cultural diversity

[brown rice]

I would like to open up the discussion of cultural diversity. Is the U.S. health care system adapting to the growing numbers of ethnic groups in our country?

For those of you in medical/nursing school is cultural awareness/sensitivity/knowledge a subject that has been adequately addressed? why or why not?

For those in practice what sort of diversity are you seeing in your patients? What is the primary ethnic/minority group that you deal with? If you have a nurse for long time have you seen a noticeable increase in the diversity of patients coming in?

Does your work environment provide a safe (non-bias) and accessible (language intreperters, material in other languages...ect.) place for people of all ethnic backgrounds?

Does your work offer training/education to enhance cultural awareness in its employees?

[MollyJ]

The book, The Spirit Catches You..., showed me just how poorly people who are not fluent in the language comprehend things when they are moving very fast and you're needing to do procedures.

All your worst fears are realized in this book, and docs and nurses become people who take people's children and relentlessly subject them to care that has no sense or meaning. The HCP's are trying to do what's "best"; the family struggles to make the procedures make sense.

I don't know how anyone gives culturally competent mental health care across cultures. I think the numbers would suggest we don't; the "patients" drop out because the care system just doesn't match their culture or their expectations.

[WashYaHands]

I recently completed my Master's research project and studied the barriers to accessing health care for the spanish speaking population in my community. Although the results of my study cannot be generalized to all communities, language proficiency was a major barrier. Other barriers included low income, lack of health insurance, not knowing where to go for care, and legal status.

I admire those who strive to provide culturally competent care to any culture that you see predominantly in your setting. While doing my research I found that many of us take the stance of, "if you come to our country, learn the language". While I certainly promote ESL programs, I found that in many cases, immigrants are hired for menial jobs and must work 80 hours a week to provide for their families. In their work setting they are grouped with other spanish speakers and therefore are not exposed to the English language and unable to assimilate English into their daily lives. At any rate, I'd like to share a quote from one of my study participants (translated into English). I found it very profound.

"We need hospitals and clinics for the Spanish speaking community, which is very large. And especially for our children who are innocent of the troubles like discrimination and the legal issues such as being an undocumented immigrant in this country...But we are human beings, and we also get illnesses."

Linda

[brown rice]

Thank you everyone for your wonderful responces! MollyJ brought up a good point when she said,

"awareness does not necessarily equate to culturally sensitive care. It's not that easy." Someone esle suggested asking if there were any special cultural considerations they would like taken. Yes, the gap between one culture to the next may be large, but I think geniune caring towards the patient in most cases can help bring the attention off any cultural no-no's you might make on accident.

PTnurse- I highly recommend you pursue the spanish class idea! I just got back from Guatemala where I took some excellent courses. I know going to another country can be intimating, but it is not near as scary as you might imagine. I would be glad to tell you more about it if you are interested.

One of the reasons I asked this question is because I am thinking that I might want to go into public health nursing and work at a community health clinic. It seems that diversity among patients would be a daily occurance.