Reverse culturally specific care...it ain't happening.

[carachel2]

My aunt has been a patient now at a *major*, very well known medical center for 2 weeks now. She had a major right-sided CVA after ovarian cancer surgery. She's had some great RNs and some bad RNs, pretty standard I would think. I have noticed a very disturbing trend though and I wanted your take on it. Please don't call me racist or biased or whatever until you hear me out.

For YEARS as an RN I have been required to attend conferences to make sure I was providing culturally competent care to our families. If the family was middle eastern, I had to learn it was traditional to address the male of the family, etc.etc. You get the point.

This hospital has an influx of RNs from India/Phillipines, etc. To say they don't even attempt to provide culturally competent care to a caucasian patient is an understatement to say the least. They walk into the room, avoid eye contact, do not introduce themselves (even though this healthcare system has a hundred thousand dollar program being promoted among staff to introduce yourself, what you are about to do, how long it will take, etc.); ignore family members, mutter under their breath and then talk as they are walking away. They make ZERO attempt to make any sort of connection and OMG...the accents. Are they even required to go through training so they can even be UNDERSTOOD? Try being a stroked out patient who is hard of hearing and trying to decipher all that.

I almost want to put up a sign that says : 1. Look her in the eye. 2. Say your name CLEARLY. 3. Announce your title 4. Tell the patient what you are about to do. ETC.

Is this a problem at your healthcare facility? Before anyone attacks me as being racist and bias, please know that the Caucasian and AA RNs caring for her ALL have looked at her in the eye, introduced themselves, announced what they are going to do and all that jazz. This is very distinctly a cultural thing.

[lunden]

sounds like it's going to take some more reinforcing, because some people just don't get it. that is very rude to not introduce yourself, let yourself known who you are etc. etc. hopefully pt advocates will continue to speak up for those who can't. i work in a dialysis facility as we don't have these type of problems (black and white rn's)

[carachel2]

sounds like it's going to take some more reinforcing, because some people just don't get it. that is very rude to not introduce yourself, let yourself known who you are etc. etc. hopefully pt advocates will continue to speak up for those who can't. i work in a dialysis facility as we don't have these type of problems (black and white rn's)

I take it back...we did have one Phillipino RN introduce herself as she was turned to the cardiac monitor. Of course it was unintelligible.

[braithiar]

This hospital has an influx of RNs from India/Phillipines, etc. To say they don't even attempt to provide culturally competent care to a caucasian patient is an understatement to say the least. They walk into the room, avoid eye contact, do not introduce themselves (even though this healthcare system has a hundred thousand dollar program being promoted among staff to introduce yourself, what you are about to do, how long it will take, etc.); ignore family members, mutter under their breath and then talk as they are walking away. They make ZERO attempt to make any sort of connection and OMG...the accents. Are they even required to go through training so they can even be UNDERSTOOD? Try being a stroked out patient who is hard of hearing and trying to decipher all that.

If they really are straight from India/Philippines maybe they are struggling to adapt to a new culture. Things that you may think are rude may not be rude in the context of their culture. And speaking up for an introduction may be difficult for them, especially if they come from a collectivist culture. Give them time.

Not that I don't understand where you're coming from. At my University many of my teachers were from China, India, and other Asian countries. They were often hard to understand and sometimes seemed rude. The ones that had been teaching there for a long time, however, were easier to understand (and often humorous) and didn't share the "rude" character flaws of their younger associates.

Just my two .

-B

[Katie82, RN]

When I worked in Hawaii, I had a very good friend who was from one of the cultures you mentioned. Our friendship, which continues to this day, never prevented us from discussing issues such as this. She once told me that she thought American nurses were unprofessional because they were bleeding hearts who saw nursing as a "Life Mission" and not a job. My reply was that I thought she was weak because she would never have the courage to advocate for a patient, especially to a physician.

[Medic2RN, BSN, RN, EMT-P]

Why would you be considered racist or biased?

You are complaining that a bunch of nurses are not giving culturally sensitive care.

I don't think it matters what culture the nurses are or the patient's - it's not being performed and that is a big part of what we do.

If those nurses are not ready yet, then they should be practicing and not dealing with real patients.

[FireStarterRN, BSN, RN]

I think you make a valid point. Is it customary in the Asian countries to not introduce oneself?

[FireStarterRN, BSN, RN]

Why would you be considered racist or biased?

You are complaining that a bunch of nurses are not giving culturally sensitive care.

I don't think it matters what culture the nurses are or the patient's - it's not being performed and that is a big part of what we do.

If those nurses are not ready yet, then they should be practicing and not dealing with real patients.

Sometimes when White people complain of racism toward them they are told that they are part of the racist establishment that has had power and privilege for so long, therefore they must be racist too.

But, these nurses are probably not racist, but unfamiliar or unpractised in Western cultural customs. Americans of all races would probably be uncomfortable with someone just walking in the room and avoiding eye contact, so the issue is cultural, not ethnic or racial.

[FireStarterRN, BSN, RN]

And, as far as the original post, maybe you should nicely complain? Talk to the manager and say that the nurse just walked in the room and started doing things without any explanation or greeting. I'm sure these nurses want to be successful in their jobs, how are they going to know how to improve without feedback?

[Nursetastic]

I'm a little more forward than a "polite complaint". I would first introduce myself to the nurse then ask her to please be sure to introduce herself, face the patient, and speak a little slower in an effort to be better understood. I would not try to sway her cultural standards but simply ask that she cooperate and meet ours halfway; I don't feel I should be expected to make a complete turn around for my patients and neither should these nurses. Then I would follow up with a discussion with the charge nurse or manager if warranted.

I would also post the sign the OP mentioned: 1. Look her in the eye. 2. Say your name CLEARLY. 3. Announce your title 4. Tell the patient what you are about to do. ETC. I see signs all the time reminding us that a patient is HOH or blind. This is basically doing the same sort of thing...just asking for an alteration in approach to accommodate the patient.

[braithiar]

I think you make a valid point. Is it customary in the Asian countries to not introduce oneself?

I won't pretend to know anything about the greeting customs in other countries. However, my point was that many countries have a culture that has different values than our own. It's possible they feel interrupting to introduce themselves would be rude. Or, perhaps nursing practice in these countries greatly contrasts with practice in the States, and their behavior is reflecting that difference.

Of course, they could just be terrible nurses. Either way, I agree with jlsRN: Complain nicely.

[RXtech]

I almost want to put up a sign that says : 1. Look her in the eye. 2. Say your name CLEARLY. 3. Announce your title 4. Tell the patient what you are about to do. ETC.

I actually think this isn't a bad idea. And when someone comes in and doesn't so these things, you could stop them and say something like, "Mrs. X is a little disoriented and doesn't hear well. It's very helpful if you remind her of who you are and why you are there before you do anything else."