29 Nov Diversity and Inclusion in Nursing
Mr Wu had just had a coronary bypass surgery. Nurses knew he was in pain because he continually used his PCA machine, but he did not display typical signs of pain such as whimpering, grimacing, or crying. Instead, he was stoic. When his nurse offered him supplemental pain medication, he refused it. This is because in Chinese culture, men showing pain is often construed as a sign of weakness and an insult to manhood.
Another patient, a Filipino, was discharged on Warfarin, a blood thinner. His nurse expressly told him not to eat to eat green leafy foods, which he understood. He was readmitted days later. His nurse discovered that he regularly ate soybeans and fish liver oils–both very high in vitamin K, which counteract the effects of Warfarin. The nurse failed to consider his cultural diet and had to reeducate him on what foods to avoid.
In both cases, nurses needed to understand cultural contexts to properly provide care. Cultural sensitivity and context are crucial in ensuring optimal health outcomes and providing patient-centered care.
In this post, Proximity Healthcare will outline diversity and inclusion in nursing: how nurses can provide culturally competent care, minimise implicit bias, ensure proper communication, and understand cultural contexts to improve health outcomes and foster inclusion in care.
What Is Diversity?
Most of us have a general understanding of diversity: that people are different and have different needs. In truth, diversity is an overarching concept that encompasses equity, inclusion, and accepting differences.
In essence, diversity is the range of people in a group. We all have different identities, experiences, and issues that should be valued and respected. This idea is called cultural relativism.
On Cultural Relativism
Cultural relativism describes how a person’s beliefs, values, and practices should be measured based on their culture, not a differing one. It emphasises understanding cultural differences, avoiding viewing our own cultures as superior, and that all cultures have their own logic and coherence. It’s useful to research when understanding inclusion, as it raises questions about how we should face ethical dilemmas varying cultural expectations can cause, particularly in groups that prioritise cultural values over medical values.
Equity
Equity recognises that to reach optimal outcomes, individuals need different levels and kinds of support. Equality means each individual or group is given the same resources or opportunities.
Inclusion
Inclusion is the sense of belonging to and being valued by a set of people or community. This means people of different genders, races, ethnicities, ages, sexualities, and abilities should be treated with respect and dignity. We should recognise that the thoughts, contributions, perspectives, and presence of people different to us can help us provide more patient-centred care. Why? When patients interact with a nurse that they identify with, they’re more likely to request care and accept medical advice.
How Does Cultural Sensitivity Impact Health Outcomes?
The varied traditions, beliefs, and values within particular cultures can impact healthcare decisions and outcomes. It can be difficult to balance care that respects beliefs while promoting well-being.
For instance: Fatima was an 18-year-old Bedouin girl who lived in a remote, conservative village in Saudi Arabia. She was shot by her cousin Hamid after she refused to marry him. She was taken to an American Air Force hospital, where routine X-rays revealed that she was pregnant. In Fatima’s tribal community law, pregnancies out of wedlock are punishable by death (stoning). The doctors involved in her case (an American neurosurgeon, a European OB/GYN, and an American internist) were aware of the tribal law and the danger Fatima would be in if her pregnancy was discovered.
The OB/GYN made arrangements for Fatima to be flown to London for a secret abortion. Her internist objected, saying that Fatima’s father should be told of the pregnancy. At the last minute, the internist told Fatima’s father about her pregnancy and her father took her from the hospital. Weeks later, it was revealed that she was stoned to death to restore her honour.
In this extreme case, cultural sensitivity was more than a diversity initiative. It was a life-and-death situation.
How can nurses become culturally competent?
How to Build Cultural Competence
Nurses can develop cultural competence by engaging with self-reflection, developing cross-cultural skills, building relationships, advocating for change, and educating themselves.
Self Reflection
Reflecting on personal biases, e.g. “people who can’t walk are silly,” is a fantastic way to develop cultural competence. Question your assumptions like a jury might, seeing both sides of why you might assume something, then draw evidence-based conclusions. This will help you provide unbiased and equitable care.
Build Relationships
Focus on similarities rather than differences to build relationships based on mutual respect. Take time to understand your patients’ unique experiences and perspectives. This could reveal vital information that could help you provide better care.
Develop Cross-Cultural Skills
Nurses who can translate quality care across multiple cultures will create better health outcomes. Connect with patients effectively and respectfully by learning a few key phrases and words from languages and cultures you experience most often. For example, London nurses might learn Bengali to better care for Bengali patients, one of London’s largest ethnic groups.
Educate Yourself
Numerous workshops aim to educate people about cultural competence. You might also learn from nurses and patients around you who are of different cultures and backgrounds. Read academic journals, publications, and other culturally relevant sources to expand your understanding of the people around you.
Advocate for Change
Use your union to advocate for culturally sensitive policies, such as a diverse international nurse workforce in recruitment, equity training, and mentorship initiatives.
As the UK’s demographics rapidly change, culturally sensitive care is more essential than ever. Nurses equipped with cultural competency skills are better able to provide culturally sensitive care that considers patients’ values, beliefs, and practices. We should aim to understand how cultural factors can influence patients’ attitudes towards care, their health beliefs, and behaviours.
Understanding the people we treat and accounting for differences will communicate, build trust, and make for better adherence to treatment plans, vastly improving health outcomes.
If you would like to be part of a nursing workforce that embraces uniqueness and inclusion, contact Proximity Healthcare. Our agency will help you find well-paying nurse agency work in the UK.