DMC COLLEGE FOUNDATION, INC.

COLLEGE OF NURSING
NCM 120
Decent Work Employment and Transcultural Nursing

Course Learning Objectives:

The course will introduce the student to theory and concepts in transcultural nursing, and
the role of culture in understanding and caring for diverse clients in health care settings. It
will provide an overview of the influence of culture on health care practices and in the
delivery of nursing care for individuals, families and communities.
This course is designed to assist nursing students in learning about culture, belief systems,
values and practices that are specific to identified cultures in order to better understand and
provide nursing care that is both culturally competent and culturally sensitive in nature.
Various cultures and concepts of health and illness will be examined; special emphasis will
be placed on providing health care in Philippine setting.

INTRODUCTION

The need to gain a global perspective of the nursing profession is the reason that
transcultural nursing courses were created. Since the world is interdependent, it is important to
incorporate healthcare that addresses the needs of those from across the world.
Transcultural nursing combines transcultural and international content to train nurses. The
course focuses on teaching nursing students about nursing in different countries, international
health organizations, cultural differences, and international health issue.
Nurses must be prepared to provide care for patients from all walks of life. Although
the practice of nursing is based on practice, theory, and research, nursing professionals must
also have a strong foundation in the concept of culture to care for their patients
properly. Nursing students who take transcultural nursing courses are prepared to provide
culturally appropriate care for each of their patients.

Transcultural nursing
Is a form of nursing that uses the concept of culture to interact with patient.
This area of practice and study seeks to provide care with an emphasis on cultural values that
focus on groups or individuals of different or similar cultures. This nursing specialty focuses on
health comparative cultural caring global cultures.

Goals of Transcultural Nursing is to teach nurses to:

1. Provide culturally equal nursing care
 2. Provide cultural specific nursing care for those with adverse human conditions
3. Promote universal nursing care for the well-being of all people, and care for the gravely
ill in a culturally appropriate manner.

How Nurses use Transcultural Nursing

Nurses who study the relationships of cultural care from the point of view of
professional nurses. As transcultural nurses, they provide safe, competent, and
knowledgeable nursing care for those in diverse cultures. By studying the similarities and
differences of diverse cultures, nurses can provide nursing care to all human groups.
The course prepares nurses for the difficult task of providing care and treatment for
those with varying religious and cultural health needs. Nursing students are prepared to
work in medical facilities across the world providing diverse nursing care.

1. Nurses use transcultural nursing in a number of ways on their jobs the first thing that they
need to know is the religion language, and cultural heritage of their patients. This
information can be helpful to determine if any of their cultural or religious beliefs are the
root cause of their current medical conditions. Some people may exercise their right to use
home remedies based on their cultural beliefs, and these remedies may have led to their
illness. It is the transcultural nursing knowledge that can prevent the patient’s condition
from worsening.

2. Nurses use their transcultural nursing skills to identify these aspects of their cultures and
religions to prevent violating their beliefs. Certain religious and cultural groups do not
believe in ingesting certain medications that may contain ingredients that are prohibited in
their particular religious and cultural groups. Nurses need to know this information so that
they can make the adjustments needed to care for these patients. Some cultures believe
that the male is the dominant figure and should provide medical treatment to patients.

3. Nurses also use transcultural nursing when caring for the mental health of their
patients. They need to know that certain cultures believe that certain mental conditions
take place because of a lack or religions harmony, and these individuals may not believe
that factors other than medical treatment and therapies can alleviate their bodies of these
mental conditions. It is important to understand the diverse religions and cultures of each
patient to provide care that does not violate any of their cultural and religious
beliefs. Transcultural nursing provides specialized care for a diverse group of people.

BASIC CONCEPTS
Transcultural Nursing
 The study of the lifeway’s and patterns of persons of various cultures including their
healthcare practices and nursing role in that culture.

Cross Cultural Nursing

 The study of the lifeway’s and patterns of persons of various cultures from
anthropological perspectives that is being applied to nursing.

Generalization
 Usually an oversimplification made about behaviors of an individual or large group.

Stereotyping
  To make a person possess or believe to possess characteristics or qualities that typify a
particular group.

Cultural Anthropology
 Is the scientific study of humans and their cultural, social, biological, and environmental
aspects of life in the past and the present

GUIDELINES FOR THE PRACTICE OF CULTURALLY COMPETENT NURSING CARE

Guideline Description:
1. Knowledge of Cultures
 Nurses shall gain understanding of the traditions, values, practices & family system of
culturally diverse IFCP they care for as well as knowledge of the complex variables that
affect the achievement of health and well-being.

2. Education and Training in Culturally Competent Care

 Nurses shall educationally prepared to provide culturally congruent health care.
Knowledge & skills necessary for assuring that nsg. Care is culturally congruent

3. Critical Reflection in their own values.

 Nurses shall engage in critical reflection of their own values, beliefs & cultural heritage
– order to have an awareness of how this qualities & issues can impact culturally
congruent nursing care
 Nurses shall gain understanding of the traditions, values, practices & family system of
culturally diverse IFCP they care for as well as knowledge of the complex variables that
affect the achievement of health and well-being.

4. Cross-Cultural Communication
 Nurses shall use culturally competent verbal & non-verbal communication skills to
identify client’s values, beliefs, practices and perceptions and unique health care needs.

5. Culturally Competent Practice

 Nurses shall utilize cross-cultural knowledge and culturally sensitive skills in
implementing culturally congruent nursing care.

6. Cultural Competence in Health Care Systems and Organizations

 Health care organizations shall provide the structure and resources necessary to evaluate
and meet the cultural and language needs of their clients
7. Patient Advocacy and Empowerment

 Nurses shall recognize the effect of health care policies, delivery systems and resources
on their patient populations, and shall empower and advocate for their patients as
indicated
 Nurses shall advocate for the inclusion of their patient’s cultural beliefs and practices in
all dimensions of their health care.
8. Multicultural Workforce
 Nurses shall actively engage in the effort to ensure a multicultural workforce in health
care setting. One measure to achieve a multisectoral workforce is thru strengthening on
recruitment and retention efforts in the hospitals, clinics and academic setting

9. Cross- Cultural Leadership

  Nurses shall have the ability to influence individuals, grps and systems to achieve
outcomes of culturally competent diverse care for the diverse populations.
 Nurses shall have the knowledge and skills to work with public and private orgs, /prof.
associations and communities to establish policies and guidelines for comprehensive
implementation and evaluation of culturally competent care.

10. Evidenced-Based Practice and Research

 Nurses shall base their practice on intervention that have been scientifically tested.
Nurse researchers shall investigate and test interventions that may be the most
effective in reducing the disparities of the health outcomes.

What Is Cultural Competence In Nursing?

Cultural competence
 Refers to the ability of a person to understand and respect the attitudes, values, and
beliefs of people with different cultural backgrounds.

Cultural competence in nursing

 Is the ability of nurses to provide nursing care to patients while demonstrating cultural
awareness toward the patient and their loved ones.

5 Important Elements of Cultural Competence in Nursing

There are several elements and principles upon which culturally competent nursing practices
are built. The following are five important elements necessary to practice cultural competence
in nursing.

1. Cultural Awareness:
 The first element of cultural competence in nursing is cultural awareness. This element
involves examining yourself, your beliefs, and your values. Practicing cultural awareness
means demonstrating a willingness to set aside prejudices against other cultures and
developing an attitude of acceptance toward all patients and peers.

2. Cultural Desire:
 A person's motivation to learn about other cultures is referred to as cultural desire. It is
an openness toward other people and the ability to accept and understand cultures and
learn from them.

3. Cultural Knowledge:
 This element of cultural competence in nursing refers to acquiring information about
the norms, beliefs, and values of others. Cultural knowledge is the aspect of cultural
competence in nursing that involves actively searching for information about patients'
beliefs, cultures, and values to help you understand and interact with them better,
strengthening nurse-patient relationships.

4. Cultural Skills
 As you deepen your knowledge of diverse cultures, it then becomes possible to develop
cultural skills. Cultural skills refer to a person's ability to collect and process relevant
cultural data as it relates to the patient's presenting problem and perform a culturally
sensitive and specific assessment. Cultural skills are useful in helping nurses engage
patients, families, and peers with meaningful interaction, and be supportive of cross-
cultural beliefs and values.

5. Cultural Encounter:
  Each of the last four elements of culturally competent nursing leads to the cultural
encounter. Cultural encounter occurs when nurses step out of their comfort zones and
venture into new environments to interact with people from other ethnicities, cultures,
and backgrounds.

5 Skills a Nurse Must Have to Provide Culturally Competent Care

It is essential for all nurses to demonstrate cultural competence in nursing. Both new nurses
and experienced nurses can learn to implement skills that promote culturally competent
nursing care. The following are a few essential skills to help provide culturally competent care.

1. Self-Awareness:
 Becoming aware of and understanding your own cultural values, attitudes, judgments,
and beliefs is vital when interacting with people from other cultures. Self-awareness is
essential because our values, beliefs, and attitudes shape our perception of others and
define how we see individuals and the world around us.

2. Effective Communication:
 Effective, culturally respectful, and competent communication is vital in all aspects of
nursing and healthcare. Effective communication can break down barriers, improve
access to healthcare services, and promote positive health outcomes for clients.

3. Willingness to Learn:
 Developing cultural competency involves a lifelong process of learning. Nurses must be
willing to learn about themselves (self-awareness), develop behaviors and social skills
relevant to diverse cultures and populations, and develop the ability to advocate for
others.

4. Ability to Demonstrate Humility:

 Humility is described as having a modest view of one's own importance. It is crucial for
nurses to learn how to demonstrate humility when dealing with others, especially in the
case of diverse cultures. Humility in cultural competence means avoiding judgment or
biases about others' beliefs and accepting those beliefs, even if they contradict

5. Be Non-judgmental:
 Being culturally competent in nursing requires setting aside personal prejudices and
biases that may lead to judgmental assumptions. Even the most well-intentioned among
us can be judgmental at times. Practicing the art of acceptance and setting aside
judgmental attitudes is a skill that demands lifelong perfecting.
 HOW TO DEMONSTRATE CULTURAL COMPETENCE IN NURSING

It is necessary for all nurses to find ways to strengthen cultural competence in their practices.
There are many ways to demonstrate culturally competent nursing. The following are ten
examples of cultural competence in nursing. In some examples, you will find a mock patient
situation. Please note, that the names do not represent any patient's real name and is used for
demonstration of the situation only.

EXAMPLE #1: Acceptance of the Patient’s Beliefs

Situation:
Ms. Nestle has been a Christian minister for more than fifty years. Her primary nurse, Nurse
Selecta, does not associate with any religious preference, stating she does not believe in a
spiritual deity or an afterlife. Ms. Nestle fears her lack of Christian views may hinder her
ability to provide the type of care she wants.

Culturally Competent Response:

Although there are an estimated ten thousand distinct religions worldwide, sixteen percent
of the world's population do not affiliate with any religion, or are atheists or agnostics. In
some cases, like the example above, a difference of religious opinions is cause for concern to
the patient, nurse, or both.

The culturally competent response in this situation is for the nurse to be attentive to Ms.
Nestlé’s wants and needs without showing prejudice or bias because of her personal beliefs.
If Ms. Nestle approaches the topic of religion or Christianity with Nurs Selecta, it is
appropriate for Nurse Selecta to listen to Ms. Nestle without feeling the need to agree with
him. In some cases, it may be necessary to set professional boundaries, including clarifying
which topics are appropriate for discussion and those that are not. Cultural competence in
nursing is best demonstrated in this scenario by the nurse being attentive, asking appropriate
questions, and finding out to what extent Ms. Nestlé’s religious beliefs influence his decisions
about healthcare.

Outcome of the Response:

When nurses show genuine interest in a patient's thoughts, values, and beliefs, it helps
reduce stress and worry. It is essential to understand that showing interest does not mean
changing your own beliefs to accommodate the patient. Instead, healthy conversations and
appropriate sharing of relevant information can help nurses determine the best course of
action in providing care while respecting the patient's beliefs and wishes.

HOW TO BECOME A MORE CULTURALLY COMPETENT NURSE

Practicing cultural competence in nursing benefits everyone involved in patient

care, including the patient, nurse, healthcare team, and the healthcare organization. There are
several things you can do to implement measures to increase your level of cultural competence.
Learning cultural competence does not have to be centered around nursing only. You can learn
to become more culturally competent and demonstrate those skills in your personal and
professional life. Once you learn and implement these skills, you can use them to demonstrate
culturally competent nursing care. The following are 10 tips to help you become a more
culturally competent nurse and individual.
1. Practice Self-Awareness:
  You can begin practicing self-awareness by exploring your own cultural history, values,
and beliefs. A few ways to practice self-awareness are to ask trusted friends or family
members to describe you, take personality tests, and ask for feedback from supervisors
and peers.
2. Learn About Different Cultures:
 There are several ways to learn about different cultures. Seek insight into diverse
cultures by reading academic books, journals, and articles focused on people from other
cultures.

3. Interact with People from Diverse Cultural Groups:

 Developing cultural competence takes deliberate action. A few things you can do to
promote cultural competence include getting involved with culturally diverse
opportunities. For example, attend events sponsored by professionals from other
cultural backgrounds or participate in campus-wide or organizational events that cater
to issues of inclusion and social change.

4. Share Things about Your Culture with Others:

 Cultural competence is not only learning about others. It also involves an element of
sharing things about your culture, values, and beliefs with others. When you share
information about the things you value, others tend to feel more at ease doing the
same, which improves cultural competence for everyone involved.

5. Seek Positions in a Culturally Diverse Setting:

 Most people have heard the old phrase, "sink or swim." It is a saying that uses
swimming as a way of describing how you either fail for lack of trying or swim because
you give it all you got. In other words, if you don't try, you sink, but you can succeed if
you kick your feet and paddle your arms until you are swimming. The same principle
applies when learning cultural competence in nursing. Seek positions in settings that are
culturally diverse. Then, put forth your best effort to learn from and about others and
allow them to learn about you.

6. Seek Cross-Cultural Interactions with Peers:

 One of the easiest ways to increase cultural competence in nursing is for nurses to
intentionally engage with peers from other cultural backgrounds. It is possible to share
thoughts and ideas, learn about other cultures from your peers and help strengthen one
another's cultural competence.

7. Consider Volunteer Opportunities:

 Volunteering is an excellent way to get involved with and learn about different cultural
practices and beliefs of people from diverse populations. Many nurses volunteer in
community health clinics, especially in underserved areas where diversity of populations
is more common.

8. Be Mindful of Your Perspective on Cultural Diversity:

 Cultural competence is a lifelong process that involves increasing your self-awareness
and developing social behaviors and skills that promote acceptance of diverse cultures.
Learning to be a culturally competent nurse means having an open mind and a
willingness to learn about and accept that cultural diversity is the norm for society. Be
aware of your personal biases, opinions, and any prejudices. Ask yourself questions
about what made you form those opinions and discover ways to overcome any negative
feelings about different cultures.

9. Attend Conferences and Events Focused on Cultural Diversity and Competence:

  One of the best ways to learn about cultural competence is to learn from others who
have high levels of cultural competence. Professional conferences, such as those offered
by nursing associations, healthcare organizations, or professional development coaches,
are excellent places to learn from experienced people. One of the great things about
attending conferences or events is the opportunity to meet people from culturally
diverse backgrounds in person.

10. Consider Learning a New Language:

 Although your job may not require it, learning a new language can benefit you, your
patients, and your organization. Learning a new language is an excellent way to build
rapport with patients who speak little or no English and helps foster trusting
relationships with patients and their families for whom there is a language barrier in
healthcare.

Prepared by:
Maria Rose Ortega- Alarin
Instructor