Impact Of Culture On Nursing: Critical Reflection On A Cultural Incident

The Importance of Cultural Competence and Diversity in Nursing

Culture is the umbrella term that encompasses the Norms And Social Behaviour found in human societies. In the context of culture, it reflects religion, food and things to wear. It is the knowledge and features of a selected group of people that encompasses religion, language, social habits, arts and music. A particular civilization society is required concerning the beliefs, art and way of life. This concept consists of the behaviours, beliefs, objects, and features common to the particular group member. It involves values, norms, language, tools, products, technologies, organizations and institutions. In culture, five basic features include learned, shared, integrated, and dynamic based on the symbols.

According to Crawford Candlin and Roger (2017), culture has a comprehensive impact on nursing. Cultural competence can help the nurse understand different ways of connecting and interacting with people of different backgrounds effectively. However, there are different cultural issues that the nurses can face because culture can raise the communication gap, language barrier and ethical issues. Nurses can face issues with diagnosis or assessment because of the religious belief of the patients (Farokhzadian Dehghan Nayeri and Borhani 2018). This paper has evaluated the impact of cultural issues on the nursing health profession as a chosen profession. It has reflected an incident of how the culture can affect the nurses and their jobs through the Gibbs cycle. In this paper, Gibb’s cycle aims to present the effect of culture on nursing.

As per Hargreaves and Page (2013), the Gibbs cycle is the most useful cyclical model of reflection that follows six stages: description, feelings, evaluation, analysis, conclusion, and the action plan. It reflects the self-reflection and management tool that can help people think logically and clearly about the various experiences that they have gone through at a specific activity or a similar situation or can draw conclusions. It allows people to improve performance as it is happening and improve it for the upcoming situations (Jasper 2003).

 It enables you to enhance the nursing practice randomly and the learning process from experience in order to better practice in the future. The first stage is a description of the incident, and the next stage is feelings, where the feelings about the critical incident have been shared. In the third stage, analysis of the experiences or the critical incident occurs (Kaya et al. 2017). In the fourth stage, evaluation of the actions of the nurses and patients happened to check the severity of the issue and the last stage is the conclusion where I have discussed what I have learnt and inaction plan I have made an action plan to improve the nursing practice in future. This reflection practice helps to learn new things from the mistakes and behaviour of others. However, it helps to improve the therapeutic relationship and holistic approach between the nurse and patient in future practice.

One of the cultural issues for the nurses involves religious beliefs and faith. In nursing, the nurses need to be open-minded about the culture. The implication of patient-centred care shows how the nurses prioritize their values and beliefs. In the nursing profession, they need to understand cultural diversity and prefer cultural diversity. In this cultural consideration, the nurses could not force or encourage any patient to get belief in one culture. Even some nurses who are culturally sensitive and well educated but lack ethnic diversity can make issues for them to provide holistic care (Monrouxe and Rees 2017). In holistic care, nurses can care for patients in the whole body, emotions, cultural, social aspects. Any cultural promotion or forcing of culture is considered misconduct. This discussion aims to analyze and explore an incident when attending a British nurse handling a patient with cancer.

Ethical and Communication Issues in Nursing Care for Patients from Different Cultural Backgrounds

For example, a British nurse who attempted to give a bible to a cancer patient was immediately sacked from the job. She is a British nurse and has been fired immediately as she has discussed her beliefs and faith with the patients. She has assured the patient that belief in Jesus can increase the chance of her survival from bowel cancer. At the same time, the patient was open-minded about religion. She has discussed that the only way to get the Lord is through Jesus. The patient has participated in prayer for Jesus as influenced by the nurse. It is morally wrong as it can affect the health of the patient. It is considered gross misconduct as the nurse has failed to consider the correct type of interpretation of the NMC Code. Even she could not distinguish between the inappropriate and appropriate expressions of religious beliefs. Even this type of conduct is considered as the violence of rights and freedoms of others.

However, in our module, we have to present a presentation on the cultural aspect where we have to present the cultural impact on nursing practice. In this group presentation, firstly, we have investigated the incidents related to culture and their impact on the nursing profession. We have presented the above critical incident about how the nurse’s inappropriate application of the cultural aspect has affected the profession.

In this section, I will discuss my feelings about the event. After analyzing the incident of the nurse, I can state that the nurse needs to learn about appropriate knowledge of culture. The nurse could not apply cultural diversity in her practice, which is insufficient. I have understood the ethical issues and misconduct. I am quite glad that I learned all professional standards for practice and behavior effectively. According to the Nursing and Midwifery council standards, I can maintain equality, inclusion, and diversity. By applying these standards, I can be better in my profession by safeguarding the public’s health and wellbeing of the public. This practice of reflection on critical reflection helps us learn and explore the feelings actions and can examine the evidence-based literature. It can help to bridge the gap between practice and theory. It helps to afford us the chance for changing our way of thinking or practice. In this reflection, we have developed skills and self-awareness in critical thinking.

I have learnt how to solve issues. I have learnt from this incident that the cultural aspect is a critical and significant area in the nursing profession. I get to know how I can act from a cultural aspect. It helps me know how to react to cultural beliefs and aspects in the future. I have understood the six principles: competence, care, compassion, courage, communication, and commitment. These are the core components of the vision. I have learned how to apply the cultural aspects to balance fairness in my nursing profession in the future. We have enhanced the knowledge and skills for up to date and can uphold the standards of the professional code.

The Gibbs Cycle: A Tool for Critical Reflection

This event Nurses have the responsibility for protecting or safeguarding and promoting the interests of the individual patients or the clients. They need to provide competent cultural care, where they need to find out the cultural values beliefs of the patient. After understanding the patient’s cultural needs, a nurse can act accordingly and wisely (O’Brien et al. 2021). In this scenario, the nurse is not trying to understand the patient’s cultural values. The American Nurses Association’s code has established the guidelines for navigating the cultural challenges that may arise due to professional and cultural differences. Different viewpoints can result in unintentional confusion or conflict.

Cultural competency is a crucial part of nursing practice. For this reason, there is a need to give the nursing degree education about cultural competence. Health disparities can be removed by cultural competence. Culture can affect a patient positively or negatively. Correct cultural competence is the key to obtaining positive outcomes (Slemon Jenkins and Bungay 2017). In this scenario, the nurse lacked culturally competent care. She could not deliver error-free holistic patient care due to inappropriate knowledge of the culture. In this scenario, the nurse has argued that the tribunal has failed to maintain her rights for religious freedom, which is endowed by the European Convention on Human Rights Article 9. The courts have rejected the claim of human rights, which is right. She has imposed her cultural beliefs on the patients, which is unfair. She has suggested adopting a culture that is not authentic and justified.

According to Yilmaz et al. (2017), cultural competence and understanding of cultural needs beliefs of the patient is a part of holistic care. Acknowledging the cultural perspectives of a patent is vital in establishing trust. It is argued by Yilmaz et al. (2017) intercultural sensitivity is contained in self-concept, social relaxation, and non-judgemental types of attitudes. The issues in cultural misunderstanding can make barriers to effective health care intervention and can cause harm. According to the Nursing and Midwifery council code, the nurses need to prioritize the people, practice effectively, preserve the safety and promote trust and professionalism (nmc.org.uk, 2022). In this incident, the nurse has tried to enforce her beliefs on the patient. She has misled the patients by influencing them to choose the handout Bibles. It can affect her intervention process, and she has violated her ethical principles of justice, beneficence, fidelity, accountability, autonomy and integrity. She could not maintain the cultural safety of the patient. In order to protect the safety of the patients, there is a need to develop cultural competence for the patients (nmc.org.uk, 2022). Cultural competence courses within the nursing practice curriculum can support the development of cultural competence. Even the training on cultural diversity can help gain a better understanding of the cultural competence necessary for effective nursing practice (Yilmaz et al. 2017).

We have developed skills in awareness and critical thinking skills by reflecting on this critical incident as we have to analyze the incident and identify the main issue. In this incident, the nurse has given a negative statement or unjustified hope that the patient can get better chances to recover after believing in Jesus. There is no doubt that it is misconduct as she has provoked the patient to get belief in the specific culture. However, we can apply critical thinking skills to get better experiences from the patient in the future. We have developed our research skills and improved evidence-based practice in this reflection of critical incidents. We have got the idea about which practices are considered misconduct. We get the knowledge about how to ignore any misconduct or misleading cultural safety. It helps us understand the weaknesses and care processes that can be used to communicate changes in the patient’s condition. We can eliminate the situations where ethical dilemmas may arise because of conflict with the nurse’s values.

Description

Conclusion

At last, I feel that I need to be aware and prioritize the patient’s cultural needs. I also ensure the patient’s cultural background before discussing or examining the patient. I realize how the nurse has put the patient at risk. Following the conversation with my mentor, I need to increase my knowledge of behaviour, eating habits and different views of various cultures. I need to develop the confidence to challenge the practice of other nurses or colleagues. In this situation, I can go through the pressure, although it is needed to ensure that my colleagues have not put the patient’s safety at risk. In nursing practice, the nurses need to observe the practice or procedure that the nurse believes wrong. They need to advocate for the patient to carry out a proper practice.

I observed that I need to control or supervise colleagues to understand cultural competency and cultural issues in their practice.

My action plan addresses working in a team. It helps them learn more about how they can communicate to contribute to quality nursing care. I aim to acquire diversity skills, communication skills while working with the patients to ensure their safety of the patients. This diversity skill will help me reduce biases and provide quality care to people of different cultural backgrounds. This action plan includes the below goal that needs to be fulfilled in a limited time-bound.

Table 1: SMART Goal

(Source: self-created)

This SMART goal can help to establish effective and quality care in future. It can help the nurse understand the patients’ needs in future practice. This action plan can enhance the skills which support implementing nursing practice via the learning and training process. This SMART goal is a direction that can be achieved by the nurses, which can be achieved by following reliable actions.

References

Crawford, T., Candlin, S. and Roger, P., 2017. New perspectives on understanding cultural diversity in nurse–patient communication. Collegian, 24(1), pp.63-69.

Farokhzadian, J., Dehghan Nayeri, N. and Borhani, F., 2018. The long way ahead to achieve an effective patient safety culture: challenges perceived by nurses. BMC health services research, 18(1), pp.1-13.

Hargreaves, J and Page, L 2013. Reflective Practice. Hoboken: Wiley

Jasper, M., 2003. Beginning reflective practice. Nelson Thornes.

Kaya, H., I?ik, B., ?enyuva, E. and Kaya, N., 2017. Personal and professional values held by baccalaureate nursing students. Nursing Ethics, 24(6), pp.716-731.

Monrouxe, L.V. and Rees, C.E., 2017. Healthcare professionalism: improving practice through reflections on workplace dilemmas. John Wiley & Sons.

nmc.org.uk, 2022. The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates – The Nursing and Midwifery Council. [online] Nmc.org.uk. Available at: <https://www.nmc.org.uk/standards/code/#:~:text=The%20Code%20presents%20the%20professional,and%20promote%20professionalism%20and%20trust.> [Accessed 23 March 2022].

O’Brien, E.M., O’Donnell, C., Murphy, J., O’Brien, B. and Markey, K., 2021. Intercultural readiness of nursing students: An integrative review of evidence examining cultural competence educational interventions. Nurse Education in Practice, 50, p.102966.

Slemon, A., Jenkins, E. and Bungay, V., 2017. Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice. Nursing Inquiry, 24(4), p.e12199.

Yilmaz, M., Toksoy, S., Direk, Z.D., Bezirgan, S. and Boylu, M., 2017. Cultural sensitivity among clinical nurses: A descriptive study. Journal of Nursing Scholarship, 49(2), pp.153-161.

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