cultural competency scenario help?

[Holistic_Nurse]

hello,

I have this scenario about cultural competency that I just do not understand. I also do these scenarios with no problem, however, this time I could not understand the intent of the coworker in the following scenario? These usually take me a 20 minutes to do, but i don't know why it just won't come to me. Can Anyone offer some direction as this is due tonight. I did not find that the coworker was doing anything culturally inappropriate. Not giving an Amish person a cd because they are Amish and assuming they dont know how to use one would seem culturallu inappropriate to me. But how does it seem inappropriate to give them a cd? I'm struggling with this one. Am I missing something? Thank you!

you are visiting an Amish family to provide healthcare services in their home. You have the healthcare team with you. When you have all finished evaluating the patient's needs you notice your colleague hand the wife a dvd/video with appropriate exercises contained on it to help address her healthcare needs (PT, OT). The woman appears a little confused, but does not say anything regarding the CD, however she looks at it perplexed, as everyone heads out the door. What assumptions was your colleague making about her ability or desire to use the CD based on her culture? How could you have handled this in a more culturally competent manner?

[203bravo, MSN, APRN]

have you researched the Amish culture and how it differs from the "English" culture?

think if there were visible cues in the home -- did they have a television? radio? electric lights?

what about the cues that the colleague missed when presenting the DVD to the family? How could this have been addressed when she looked visibly confused when presented the material in this format? What other resources could have been offered that would be more acceptable within this Amish community?

[Mergirlc, MSN, APRN, NP]

This might be too late if your homework is due....but Amish typically do not use modern-day appliances like TV, radio, or CD player. Much of their energy comes from generators, solar power and they do use batteries.

Remember, they do not drive cars - they use horse-drawn buggies for transportation. Do not confuse them w/ the Menonites who look Amish, but do use modern things such as cars.

There is no way an Amish person is going to use a CD or even have a CD player in their home. More than likely, they probably would not even have a TV. Your best scenario would be to give the Amish person a book or printed material on what you need them to know. You may also have to just handwrite it on a piece of paper for them if it's too difficult to go somewhere and get printed copies. I suppose if the situation is not too urgent, you can send instructions via regular postal service too.

[Holistic_Nurse]

Yes it was due yesterday but regardless I needed a reply to better Understand them because I was confused about Amish culture. I read a few pieces that said the majority of people stay away from all electronics but some have adapted and changed so I think that's why I was confused. I'm glad you explained the difference between the two cultures! Now it makes sense why some people use electricity and some don't! I managed to answer the scenario last night but sticking to the idea that traditional Amish do not use electricity as I remember and by giving the cd to the patient shows she did not preform a learning assessment or evaluate the environment to see f it was appropriate to use. Thank you very much!

[Mergirlc, MSN, APRN, NP]

No problem. I had a friend who visited Amish country once and he told me he had actually seen some Amish teens going down the street in their buggy and one had a radio underneath a blanket listening to a rock song. They obviously shouldn't have, but hey........they were teens and probably very curious.

My guess is as we progress, we'll probably be seeing many of the younger Amish generation straying away from that lifestyle.

It is a very faith-based, simple way of living.

Also, in the future if you ever had to describe the lifestyle of the Amish, it would probably be similar to people living in the 1870's, but with better equipment (tools, farming equipment, etc..)

They are excellent wood-workers and sewers!

[Tenebrae, BSN, RN]

You can take the lesson from this one and apply it to any culture.

In this case, chances are an amish person isnt going to be able to listen to the CD, there for the information isnt going to be conveyed and the health outcomes remain poor.

Lets say in another scenario, a patient is discharged with a prescription for medication that they cant afford to get filled because its a choice between the prescription and putting food on the table for their family. The patient doesnt get the needed medication, chances are the illness isnt properly treated which can result in readmission to hospital

We have a thing in NZ called the Treaty of Waitangi (google is your friend) and we have whats called the treaty principles which we are encouraged to incorporate into our nursing practice. These include active participation eg the patient is participating in the healthcare process, protection of their culture eg acknowleding the place of the patients culture in their world and partnership, eg working with the patient and their family