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?

[shannonRN, BSN, RN]

great question...my hospital sees a wide variety of patients. caucasians, african americans, serbians, croatians, mexican, idian, spanish, pakistan....there is a list of intreperters however they are usually only available on days. we also have a well diversified staff, so they are usually willing to help out when the designated intreperter isn't available. i don't think that we have handouts in any other languages than english. that would be a wonderful program for education to implement....a couple of years ago my hospital did a cultural diversity inservice. it was pretty interesting but haven't seen anything like that since.

[Mkue]

I've had two nursing courses and both courses so far have addressed cultural diversity.

Previous courses also discussed it: Sociology, Ethics, English Lit, Psychology, Abnormal Psychology and Life Span Psychology.

Many 4-yr. and some 2-yr colleges REQUIRE Multicultural Diversity as a required course for general education.

[caliotter3]

My program had a mandatory course on multicultural diversity. In addition, every nursing course addressed the subject to the point of nausea. There is a point of overkill and when that much emphasis is placed on something, sometimes a negative consequence ensues. Students would start to counter with questions about motive and driving forces. It got to the point that a low key response among the students would start up: "just trying to justify their preferential treatment of certain students". I do not feel that I need to be browbeaten about anything and also grew to resent the bad learning atmosphere this topic generated. There were plenty of topics in nursing care that needed emphasis but went lacking while the instuctors wasted time on something I heard the first time it was mentioned.

[live4today, RN]

Originally posted by shannonRN

great question...my hospital sees a wide variety of patients. caucasians, african americans, serbians, croatians, mexican, idian, spanish, pakistan....

What about Black Families, Shannon? Does your hospital also see Black Families? You didn't mention them. And no.....not all Black families are African American.......so this is why I pose the question to you. I am a Black member of society in a Black Family, so wanted to know if we are included too? Thanks! :kiss

[rebelwaclause, ASN, RN]

I work in what has been deemed an "urban" facility. Rightfully so, since the hospital is in a predominately black and Hispanic populated city (The Bay Area is a melting pot).

The staff is primarily Asian and Black. Most MD's are Asian and White.

I haven't decided that even though I've mentioned the ethnicities that comprise the hospital I work for, whether or not we are culturally diverse. My definition would mean there is a healthy percentage of most nationalities, which is NOT represented where I work. Additionally, I feel we suffer for it. Our facility is always under a microscope (We are part of a a HUGE hospital family) for "doing something wrong". Most of the accused wrong doings are perceived, thank goodness. Mostly guideline issues, which often times a guideline doesn't exsist. I also think our management tends to be more crisis care than I care for....Fixing problems as they come rather than being proactive. Our staff is very talented, but requires ongoing training, in-services and plans for growth as anyone else. "Same old - Same old." Stuff never changes from hospital to hospital.

[MollyJ]

My BSN completion program had a strong emphasis in multi-cultural diversity but I think awareness does not necessarily equate to culturally sensitive care. It's not that easy.

I would recommend ANY ONE read this book:

The Spirit Catches you and you fall Down by Ann Fadiman.

This is the fascinating story of a Hmong child with a serious seizure disorder and developmental delay and her adventures with the local hospital as retold through the compassionate eyes of a woman who took the time to know the family.

Words I might use: chagrining; difficult; sad. The family and health care providers were unable to bridge their cultural gap and it is (to my mind) not particularly anyone's fault. While I admit that health care providers are morally compelled to be culturally sensitive, neither can we entirely abdicate our culture to the needs and perceptions of another.

Actually, the family shared many of the same characteristics I have seen in parents of severely affected parents; they saw their situation with a sense of hope that seemed at times idsproportionate to the reality.

Anyhow, what I really want to say is that the intention to be culturally sensitive can be really challening and beyond comprehension to implement. As in so many things in nursing, we can only move forward, learn from our mistakes and try to do better. Always we move toward doing the right thing.

[fergus51]

Our main minorities are either Asian (mainly Chinese, but from other countries as well) and Indian (from India which is so diverse in itself, it is almost impossible to generalize about that country but we get mostly Sihks from Punjab) or Native. I asked a woman from immigrant services to come give an inservice and it was great. Unfortunately I think there are a few nurses in our unit who feel that new Canadians should adopt our way of life and she shouldn't have to accomodate them when it comes to their customs. While I agree we don't have to, I think it is a nice thing to do. I find most families are pleased if you ask if their are any cultural considerations you should be aware ofwhile providing their care.

[rebelwaclause, ASN, RN]

Now that I think about it, I wonder if working a shift such as the night shift makes a difference? I'm sure there are more nationalities represented during the day and evenning shifts.

[ptnurse]

I work in an inner city facility. We are a teaching hospital as well as housing the only trauma center and burn center in the city. Our patients are overwhelmingly poor and/or elderly. Except for some patients that come in related to trauma or burn. Never really thought too much about the cultural makeup of the patients. If you have a job that provides insurance and are at my facility it is usually trauma or burn related. Have noticed an increase in the last couple of years of Hispanic patients. Overwhelming my hispanic patients have been almost completely unable to speak English. Have thought about taking a spanish class, but have not done it yet. I just get sooo scared at the idea of being somewhere in Mexico, being hurt and not being able to speak the language well enough to get some help. I really need to do something about taking a spanish class. The nursing staff is probably 3:1 black to white. We have several nurses right now from the Phillipines.

[shannonRN, BSN, RN]

cheerfuldoer, we definately have black families...i knew i wouldn't be able to name all of the people we care for hence the .... but i did say caucasians and not all caucasians are the same...with different cultures come different beliefs and religions one example could be the amish... cultural diversity is a huge area and i didn't mean to leave out or offend anyone. sorry!

mollyj, am reading the spirit catches you now....truly fascinating!

[srose]

MollyJ - I read that book too, and I loved it. My father uses it in a course he teaches on multiculturalism in counseling, and I really think that every healthcare student should read it.

Just my two cents :)