Mulitcultural Nursing- pts and nurses views wanted

[kukukajoo]

Thanking you all in advance for sharing!

I have seen this on here in the past, but not a whole lot and am looking for input from nurses who have had pts from other cultures as well as nurses from other cultures and their experiences. This would include religion as well and Parish Nurses may even have some unique experiences.

I have teamed up with a partner (from Korea) and we are doing our senior project and presentation (presented at a nursing symposium in NH) on transcultural nursing.

Would you share your experiences with us please? I have ordered books and begun looking up information but I find that those in the trenches provide the best knowledge for sure.

[queenjean]

If you can find a couple of nurses/doctors/health care workers amonst the refugees, that would be awesome.

A couple of times I have been lucky enough to encounter a medical worker from another culture and have the time for me to provide a tour of my facility. German, Spanish, English, and Chinese are the ones that immediately come to mind. One medical worker to another--you can get right down to business, with questions ranging from architecure to physician orders and implementation to nurse education to nurse to pt ratios, on and on. It is so cool.

So,that's my recommendation. Try finding someone with health care experience amonst your refugee/immigrant group, take them on a tour of your facility, and the brainstorm together about the similarities and differences. It has always been an eyeopener all around when I have been able to do this.

ETA: of course you run the risk of one person's experience and impressions representing a whole groups. We all know that working in a small rural hospital is different than working ina tertiary care center, and you have to keep that in mind when you are learning about your immigrant's work experience. But still, even with that caveat, it is still so informative and amazingly interesting. I personally find it really amazing, the differences in health care skills and philosophies I find among cultures I consider similar--like German.

[Elvish, BSN, DNP, RN, NP]

i am german and as a german i can say we are very scheduled people , we like plans and we like to have everything done in a timely manner and we are very independent

which means if you have a german patient make sure they know what is going on

make sure you give the medications on time ( very important)

we also do not show pain so if you have especially an older german if they have pain they will always say no, because showing emotions or pain is a weakness

we like our space, we do not like to be touched by strangers or hugged

( that was odd for me in the beginning because everyone was hugging me, now i am used to it)

generally germans like to be informed about everything that is going on

Thanks for that info! I have a German friend who is exactly as you say!.

[kukukajoo, LPN]

There is at least one former doctor that I know of in the Bosnian group. He does not practice here (I placed him at the factory, which thrilled him just that he was working!).

You see, in war torn countries, it can be impossible to get your credentials to prove your education, work history, etc. and they have to pass English tests, and I think they face more education as well as residency, etc. Can be a daunting process that can take years. Sad if you think about it. Also a CNA at the hospital was also a doc. She is going through LPN school at the moment.

I appreciate all the tips and information! I will be plugging away and I will share the written portion of my report once it is done.

Thanks again and keep 'em coming!

PS- my old boss was German and also exactly how you describe!

[Fiona59]

My city has a huge refugee population, sponsored mainly by the Catholic Social Services and the Lutheran and Mennonite churches.

Our Somali refugees are mainly young men under the age of 25 who have basically come from camps to a western society. Unfortunately many have become involved in drugs and gangs, so we mainly see them for gunshots and stabbings. They are a difficult group to provide care for as women are beneath their radar. When we do have female patients, they are very demanding and heavy work. They have an expectation that the nurses will do everything for them. The unit fridge is raided to provide food for their visitors. Visiting hours are a nightmare often resulting in calls for security.

We also have a fair sized Afghan community. Again it is a culture clash. The men will decide when and if their female relatives will recieve treatment. We've had a few incidents when they point blank will tell a female doctor to get out of the room and they want a male. They are very demanding on the system.

I'm all for cultural sensitivity but it has to be a two way street. The Bosnian and other former Yugoslavs who migrated in the '90s were a much easier to assimilate population as they where exposed to western ideas, culture and face it before the Balkan Wars, they were a western population.

It is when male dominated cultures that meet western healthcare that you will have problems. Our services are provided mainly by women and until these cultures demonstrate a respect for women there will be issues. I know the Koran values women but the vast majority of the patients we deal with have little or no education and their religion has been passed on by Imans who are often very fundamentalist in their views.

We had one Afghan family who's father stated he was a Dr. back home but had never examined a woman or child in his career. He was arrogant, rude, and wanted a private room for his family member and demanded "that they be treated with the respect his position as a Dr. deserved". I hope this man never, ever makes it into a foreign trained resident programme as his treatment of his family, female doctors and the staff of our hospital was vile.

Lousy, rude humans occur in every culture and of every educational background.

[elliejayRN]

Oh, that same chart is hanging prominently in the nutrition office in one of the major hospitals in northern va area. When I saw it for the first time, I just dismissed the entire chart. I figured if they couldn't get that right about a people who have been here since the 1620's then they surely couldn't get anything else right. The book with those false values was actually a recent book, nursing community health book copyright 2006. That is perhaps one of the greatest problems with the concept of multiculturalism-because its usually other people writing about what a culture values. One just can't help but to put their own cultural influence into what they are writing. One's own cultural background actually perceives what is important, not necessarily the other way around. In the end, its usually a tool perhaps to decrease the anxiety of the majority as they can then categorize. I really don't know how much good it actually does though. Just look over the posts so far that Bosnian situation, to me they sound no different than the 99% immigrants that have come here, but boy those Bosnians had it so tough and such hard workers, so then who are the lazy, had an easy life immigrants coming here? We are a nation of immigrants. Good Luck.

[nightmare, RN]

Sadly I had an old nursing textbook here (I wish I could find it now) that had a bunch of different food parymids in it for various ages, groups. Reading through it I was disgusted to see Koolaid on the one for blacks as a drink!! There were other racial biases, but that whole koolaid thing really tripped my trigger and I will never forget how racist the charts were.

OK I'm British so I need to ask ,what is the racial bias about coloured people drinking a particular drink?

[elliejayRN]

OK I'm British so I need to ask ,what is the racial bias about coloured people drinking a particular drink?

It's just that it pretty much lumped all black people as being poor as Koolaid is a matter of economics, not really actually being a preference over more nutrional drinks. Understand, basically a negative racial stereotype. Simply, the statement isn't as nice as Brits drinking milk in their tea, fish and chips or bangers and beans. Thats all.

[kukukajoo, LPN]

OK I'm British so I need to ask ,what is the racial bias about coloured people drinking a particular drink?

Yes, it was implying that the blacks were too poor to afford anything good for them like a glass of juice! Horrid generalization if you ask me!

Tell me, in Scotland you must see a fiar share of different cultures. Are there any accomodations that you have had to make for any certain group? Do the scottish people have any certain views on healthcare that others should know about?

[nightmare, RN]

Scots as a race are very proud,stoic people.This can mean that they will not go to the doctor until they are absolutely in agony.Unfortunately ,especially amongst the older generation,this means that treatable things get left till they are untreatable because they 'just put up with them'.

We have a wide variety of different immigrant populations since the EU opened up.I think the main problem at the moment is the language barrier that can exist between the nurse and a sick person from another country.Also ,of course,people of other nationalities have their own ways of dealing with medical care.I work with a nurse from an EU country and she is always sending home for drugs to self treat herself!

[Fiona59]

It was like saying all "Glaswegians drink Irn Bru and are drunk on the street every night" or all "Aberdonians are tight with the cash and are drunk on the street every night":sasq::deadhorse

[classicdame, MSN, EdD]

You know, the whole thing boils down to treating other people with respect. Too bad we have to teach that. However, I do not buy in to the theory that nurses need to know how various cultures react to various situations. There are too many variables. This also can lead to stereotyping. Heck, I don't feel I represent every other person from my hometown! But it is very important to just be nice and considerate of others.

[kukukajoo, LPN]

I can vouch for the Scots and stoicism- my gram is a perfect example of a stoic stubborn scot lassie. She had ovarian ca mets that went undaignosed for a long time. She had a bowel blockage and literally looked about to birth twins and was vomiting up fecal matter. Did she even think to go to the docs? heck no too stubborn! I had to MOVE back home to NH from CT and literally almost drag her to see the specialist- who happened to be a scot with a great accent by chance!

The pain and discomfort must have been terrible.

She was going to refuse surgery which would have meant death soon, but Doc convinced here and I would not leave her side.

Oh and it gets better- post surgery- despite a hemmorage and also a clot in her leg that needed to be stripped, and her surgery was complete hysterectomy, oopherectomy- everything and a bowel resection. NO pain meds for gram other than Tylenol when she was three days post op! She was cut from pubis to sternum!

As far as respect and courtesy, that is without saying. That is part of our job and should be done no matter who is your patient.

But there are very real differeces between cultures and religions that go much beyond that. For instance, would you automatically give a jehova some blood products against thier wishes, heck no. Why would you NOT want to be knowledgeable about something that can help your patient? It goes much beyond differences in people in your hometown, this is the whole world here we are talking about not that Johnny does not like applesauce, and Marie wants her sheets folded a certain way and X amount of pillows.

Having knowledge and understanding I don't imagine leads to stereotyping, but rather an awareness that their needs may be a bit different and maybe the nurse should investigate a little further.

On the contrary, I find most stereotypes and racism is based on ignorance, not knowlegde.