Cultural nursing

Nurses General Nursing

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Have you ever cared for a patient that had different cultural views than you, and as a result had trouble caring for that patient?

I live and had always lived in parts of the country that was predominantly caucasian. Here in Wisconsin, we have a group of Asian-Americans that are called Hmong. There are refugees from Laos that settled here and in other parts in the U.S. Suffice to say that when I graduated nursing school, I had very little interaction or understanding of this group. My first week off orientation, I had a Hmong adult female that spoke no english. She was being treated for pneumonia and when I hung the antibiotic, she became very dyspneic. She looked as though she was having an allergic reaction to the medication, though it was hard to know for sure because of the language barrier. All I know is that in 10 minutes she had 15 members of her family there at her side. Meanwhile, I gave her steroids and RT gave her an updraft. Come to find out later, that she thought that I was the "devil" because of the steroids and updraft and the lack of understanding that was going on.

Needless to say, that she got better and I enrolled in the first cultural diversity in nursing class that I could find. There really are some huge issues in health care among different groups.

So I am curious what you have run across as nurses that was unique to a certain culture in your area.

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You must read "The Spirit Catches You and You Fall Down." (nonfiction) I don't remember the name of the author. It is about a community in California that has a large Hmong population. There is a young Hmong girl with severe epileply. None of her family speaks English--they don't even understand numbers because apparently they don't have numbers in Hmong. Anyway, the author does a great job in showing the frustrations and misunderstandings on both sides. If you have a large Hmong population this is an absolute must read. And very interesting for everyone else.

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I agree with lgreen! "The spirit catches you" is a must read for any medical person. It doesn't matter if you run into a Hmong patient, or any culture other than yours... it shows how important it is to take each culture seriously and appreciate our differences. That book, and my anthro class has given me a great interest in cross-cultural nursing. Here in Hawaii we have many different cultures and I am anxious to learn about all of them.

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It's a real eye opener in clinical. From a small town and doing clinical in a city hospital, big difference. I am finding that I cannot make any assumptions about levels of understanding. Was doing bigshot teaching the other day, realized that the mom had understood none of it. Made me evaluate the words, gestures, etc. that I needed to use to get my points across to her.

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Originally posted by bnsoon

It's a real eye opener in clinical. From a small town and doing clinical in a city hospital, big difference. I am finding that I cannot make any assumptions about levels of understanding. Was doing bigshot teaching the other day, realized that the mom had understood none of it. Made me evaluate the words, gestures, etc. that I needed to use to get my points across to her.

:confused: :confused:
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Specializes in Vents, Telemetry, Home Care, Home infusion.

Welcome, bnsoon...understood you completely!

Had women from Laos, no English, that needed fleets enema for bowel prep at 6AM---asked middle shift if husband (translater) told her about it "NO, didn't think of it". GRRRRR

So 5:45 AM, showed her back of box, called husband who translatted --still worried look on face but nodded yes. Called AT+T Language line to interpret---10minutes just to explain enema to interpreter but patient relaxed and enema easily given.

Another occassion, had Hassidic Jewish family from NY at my West Philly hospital with mostly African American clientele. Father had brain tumor and was just placed on a ventilator. I came in at 3PM to work double on a friday "to help out". At 7PM, sons are telling me I need to shut off the ventilator as sundown and Sabbith. I explained why I couldn't do that and the sons got VERY angry with me, a female, telling them what to do! I called resident to explain situation. It was a very uncomfortable 12 hrs with them. When I came back in that next night, they presented me with a box of chocolates, as Oncologist had spoken to the sons and they had finally HEARD AND ACCEPTED his terminal condition. It was a totally accepting and calm atmosphere that shift.

We asked our RN Educator Pat for Cultural Diversity training as we realized many cultures starting to come to our ER and we needed to learn more---still learning to this day.

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Specializes in Neuro Critical Care.

Took care of an arabic woman with throat and neck cancer who had undergone several surgeries and bouts of chemo-radiation. Pt was in sever pain and didn't want anymore treatment but was unable to make her own decision because she was female. What a culture shock! Sometimes it is difficult to know where ethics ends and cultural respect begins.

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Absolutely Bellehill! I took care of a postpartum pt. who is arabic. Her husband was chomping at the bit to have her discharged, I'm not so sure she was in such a great hurry to get home. Hard to know who to look after when the men make demands. Taught nothing in school but to look after the entire family and consider their needs! Good luck making a decision with that one!

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Here is an Excellent Reference that we use in my BSN program though Excellsior College.

Thanscultural Health Care. By Larry D. Purnell and Betth J. Paulanka ISBN 0-8036-0208-1

It does not cover every culture. However it with the CD cover about 28 of the most common cultures in the USA.

My Italian husband saw a print out I did from the disk on Italians and said it was right on.

In the discussion of each culture it covers 12 domains of culture.

Overview, inhabited localities, and topograghy (U.S.)

Communication, Family roles and organization, workforce issues, biocultural ecology, high risk health behaviors, nutrition, pregnancy and childbearing practices, death rituals, spriituality, health care practices, health care practioners.

I was surprised by some of the things I learned from this book. And amaizingly it presented some surprises about my spouse that he verified. It helped to esplain some things for me about him. Mind you he was born in the USA. That is the point of the book these are cultures within the US. Some are receient arrivals some have been here for generations whom we assume we know and that their culture and mine are the same.

Great book.

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You might be interested. Started new job this week. While poking around the office found a book. Opened it and the page that fell open was addressing Hmung culture.

Looks like a great resource. Title was Culture and Nursing Care a Pocket Guide. Was actually a bit tall for a pocket (beside the point)

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Yes, I have. Lived in the southeastern part of Turkey for 15 months. Very family oriented in their care. Also, no nursing homes... a loved one stays with family members since there are no long term facilities.

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Yes, I see a lot of different cultures (Asian,European, American, Canadian,Philipin )in my job, in the beginning very difficult to understand.

Very interesting! and nice to work with different people.

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