Why info on white culture omitted from cultural compence in textbooks?

[ArrowRN]

This is more an observation or comment I've noticed about nursing textbooks. They all emphasize cultural competence yet all omit information on white/Caucasian culture. Why is this? How am I to be a culturally competent nurse if the schools do not teach about the major cultural population in the USA?

I remember the first time I was all excited about learning cultural competence and thought it would be a great way to further understand the American culture. Boy was I disappointed. All books seem to think the culture means either being African American, Native Indian, Asian or Hispanic. Even chapters that refer to nutrition omit the tastes of the Caucasian culture. The forces that be who write these books needs to give information about all cultures being reasonable. Granted the fact that most the the writers are white, at least from the books I've had thus far. Also the majority of people represented as clients or residents or patients are also white, how then can one learn about their culture when it is never taught?

One of the white dudes in my class made the same observation which is how this topic first came to light. With him having an immigrant wife and me being an immigrant, both of us were surprised at the lack of available information. Thoughts? comments?

[wooh, BSN, RN]

Personally, I think an excellent way to teach cultural competence would be to make nursing students volunteer in communities with people from a different culture.

Sheesh, just sending people from the suburbs to the inner city hospital was an experience for my nursing class. :)

Please tell me what would be taught in a "white mainstream culture" class related to nursing? What specific information do you believe is being excluded from instruction? I don't think anyone has been able to explain this to me yet people are arguing that so much is being excluded.

Well for example, if the care plan requires jumping, your white patients won't be able to do so.

[nurseprnRN, BSN, RN]

Culture absolutely can have an effect on physiology. In fact you provided a perfect example, I've just read on numerous sources that the reason Amish are more prone to maple syrup urine disease is the the Amish culture is prone to inbreeding. Here is a quote from Wikipedia, not a peer reviewed article but I've seen this in a few places so in my opinion in has some basis.

"MSUD is an extremely rare disorder and usually affects 1 out of 180,000 children. However, in the Menonite (Amish) populations, such as in Lancaster, PA, it is much more prevalent. As many as 1 in 176 newborn children may acquire the disorder. The reason the disease is more prevalent in the Amish population is the fact that the Amish are prone to inbreeding."

I also read some where that said due to a smaller gene pool, this disease is more common among Amish.

There is a difference between membership in a gene pool and culture. Of course the incidence in that population is higher because of generations of inbreeding. However, the presence of MSUD, even in a known Amish/Mennonite family, does not tell you anything about the culture per se (in and of itself). There are, for example, many persons of Amish/Mennonite descent who do not follow all (or any) of the old ways but may have children c MSUD.

No one is suggesting "ignore." What we are saying is "take facts at hand more seriously than assumptions about culture."

[BrandonLPN, LPN]

I think whenever a textbook suggests that a particular culture (but let's be honest, they might as well say race) tends to do this, or prefers we do that, they're treading on thin ice. It's well-intentioned, but intent and outcome don't always coincide. They sound ignorant when they're trying to be progressive.

I bet the textbooks that omit a passage about "white culture" were written by white authors. When they try to write about their own culture in those terms, the absurdity of it all probably sinks in.

[restlessnerd]

I meant that people writing about culture tend to focus on the other, what they think of as different. They assume that the imagined majority culture is common knowledge and uniform and that it's unnecessary to examine the sociocultural factors that affect health behavior for "them". All of these assumptions are incorrect. I know this post is old but I just saw this again and thought that my response needed clarifications.

[nurseambition]

As a " white person" I say who cares. I hate hate haaaaated the cultural competency stuff because they always sound so stereotypical to me. To lump the way you interact with a young fillipino catholic lady may be totally different compared to an elderly Hindu man....or exactly the same! Because who cares , really? China alone has a billion or so people and they are not all the same. Meet the patient where they are in terms of pain, personal preferences, ability to speak English or not, etc. African Americans and people who are recently immigrated from Nigeria are not to be painted with the same wide brush, you know? I am chatty, I smile, I make eye contact, I sit down if they are sitting, I hug, I shake hello, hold hands, I explain what I'm doing etc to everyoneeeeee until I sense that this individual person or their family isn't feeling the same vibe. Italians and English are both white Europeans......not the same in terms of food, demeanor, whatever. Funny story, I speak juuuust enough Spanish to get by working in Texas, and the majority of coworkers and pt who speak Spanish are indeed Mexican.....so I tried to be nice to an elderly Hispanic pt and tell her about my sister doing a summer abroad in mexico city and asking her when the last time she was " home" to mexico, etc. She smiled and says in broken English , " oh no no Nicaragua!" Oops. Another time when working with an Asian family the son nodded his head in agreement with me, but I thought, oh, maybe he is bowing to me? So, I bowed down in return , hands clasped, whole thing and when I looked up he had a look of sheer confusion on his face. I couldn't help but crack up, apologize and pat his shoulder, and things were okie dokey after. But I felt dumb! Bottom line, if you treat every one professionally and with respect and proper nursing care, you can tweak your style to what fits that pt and family in that moment. You'll always be in good graces with that formula, I believe.[/quote']

This!!! How I feel exactly. Respect and a smile goes a long way. Never make assumptions when you speak with the pt and the family you'll figure out how to proceed.

[Ruby Vee, BSN]

Unfortunately, it's okay to be uncultrually competent to white people because they are the majority and so they are considered privileged and therefore, are supposed to be okay with how people from different backgrounds chose to interact with/treat them even if that treatment is unacceptable by traditional European decent standards.

You nailed it.

White culture is considered unimportant to study for some reason I do not profess to understand. We are supposed to be "culturally sensitive" to every OTHER culture, but no one is expected to be sensitive to OUR culture, even here in OUR country.

I would think it would be valuable even for those of us who grew up in "white culture" to understand the prevailing culture, even if only to help understand ourselves and the reactions we have to other cultures.

[calivianya, BSN, RN]

Maybe I'm the only one who found the cultural competence stuff valuable, but I never took it as an absolute. It took it as valuable because it showed me that there were people who had those ideas. I'm trying to think of a specific example that made a difference for me and failing, but let's take Jehovah's Witnesses for the sake of argumentation. I already knew they usually don't want blood products, but if the first time I was exposed to that information was from the patient in front of me, who might be a young mother with two young children and a dangerously low hemoglobin, for the sake of argument, I might judge her for being selfish for arbitrarily refusing blood products and risking depriving her children of their mother and it might just come across on my face. Once I know a belief exists, I feel like it's much less likely to shock me and I will be much less likely to react adversely to it when I encounter it in the wild. I'm glad my first experiences with some "crazy" (based on my belief system and perspective, not that these are actually crazy) beliefs was in a textbook and not in person.

[LoriRNCM, ADN, ASN, RN]

I did? Im not coming anywhere close to this topic. No way no how.

BAHAHAHA!!!!

[LoriRNCM, ADN, ASN, RN]

Sheesh, just sending people from the suburbs to the inner city hospital was an experience for my nursing class. :)

Well for example, if the care plan requires jumping, your white patients won't be able to do so.

Y'all are killin' me!

[ThePrincessBride, MSN, RN, NP]

There is no "white culture" but there is a dominant culture which could be considered the "white culture." Also it needs to be said that unlike minority groups, whites do not share a common experience unlike black Americans for example who share a very deep and oppressive history.

However, there are Italian cultures, German cultures, etc within American society that could be considered "white cultures." But because whites descending from Italian immigrants had a different experience from german descendants or white Americans from the mayflower, it would be ridiculous to labelit as white culture.

[liketheairport]

I hate the term "white people". OK, I'm a "white" Anglo-Saxon Protestant. But, Cajuns (or Acadiens) aren't exactly like people from Ireland, or from England, or from France, or from Russia. Louisiana, for instance, isn't quite like Georgia or Alabama or Florida or Texas. I put "Acadian" on my census form. Every state, country, city, town is different. We can assume that people from the South are ignorant, or that people from New York are sophisticated. But, neither is necessarily true.

The sooner we celebrate those differences, the sooner we can understand them, and the sooner we can stop letting them divide us.