Davidhizar’s Transcultural Assessment Model: Environment Control

A

Internal or external control and factors

32
Q

Griger & Davidhizar’s Transcultural Assessment Model: Biology

A
  • Think of “personalized medicine”

- Each person’s own body system reacts to medical treatment

33
Q

Griger & Davidhizar’s Transcultural Assesement Model: Key Points

A
  1. Use TAM in client encounters as a way to determining what you need to know to work with this person
    - Takes their own unique situation into account
    - Lets you find out about their own cultural needs/ practices
  2. Environmental control: More about perceptions of internal control (I’m the boss of me_ vs external control (it’s up to God/fate/ etc) than about the “environment”
  3. Biology: May be links to ethnicity but don’t assume. Treat each client in an individual way
34
Q

Summary: CC & CS

A
  1. In Canada, treat each client as an individual and work with the client to determine care needs and preferences
  2. Golden rule: “Do unto others as you would have done unto you”
  3. Can use models as “starting points” for conversations with your client- but have the conversation
  4. Be aware of stereotypes and biases- work to reduce these

NURS 201 (21 decks)

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