Culture, Diversity, and Relational Practice

Providing culturally responsive care requires adopting concepts of relational practice which involves providing the best care for diverse populations.

While practicing self awareness and recognizing differences without bias. As a community health nurse or CN, you'll provide safe, competent and ethical care.

Ok. So there are some important concepts to keep in mind when providing care for your patients, culture refers to behaviors and beliefs learned and shared within a group of people.

Now, people aren't born with culture, instead it's learned from experiences. So it can adapt over time with new situations and contexts.

Culture can be invisible in that it's experienced through shared rituals and behaviors that can impact how people respond to situations and make decisions in a cultural context.

Diversity looks at how traits such as age, gender, race, religion, sexual orientation and income level shape similarities, differences and power dynamics among people.

Diversity can be visible or invisible. Visible diversity includes observable characteristics like age, physical appearance, race and gender.

Whereas invisible diversity involves traits that aren't immediately obvious such as religion, occupation and sexual orientation.

While those who are visibly diverse are at increased risk of experiencing stereotyping or discrimination. Those with invisible diversity might feel overlooked.

Race is a social classification where an imagined hierarchy of value is based on physical characteristics like skin color.

On the other hand, ethnicity involves belonging to a social group that has certain cultural patterns in common like beliefs, values and customs and is influenced by factors like geographic location, heritage, education and income level.

Keep in mind that people of the same race can have different ethnicities and cultures. For instance, black individuals are often wrongly viewed as sharing the same ethnicity and culture, even though they're a diverse group with ancestry and heritage that can be traced back to North America, Africa, the Caribbean or elsewhere.

Now, relational practice can be further developed by integrating cultural safety and cultural humility into practice. Cultural safety considers how historical contexts have led to the development of dominant health care delivery systems which have disempowered marginalized groups.

It aims to identify power imbalances between providers and patients to foster equity, reduce discrimination and promote inclusive and respectful care.

For those of all cultural identities. Don't forget that cultural safety is defined by the patient during nurse patient interactions.

Meaning that it's only present when the patient feels respected, safe and free from prejudice and discrimination. Cultural humility builds on cultural safety by encouraging nurses to identify and acknowledge their own biases.

Developing cultural humility is a continuous lifelong process of self reflection and self critique where one's own deficiencies in knowledge and understanding of diverse cultures are recognized by being self aware and actively learning from patients experiences and cultural backgrounds.

Nurses can use cultural humility to take responsibility for their own interactions with their patients. As the community health nurse, you'll use concepts of relational practice to guide cultural assessment and provide culturally responsive care.

Begin by performing a cultural assessment to understand your patients beliefs, values and behaviors. Inquire about their unique individual traits, including their birthplace length of time in the country and how they define their culture.

Remember that some patients might be reluctant to share their cultural identity due to distrust of healthcare professionals, fear of discrimination or differences in language.

So be sure to ask non leading questions, actively listen in a nonjudgmental manner and provide adequate time for your patient to respond.

Remember to be cognizant of cultural variations in verbal communication such as cadence, dialect and word pronunciation as well as nonverbal factors like hand gestures, eye contact and the preferred physical distance between you and your patient.

Also keep in mind that your patient is an expert on their own culture. So explore their individual values and beliefs rather than assuming they follow practices that are stereotypical of their culture or background.

One way to do this is by asking open ended questions such as tell me about the role religion or spirituality plays in your life.

You may also need to gather information from family members, traditional health practitioners or a medical interpreter to best understand your patient's needs.

During your assessment, be mindful that all those specific conditions are more prevalent in certain populations. Many health risks are more strongly tied to social determinants of health like living arrangements or employment than race and culture.

For instance, indigenous peoples have a higher risk of type two diabetes which have been linked to factors like systemic poverty, educational barriers and limited health care access.

So in these situations, your health prevention efforts should also be focused on these socioeconomic factors. When developing and delivering resources, education and services seek to understand your patient's health beliefs and accommodate your patient's wishes.

When appropriate. For example, if your patient prefers nontraditional healing practices and remedies, ensure they can be blended safely with needed traditional Western medicine.

Also remember to collaborate with your patients and their loved ones through shared decision making to guide their plan of care.

All right, as a quick recap, providing culturally responsive care requires adopting concepts of relational practice which involves providing the best care for diverse populations.

While practicing self-awareness and recognizing differences without bias as a community health nurse or C HN, you'll provide safe, competent and ethical care.