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?
I don't think the stereotypes are helpful in teaching, "This is how I treat every patient that looks like x or speaks language y." What I do think is helpful is that when you're giving care to a patient, and a practice you're unfamiliar with enters the equation, you aren't totally befuddled and at least have a vague recollection of what it's for.
Only such instance I have found my exposure to some cultures helpful is when I saw cupping marks on the back of a patient. Everyone else was thinking abuse, when I knew it was this patient's belief for healing. Rather than jump the gun, one should ASK what alternative medicine or other therapies they use or believe in. Pretty easy, really.
Everyone is talking about how ridiculous the "stereotypes" are when culture is being discussed in nursing textbooks. Can anyone give me an example of a "stereotype" taught in a nursing textbook that they are referring to?
There is a big difference between teaching culture, and teaching stereotypes. Stereotypes are over simplistic opinions about things that have no basis. So, I would really like an example of a stereotype that's been taught in your nursing school that has no basis in reality.
Stereotypes MAY have a basis in reality, but not ALL people of a certain culture may ascribe. Such as Hispanics are usually quiet when they are in pain. African Americans tend to be more vocal when someone passes away.
[h=3]Blacks[/h]One of the more common stereotype examples is stereotypes surrounding those who are Black. Saying that all Blacks are good at sports is a stereotype, because it’s grouping the race together to indicate that everyone of that race is a good athlete.
[h=3]Men and Women[/h]There are also some common stereotypes of men and women, such as:
Men are strong and do all the work.
Men are the "backbone."
Women aren't as smart as a man.
Women can’t do as good of a job as a man.
Girls are not good at sports.
Guys are messy and unclean.
Men who spend too much time on the computer or read are geeks.
[h=3]Cultures[/h]Stereotypes also exist about cultures an countries as a whole. Stereotype examples of this sort include the premises that:
All white Americans are obese, lazy, and dim-witted. Homer Simpson of the TV series The Simpsons is the personification of this stereotype.
Mexican stereotypes suggest that all Mexicans are lazy and came into America illegally.
All Arabs and Muslims are terrorists.
All people who live in England have bad teeth.
Italian or French people are the best lovers.
All Blacks outside of the United States are poor.
All Jews are greedy.
All Asians are good at math. All Asians like to eat rice and drive slow.
All Irish people are drunks and eat potatoes.
All Americans are generally considered to be friendly, generous, and tolerant, but also arrogant, impatient, and domineering.
[h=3]Groups of Individuals[/h]A different type of stereotype also involves grouping of individuals. Skaters, Goths, Gangsters, and Preps are a few examples. Most of this stereotyping is taking place in schools. For example:
Goths wear black clothes, black makeup, are depressed and hated by society.
Punks wear mohawks, spikes, chains, are a menace to society and are always getting in trouble.
All politicians are philanders and think only of personal gain and benefit.
Girls are only concerned about physical appearance.
All blonds are unintelligent.
All librarians are women who are old, wear glasses, tie a high bun, and have a perpetual frown on their face.
All teenagers are rebels.
All children don't enjoy healthy food.
Only anorexic women can become models.
[h=3]Sexual Stereotypes[/h]Sexual stereotypes, on the other hand, suggest that any feminine man is gay and any masculine woman is a lesbian. Those who believe gay stereotypes may also believe that homosexuality is immoral, wrong and an abomination.
That is a great question. We learn about diversity at work, and it is always a generic teaching on general ethnic/minority cultural responses. Where I work, we have a diversified (ethnic, age, gender) staff, and I believe the focus in diversity training is teaching whites how to deal with different ethnic/minority cultures, but does not reciprocate with educating staff about the diversity among caucasians. Understanding that cultural diversity, a set of beliefs, values, can vary among people of the same culture is so important. Understanding the differences between religious beliefs, economic status, gender issues will enhance understanding of human diversity and culture. Respecting individual values, concerns and beliefs will enable nurses to be culturally competent.
Stereotypes MAY have a basis in reality, but not ALL people of a certain culture may ascribe. Such as Hispanics are usually quiet when they are in pain. African Americans tend to be more vocal when someone passes away.
[h=3]Blacks[/h]One of the more common stereotype examples is stereotypes surrounding those who are Black. Saying that all Blacks are good at sports is a stereotype, because it’s grouping the race together to indicate that everyone of that race is a good athlete.
[h=3]Men and Women[/h]There are also some common stereotypes of men and women, such as:
[*]Men are strong and do all the work.
[*]Men are the "backbone."
[*]Women aren't as smart as a man.
[*]Women can’t do as good of a job as a man.
[*]Girls are not good at sports.
[*]Guys are messy and unclean.
[*]Men who spend too much time on the computer or read are geeks.
[h=3]Cultures[/h]Stereotypes also exist about cultures an countries as a whole. Stereotype examples of this sort include the premises that:
[*]All white Americans are obese, lazy, and dim-witted. Homer Simpson of the TV series The Simpsons is the personification of this stereotype.
[*]Mexican stereotypes suggest that all Mexicans are lazy and came into America illegally.
[*]All Arabs and Muslims are terrorists.
[*]All people who live in England have bad teeth.
[*]Italian or French people are the best lovers.
[*]All Blacks outside of the United States are poor.
[*]All Jews are greedy.
[*]All Asians are good at math. All Asians like to eat rice and drive slow.
[*]All Irish people are drunks and eat potatoes.
[*]All Americans are generally considered to be friendly, generous, and tolerant, but also arrogant, impatient, and domineering.
[h=3]Groups of Individuals[/h]A different type of stereotype also involves grouping of individuals. Skaters, Goths, Gangsters, and Preps are a few examples. Most of this stereotyping is taking place in schools. For example:
[*]Goths wear black clothes, black makeup, are depressed and hated by society.
[*]Punks wear mohawks, spikes, chains, are a menace to society and are always getting in trouble.
[*]All politicians are philanders and think only of personal gain and benefit.
[*]Girls are only concerned about physical appearance.
[*]All blonds are unintelligent.
[*]All librarians are women who are old, wear glasses, tie a high bun, and have a perpetual frown on their face.
[*]All teenagers are rebels.
[*]All children don't enjoy healthy food.
[*]Only anorexic women can become models.
[h=3]Sexual Stereotypes[/h]Sexual stereotypes, on the other hand, suggest that any feminine man is gay and any masculine woman is a lesbian. Those who believe gay stereotypes may also believe that homosexuality is immoral, wrong and an abomination.
MassED, yes, not all people of a certain culture will ascribe to a certain stereotype. That's the very definition of a stereotype
Also, You listed many great examples of stereotypes. This is a perfect example of the difference between stereotypes and culture/trends/research/facts. Going into the hospital assuming all blondes are unintelligent is a ridiculous stereotype and was not taught in nursing school and is not cultural competence. But going into the hospital knowing that a certain race of people may be more prone to diabetes, for example, is being smart and that means better care for your patients.
This is an interesting conversation. I would think it is impossible to teach all cultural differences. Even within the so-called minority cultures there are extreme differences: a Native American from a tribe in Florida will not have the same cultural references as a Native American from Alaska, a Mexican American will not have identical cultural beliefs as a Cuban American, an Asian American of Chinese descent probably doesn't have a lot in common with a Korean American, etc. Caucasian Americans can identify themselves with any number of subcultures, all with very different beliefs. Just because Caucasians are the majority population does not mean all are the alike, any more than any other race.
MassED, yes, not all people of a certain culture will ascribe to a certain stereotype. That's the very definition of a stereotype
Also, You listed many great examples of stereotypes. This is a perfect example of the difference between stereotypes and culture/trends/research/facts. Going into the hospital assuming all blondes are unintelligent is a ridiculous stereotype and was not taught in nursing school and is not cultural competence. But going into the hospital knowing that a certain race of people may be more prone to diabetes, for example, is being smart and that means better care for your patients.
Physiology is not cultural. Knowing that many Amish and Mennonites are prone to maple syrup urine disease tells you exactly nothing about their culture; and if you have someone who has that, you don't know if s/he is Amish, either. Knowing that blacks are more prone to diabetes and agressive breast cancer tells you nothing about an individual's culture; knowing this is not cultural nursing.
Everyone is talking about how ridiculous the "stereotypes" are when culture is being discussed in nursing textbooks. Can anyone give me an example of a "stereotype" taught in a nursing textbook that they are referring to?
There is a big difference between teaching culture, and teaching stereotypes. Stereotypes are over simplistic opinions about things that have no basis. So, I would really like an example of a stereotype that's been taught in your nursing school that has no basis in reality.
I'll give you one I remember, and had to enlighten a cohort about, and it's pertain to my "race". It also ties in to the OP's current studies:
I remember reading that AA women prefer to shower after their lochia transitions from red to a lighter color (I paraphrasing if course, and due to TOS, if I could I would get this book and cite BOTH books-this was taught to me as a PN and RN student; at least it was in the reading; the most recent source was about 3 years ago for my RN studies, and about 8 years ago for my PN studies). One of my cohorts came up to me (my PN rotation) and stated that her pt wanted to take a shower, but was hesitant because in the book it states that AAs prefer to wait for the lochia to clear up, etc...my instructor, who is AA, and could hear the conversation, enlightened her if the pt wants a shower GIVE her a shower.
That's my example... my take is...a big NO...
Same thing about the diet, AAs diet, yes while healthy but made improperly, we eat fried foods etc...um, not always , That may have been the norm for many years, however, AAs can be vegan, eat healthy, etc, even despite disparities....sometimes it's automatically assumed that AAs are obese because of eating habits, when it could be a thyroid issue, or other hormonal issues that AAs can be sensitive to.
Also, there are AAs with Cystic fibrosis; yes, it's common in Caucasians, however, yes, AAs can have that disease process as well.
It behooves one to go in with the mindset of assess thoroughly, as been expressed in previous posts.
My take is sometimes the cultural competency is not enough, it's more "low information" instead of "for your consideration"...the student nurse runs the risk if taking information literally, hence transitioning as a novice nurse with this information. It's still needed, and relevant, as we don't know the experiences of our patients, and it would be useful to understand those aspects, but it should be done as accurate as possible.
Physiology is not cultural. Knowing that many Amish and Mennonites are prone to maple syrup urine disease tells you exactly nothing about their culture; and if you have someone who has that, you don't know if s/he is Amish, either. Knowing that blacks are more prone to diabetes and agressive breast cancer tells you nothing about an individual's culture; knowing this is not cultural nursing.
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.
So, another example, ones Diet, is a huge cultural factor that will absolutely make some cultures more susceptible to diabetes, obesity, heart failure, etc. No, it's not 100% culture and its not always 100% genetics but to ignore either one would be a disservice to patients.
I'll give you one I remember, and had to enlighten a cohort about, and it's pertain to my "race". It also ties in to the OP's current studies:
I remember reading that AA women prefer to shower after their lochia transitions from red to a lighter color (I paraphrasing if course, and due to TOS, if I could I would get this book and cite BOTH books-this was taught to me as a PN and RN student; at least it was in the reading; the most recent source was about 3 years ago for my RN studies, and about 8 years ago for my PN studies). One of my cohorts came up to me (my PN rotation) and stated that her pt wanted to take a shower, but was hesitant because in the book it states that AAs prefer to wait for the lochia to clear up, etc...my instructor, who is AA, and could hear the conversation, enlightened her if the pt wants a shower GIVE her a shower.
That's my example... my take is...a big NO...
Same thing about the diet, AAs diet, yes while healthy but made improperly, we eat fried foods etc...um, not always , That may have been the norm for many years, however, AAs can be vegan, eat healthy, etc, even despite disparities....sometimes it's automatically assumed that AAs are obese because of eating habits, when it could be a thyroid issue, or other hormonal issues that AAs can be sensitive to.
Also, there are AAs with Cystic fibrosis; yes, it's common in Caucasians, however, yes, AAs can have that disease process as well.
It behooves one to go in with the mindset of assess thoroughly, as been expressed in previous posts.
My take is sometimes the cultural competency is not enough, it's more "low information" instead of "for your consideration"...the student nurse runs the risk if taking information literally, hence transitioning as a novice nurse with this information. It's still needed, and relevant, as we don't know the experiences of our patients, and it would be useful to understand those aspects, but it should be done as accurate as possible.
Well, your classmate also has to use common sense. Just because a nursing textbook says a certain race of people may like to shower at a certain time after giving birth, you don't refuse to let them shower when they ask for a different time. Thats just silly. The point is to show students that it's ok, and normal, when certain people DO want something done a different way. You don't go into a hospital forcing people to assimilate to any cultural practice and hopefully nursing schools aren't teaching this.
I don't like when individual preferences get attributed to culture. As for whites being the main culture so we all know what that is since it is shoved down our throats (paraphrasing) among white americans there are many differences . among all americans white , black , of hispanic origin, and asian and others most differences seem to be regional and socio-economic , at least from my experience.
MassED, BSN, RN
2,636 Posts
Only such instance I have found my exposure to some cultures helpful is when I saw cupping marks on the back of a patient. Everyone else was thinking abuse, when I knew it was this patient's belief for healing. Rather than jump the gun, one should ASK what alternative medicine or other therapies they use or believe in. Pretty easy, really.