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?

[anotherone, BSN, RN]

there are differences among americans. Honey boo boo is one cultural group, the real housewives representive of another. It is silly to assume there aren't differences among other ethnicities or nationalities. Hispanics get lumped together because of a common language. Why don't australians, jamaicans and Canadians get assigned to the same box?

In my experience, most people know what is part of the mainstream, if their culture or religion warrants another approach they let you know and should. Nursing examples I can think about ... not wanting pts to go to morgue after dying or dietary restrictions or no blood products. Because we are raised in it, it is difficult to tell... can anyone here who is not an american shed light on some differences in american culture from others?

When I lived in a very diverse neighborhood I got "americans talk too much/ too friendly" from one group from another I was told we are standoffish and unfriendly. i guess it is relative

[restlessnerd]

I love the original question and the thread following it! It is very telling that white mainstream culture is excluded from instruction. Thank you for bringing this up.

[tag2007]

I love the original question and the thread following it! It is very telling that white mainstream culture is excluded from instruction. Thank you for bringing this up.

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.

[MassED, BSN, RN]

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.

Disease predisposition with certain races is not stereotyping, it is fact-based.

ie: Tay-Sachs Disease is more frequently seen in ethnic populations, such as Ashkenazi jews.

or...

Sickle cell anemia is most common in people whose families come from Africa, South or Central America (especially Panama), Caribbean islands, Mediterranean countries (such as Turkey, Greece, and Italy), India, and Saudi Arabia.

[MassED, BSN, RN]

there are differences among americans. Honey boo boo is one cultural group, the real housewives representive of another. It is silly to assume there aren't differences among other ethnicities or nationalities. Hispanics get lumped together because of a common language. Why don't australians, jamaicans and Canadians get assigned to the same box?

In my experience, most people know what is part of the mainstream, if their culture or religion warrants another approach they let you know and should. Nursing examples I can think about ... not wanting pts to go to morgue after dying or dietary restrictions or no blood products. Because we are raised in it, it is difficult to tell... can anyone here who is not an american shed light on some differences in american culture from others?

When I lived in a very diverse neighborhood I got "americans talk too much/ too friendly" from one group from another I was told we are standoffish and unfriendly. i guess it is relative

Having lived in about 13 states, each place has their own culture. You learn the culture in the south, from the food to the language. In the Northwest, you learn about native american culture and its impact on healthcare. You learn about Meth! In New England, you learn again certain language and indigenous people, plants, activities, etc. You have to adapt to these environments and adopt to a certain extent if you ever expect to assimilate. Knowing this, it is another conversation about immigrants who refuse to learn the culture dominant in their surroundings. It's important for me to learn, to belong, to participate, to include others, just as I would if I lived in another country (and I have). Why be in a certain area if you hate it? Why not try to learn? Why stay in an area that you don't feel connected?

Also, Canadians are lumped together. So are Jamaicans, Australians, Germans, English, Italians, Somalians, Japanese, etc. Every single group is stereotyped. Think about it. It is the human culture. It is life.

[KelRN215, BSN, RN]

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.

Holy crap, I laughed out loud reading this. I can totally imagine this student saying "my patient wants to shower but has lochia rubra. She is black and according to my book, black women don't want to shower until they have lochia serosa. What do I do?" The patient wants a shower, you GIVE HER A SHOWER! Ha.

To the person who asked about stereotypes taught in nursing- when I began my first job, as part of the new grad program we might have had a cultural awareness day or something. The nurses from staff development told us that when we are caring for Jewish children, their fathers will likely ask us if we have our periods and that if we do, they may not want us caring for their child or they may not shake our hands or touch things we touch. I remember we told this to one of our Jewish colleagues (who was very orthodox, observed the Sabbath religiously, now lives in Israel, etc) and she thought it quite ridiculous that they would suggest this is common. I have cared for many Jewish patients in the hospital and in home care and have never once been asked this question.

Actually writing this reminds me that I was at a Jewish patient's house this morning... and I have my period... according to this lesson from many years ago it should have been an issue. Oh well they were wrong.

[sarahmac09]

I'm not sure if something along these lines has been said already, but I think what it comes down to is that white privilege leads to the notion that "white culture" is already so ingrained into our society that it does not need any further explanation or study. I think it is certainly important to focus on people in as many cultures as possible in order to create a complete/complex learning environment and to establish standards of patient care for people of all cultures. Your question may not be an issue in all texts, such as those written by people of backgrounds other than white or possibly caucasian. This is definitely an interesting topic.

[anotherone, BSN, RN]

Holy crap, I laughed out loud reading this. I can totally imagine this student saying "my patient wants to shower but has lochia rubra. She is black and according to my book, black women don't want to shower until they have lochia serosa. What do I do?" The patient wants a shower, you GIVE HER A SHOWER! Ha.

To the person who asked about stereotypes taught in nursing- when I began my first job, as part of the new grad program we might have had a cultural awareness day or something. The nurses from staff development told us that when we are caring for Jewish children, their fathers will likely ask us if we have our periods and that if we do, they may not want us caring for their child or they may not shake our hands or touch things we touch. I remember we told this to one of our Jewish colleagues (who was very orthodox, observed the Sabbath religiously, now lives in Israel, etc) and she thought it quite ridiculous that they would suggest this is common. I have cared for many Jewish patients in the hospital and in home care and have never once been asked this question.

Actually writing this reminds me that I was at a Jewish patient's house this morning... and I have my period... according to this lesson from many years ago it should have been an issue. Oh well they were wrong.

Although a stretch.... isn't also true that a pt may believe one thing but in the presence of someone from a dominate culture do what us culturally acceptable in that culture? Example- american women who don't routinely cover their heads doing so in foreign countries where that is expected. I think it is stupid to assume that even a super religious jewish father would ask a stranger about their period..... because i think most of them would know that that is completely inappropriate in mainstream american culture...alot of this stuff makes it seem as if americans are individuals but others arent

[LadyFree28, BSN, LPN, RN]

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 am we'll aware of this...again, this is just a small example of how "low information" IMO gets translated, especially if they have NEVER interacted with a different culture, even in one's own area. A ton of people have no reference to other cultures if all they know is their own. I learned that many moons ago when this happened.

It may be silly; however, in this time in our country, the silliness sometimes come down to downright division...a percentage of people do not want to realize we all have the same concerns issues, same Maslow's needs...we are all similar in that, yet we get those needs very individualized; not based on a group's "type".

As a nurse, I never made assumptions towards anyone I took care of, and my interactions with many cultures have ensured it was about my patients, and our relationships have been 99% effective.

I remember when I had a Spanish Speaking patient who was from Mexico-she thought I was Mexican, although I am AA...I found out what my dialect would sound like; that was the first time I had a conversation with a Spanish speaking patient-and tis was before he language line was readily available, at least a the facility where I was working. I am originally from California, so it may be my original accent, even though I have resided in the Northeast for about 25 years. That was a cultural reference that was interesting for my patient and I. :)

[LadyFree28, BSN, LPN, RN]

Holy crap, I laughed out loud reading this. I can totally imagine this student saying "my patient wants to shower but has lochia rubra. She is black and according to my book, black women don't want to shower until they have lochia serosa. What do I do?" The patient wants a shower, you GIVE HER A SHOWER! Ha.[\QUOTE]

You would've loved the expression of 2 African American females when it went down ....at least she came to us for "verification"

When I saw it again as a RN student, we had a good laugh about it; and no one actually took it literally...I was about to raise all hackles about it, the professors emphasize the individual assessment.

To the person who asked about stereotypes taught in nursing- when I began my first job, as part of the new grad program we might have had a cultural awareness day or something. The nurses from staff development told us that when we are caring for Jewish children, their fathers will likely ask us if we have our periods and that if we do, they may not want us caring for their child or they may not shake our hands or touch things we touch. I remember we told this to one of our Jewish colleagues (who was very orthodox, observed the Sabbath religiously, now lives in Israel, etc) and she thought it quite ridiculous that they would suggest this is common. I have cared for many Jewish patients in the hospital and in home care and have never once been asked this question.

Actually writing this reminds me that I was at a Jewish patient's house this morning... and I have my period... according to this lesson from many years ago it should have been an issue. Oh well they were wrong.

Oh well...

[ArrowRN, BSN, RN]

Is there a "white culture" in the United States? I don't think so. As a New Englander let me tell you that my culture is nothing like many others in this country that are also "white". The South and The West Coast are like foreign countries to me.

I generally dislike when under the umbrella of "cultural competence", students are taught "Jews do this, Black people do this, Hispanic people do this" etc. Where does cultural competence end and stereotyping begin?

In the beginning of the "birth of America" the Europeans bought that culture with them. Were it not so, European Americans would have been assimilated by the dominant culture of that time, who were the Native Americans. But no assimilation took place. So yeah there is a "American culture" as opposed to the current culture of the British Culture. Be it that Americans have moved from what their traditional forefather did and hence there are difference in every sub-culture. Like wise there are differences in every African American sub-cultures as well. Mind you that African American who were to go to Africa and think they are African, would not be accepted as such. In other words there are huge differences in black cultures and even African American sub cultures exist as well, even though most assume we all eat fried chicken, listen to hip-hop and wear our pants on the ground and have been in jail at some point in our life.

I thought this "What would you do episode" was fair representation of stereotyping against African Americans. However I changed my mind on this because it was not a balanced experiment. To make it balanced they needed to have different races and sexes pretend to be the owners of the car, and also have different races within the witnesses who saw the "crime".

Racial Profiling Cars Being Robbed (Black Guy Gets Citizens Arrest While Blonde Girl Robs Car!) - YouTube

Anyways I appreciate all the different viewpoints. Honestly, never expected more than a couple responses. This turned out to be a very learning experience and healthy conversation is always good without us trying to bash each other and just appreciate the differences. There's hope for America after all.

[LadyFree28, BSN, LPN, RN]

I'm not sure if something along these lines has been said already but I think what it comes down to is that white privilege leads to the notion that "white culture" is already so ingrained into our society that it does not need any further explanation or study. I think it is certainly important to focus on people in as many cultures as possible in order to create a complete/complex learning environment and to establish standards of patient care for people of all cultures. Your question may not be an issue in all texts, such as those written by people of backgrounds other than white or possibly caucasian. This is definitely an interesting topic.[/quote']

This quote immediately makes me think about my Sociology class many moons ago (many moons before my nursing studies) about how we examine stereotypes versus "cultural concepts."

One of the stereotypes or "cultural concepts" that we examined is the idea that Caucasians are very individual oriented, prefer to lead, do not emphasize family ties or loyalty and like to identify concepts in categories.

(I don't think of Caucasians of having these qualities; I think anyone could have these personal qualities, btw.)