Assessing Culture
When a nurse walks into a patient’s room an assessment begins. The nurse will begin to assess things such as the central line, IVs, the patient’s orientation but also the nurse assesses the patient’s look, language and the dynamics of the family in the room. Without meaning to the nurse will assume things about the patient’s culture and some may even adjust their care under the assumption. Our country has a wide variety of different cultures, which can make nursing care at times challenging (Edelman & Mandle, 2010). Assessing a patient’s culture is just as important as taking a health history or learning what medications the patient takes at home. Understanding a patient’s culture and taking their culture into consideration during their care could greatly impact the way the patient respond to the care being given (Edelman & Mandle, 2010).
Every patient is different and his or her cultures are different. Many cultures believe that illness comes from something such as bad karma not from unhealthy food choices or lack of physical exercise (Rankin & Stallings, 1996). Use questions to ask the patients about their understanding of the illness, what kind of treatment are they expecting to have, and what are their fears (Rankin & Stallings, 1996). These types of questions can help form a teaching plan that the patient understands and feels like they are a part of. Also finding out how embedded a patient is in their culture can be useful. Ask questions about how long the patient has been in the country, what are their dietary habits, does the patient have associations with native healer or folk medicine doctor (Rankin & Stallings, 1996). Tools such as the Heritage Assessment tool asks these questions and can make taking care of the patient more of a seamless process.
Cultural differences affect patients’ attitudes about medical care and their ability to understand, manage, and cope with the course of an illness (Rankin & Stallings, 1996). A patient’s culture can bring specific ideas and values that can alter the effectiveness of their care because the patient won’t report symptoms and/or they have different beliefs in the way medications and treatments should be delivered. Many cultures also have different ideas of how death and dying should be managed. Unfortunately expectations of many health care workers are that these patients should conform to the mainstream values. This creates barriers between the patients and providers making it more difficult to treat the patient effectively and makes a stronger argument that assessing culture is vital (Rankin & Stallings, 1996).
Using the Heritage Assessment Tool three families from different cultures were interviewed. These families were asked to fill out the assessment and discuss their beliefs on health maintenance, health protection and health restoration. The first family interviewed was a family with strong cultural beliefs. The family migrated here from Africa in search of better opportunities for their family. Before coming to the United States the family’s health care consisted only if a need arouse. The family only had minimal access to preventive medication such as vaccinations. Many died in their culture from diseases that can be prevented by preventative health care and proper health maintenance. The use of prayer is strongly used for sick family members; the spiritual leaders would come together with the family and pray for the illness to be removed. Communities are strong within this culture and they use each other to help care for the elderly or sick members. The women in this culture take care of each other during the prenatal period and during labor. Women are trained to be midwives and instead of going to hospitals so they deliver infants at home or in birthing centers. Only the wealthier members receive care from trained physicians in a hospital like settings. Being exposed to the westernized
