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Multicultural needs bring on new opportunities
NOVEMBER 1998, VOL 68, NO 5 PRESIDENT’S MESSAGE
Multicultural needs bring on new opportunities
R
ecognizing the difficulty in explaining and communicating a surgical procedure to multicultural patients and their family members is an important aspect of our professional practice. As we look at such issues and ways of dealing with illness and injury, it is important to understand cultural beliefs, lifestyles, and social classes. The United States has always had a variety of different people and cultures. Demographers confirm that there were 12 million new immigrant arrivals during the past decade.’ There is a broadly defined American culture; every American also belongs to other cultural groups. A person raised in rural Mississippi is a part of a culture that is different from someone raised in New York. Cultural patterns are learned, and most of them are learned during childhood. These aspects of culture remain and provide our responses to events such as birth, childbearing, surgery, illness, and death. As much of what constitutes culture is subconscious, people have a tendency to believe that their way of doing things is the “right” way.2
DIFFERENCES IN BELIEFS Suppose one morning you look in the mirror and see blotches covering your face and chest. You hope it’s not serious; however, you rush to the doctor. Would people from every culture draw the conclusion you did? In
one South American tribe, this skin condition is so common that the few people who aren’t spotted are believed to be unhealthy. If an American talks aloud to spirits, he or she is likely to be defined as being insane. In some tribal societies, however, someone who talks to invisible spirits might be honored for being in close contact with the spiritual world. This person might be declared a shaman, or “witch doctor,” and instead of being treated for a medical illness, would be expected to treat other people’s medical problem^.^
THE IMPORTANCE OF UNDERSTANDING CULTURAL NEED In the August 1998 issue of The American Journal of Nursing, Loretta Godfrey, RN, recalls a story of a Navajo woman and her son who were selling handmade jewelry to passersby. The woman had injured her ankle more than one year previously and was wearing an old splint. She explained that she had been afraid to go to the “big city” to have the recommended surgery to fix her ankle, but now she could no longer stand to bake bread in the morning and was considering having the surgery. Baking bread was the activity that motivated her to consider getting treatment. In the article, Claire Johnson, RN, CEN, recalls another example of a cultural mistake and learning experience in which she alienated the family members of 744 AORNJOURNAL
the patient for whom she was caring. Many years before, she was caring for a baby whose family members were p. sMIMAKER refugees from the Vietnam War. She noticed a string on the baby’s wrist that was extremely tight, causing a red groove. She cut the string, not knowing anything about Vietnamese cultural practice. She upset the family terribly because they believed the string was protecting the child from evil.4 Cultural competence has many different definitions. Most definitions focus on interpersonal and clinical competence issues. Cultural competence is the ability to deal with individuals on different levels, ranging from a * transcultural assessment to identifying factors such as religious views or folk cures that may influence a patient’s behavior when ill. It is important to know individual beliefs, values, attitudes, and religious views and how they influence people. Cultural competence is about caring and wanting to know what maker people fearful. The outcome is respect for our patients, regardless of what we may have thought is the right and only way of doing something. In 1996, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) listed
NOVEMBER 1998, VOL 68, NO 5
education of patients and family members as one of the functions critical to patient care. The JCAHO standards also include a statement mandating that education include cultural, religious, and emotional barriers: As nurses strive to improve the health and well-being of many cultures, a global perspective is challenging. Cultural competence is a new stage for the nursing profession and now is part of the performance review in many facilities. AORNS ROLE IN MEETING CULTURAL NEEDS AORN also recognizes cultural diversity as an essential part of perioperative nursing. Our International Advisory Board, chaired
by Ellen Murphy, RN, JD, CNOR, FAAN, met in Denver in August. Caring for a culturally diverse patient population was one of the many items discussed. Advisory board members discussed AORN’s international involvement, and they will send a proposal to the November Board meeting requesting incorporation and establishment of an international organizational presence in AORN’s strategic plan. The following goals were identified by the International Advisory Board: enhance quality patient care globally, maximize global recognition of AORN’s contributionto surgical care, m enhance the members’ ability
NOTES l. N Lester, “Cultural competence: A nursing dialogue,” The American Journal of Nursing (August 1998)
2. 2. B Bullough, V Bullough, eds, Nursing in the Cornmunity (St Louis: Mosby, 1990) 522. 3. J M Henslin, Sociology:A Down to Earth Approach,
to incorporate cultural diversity into patient care planning, strengthen the financial position of the Association. BRINGING NURSES TOGETHER Understanding transcultural nursing brings nurses together worldwide. If our epitaph were being written today, how would it read? What would it say about what we are leaving behind? Would it describe how we touched the world in a positive way? I believe it would read “Perioperative nurses gave all they could to whomever they could, and thiy left the world better than they found it.” RUlH P. SHUMAKER RN, BSN, CNOR
PRESIDENT
fourth ed [Boston: Allvn and Bacon, 1998)520. 4. Lester, “culturk competence: A nursing dialogue,” 5 . 5. R Davidhizar, S B Dowd, M Bowen, “The educational role of the surgical nume with the multicultural patient and family,” Today’sSurgical Nurse 20 (July/August 1998)20.
San Francisco Hotel Changes for 1999 Congress When making plans to attend the 1999 Congress in San Francisco, note the following hotel changes. The ANA Hotel has changed its name to Argent Hotel. The rates at the Clift Hotel have been lowered
to $179 for a single or double room, $209 for a triple room, and $239 for a quad room. For more information about Congress room accommodations, call ITS at (800) 424-5249.
AORN Seeks Independent Contractors Opportunity’“ Interim Management Services of the AORN employment referral service is currently accepting curriculum vitae and resumes for individuals interested in becoming independent contrac-tors with AORN. These positions are available on a contract basis only and average from one to six months in length. Prerequisites include: bachelor’s degree required, master’s degree preferred;
flexible schedule; adaptability and ability to perform in a variety of settings; and knowledge base, experience, and skills to provide client organizations with needed expertise. Please send your curriculum vitae or resume to Pat Niederlitz, opportunity‘” program manager, AORN, 2170 S Parker Rd, Suite 300, Denver, CO 80231 or telephone (800) 755-2676 x 8243.
746 AORN JOURNAL
Multicultural needs bring on new opportunities
R
ecognizing the difficulty in explaining and communicating a surgical procedure to multicultural patients and their family members is an important aspect of our professional practice. As we look at such issues and ways of dealing with illness and injury, it is important to understand cultural beliefs, lifestyles, and social classes. The United States has always had a variety of different people and cultures. Demographers confirm that there were 12 million new immigrant arrivals during the past decade.’ There is a broadly defined American culture; every American also belongs to other cultural groups. A person raised in rural Mississippi is a part of a culture that is different from someone raised in New York. Cultural patterns are learned, and most of them are learned during childhood. These aspects of culture remain and provide our responses to events such as birth, childbearing, surgery, illness, and death. As much of what constitutes culture is subconscious, people have a tendency to believe that their way of doing things is the “right” way.2
DIFFERENCES IN BELIEFS Suppose one morning you look in the mirror and see blotches covering your face and chest. You hope it’s not serious; however, you rush to the doctor. Would people from every culture draw the conclusion you did? In
one South American tribe, this skin condition is so common that the few people who aren’t spotted are believed to be unhealthy. If an American talks aloud to spirits, he or she is likely to be defined as being insane. In some tribal societies, however, someone who talks to invisible spirits might be honored for being in close contact with the spiritual world. This person might be declared a shaman, or “witch doctor,” and instead of being treated for a medical illness, would be expected to treat other people’s medical problem^.^
THE IMPORTANCE OF UNDERSTANDING CULTURAL NEED In the August 1998 issue of The American Journal of Nursing, Loretta Godfrey, RN, recalls a story of a Navajo woman and her son who were selling handmade jewelry to passersby. The woman had injured her ankle more than one year previously and was wearing an old splint. She explained that she had been afraid to go to the “big city” to have the recommended surgery to fix her ankle, but now she could no longer stand to bake bread in the morning and was considering having the surgery. Baking bread was the activity that motivated her to consider getting treatment. In the article, Claire Johnson, RN, CEN, recalls another example of a cultural mistake and learning experience in which she alienated the family members of 744 AORNJOURNAL
the patient for whom she was caring. Many years before, she was caring for a baby whose family members were p. sMIMAKER refugees from the Vietnam War. She noticed a string on the baby’s wrist that was extremely tight, causing a red groove. She cut the string, not knowing anything about Vietnamese cultural practice. She upset the family terribly because they believed the string was protecting the child from evil.4 Cultural competence has many different definitions. Most definitions focus on interpersonal and clinical competence issues. Cultural competence is the ability to deal with individuals on different levels, ranging from a * transcultural assessment to identifying factors such as religious views or folk cures that may influence a patient’s behavior when ill. It is important to know individual beliefs, values, attitudes, and religious views and how they influence people. Cultural competence is about caring and wanting to know what maker people fearful. The outcome is respect for our patients, regardless of what we may have thought is the right and only way of doing something. In 1996, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) listed
NOVEMBER 1998, VOL 68, NO 5
education of patients and family members as one of the functions critical to patient care. The JCAHO standards also include a statement mandating that education include cultural, religious, and emotional barriers: As nurses strive to improve the health and well-being of many cultures, a global perspective is challenging. Cultural competence is a new stage for the nursing profession and now is part of the performance review in many facilities. AORNS ROLE IN MEETING CULTURAL NEEDS AORN also recognizes cultural diversity as an essential part of perioperative nursing. Our International Advisory Board, chaired
by Ellen Murphy, RN, JD, CNOR, FAAN, met in Denver in August. Caring for a culturally diverse patient population was one of the many items discussed. Advisory board members discussed AORN’s international involvement, and they will send a proposal to the November Board meeting requesting incorporation and establishment of an international organizational presence in AORN’s strategic plan. The following goals were identified by the International Advisory Board: enhance quality patient care globally, maximize global recognition of AORN’s contributionto surgical care, m enhance the members’ ability
NOTES l. N Lester, “Cultural competence: A nursing dialogue,” The American Journal of Nursing (August 1998)
2. 2. B Bullough, V Bullough, eds, Nursing in the Cornmunity (St Louis: Mosby, 1990) 522. 3. J M Henslin, Sociology:A Down to Earth Approach,
to incorporate cultural diversity into patient care planning, strengthen the financial position of the Association. BRINGING NURSES TOGETHER Understanding transcultural nursing brings nurses together worldwide. If our epitaph were being written today, how would it read? What would it say about what we are leaving behind? Would it describe how we touched the world in a positive way? I believe it would read “Perioperative nurses gave all they could to whomever they could, and thiy left the world better than they found it.” RUlH P. SHUMAKER RN, BSN, CNOR
PRESIDENT
fourth ed [Boston: Allvn and Bacon, 1998)520. 4. Lester, “culturk competence: A nursing dialogue,” 5 . 5. R Davidhizar, S B Dowd, M Bowen, “The educational role of the surgical nume with the multicultural patient and family,” Today’sSurgical Nurse 20 (July/August 1998)20.
San Francisco Hotel Changes for 1999 Congress When making plans to attend the 1999 Congress in San Francisco, note the following hotel changes. The ANA Hotel has changed its name to Argent Hotel. The rates at the Clift Hotel have been lowered
to $179 for a single or double room, $209 for a triple room, and $239 for a quad room. For more information about Congress room accommodations, call ITS at (800) 424-5249.
AORN Seeks Independent Contractors Opportunity’“ Interim Management Services of the AORN employment referral service is currently accepting curriculum vitae and resumes for individuals interested in becoming independent contrac-tors with AORN. These positions are available on a contract basis only and average from one to six months in length. Prerequisites include: bachelor’s degree required, master’s degree preferred;
flexible schedule; adaptability and ability to perform in a variety of settings; and knowledge base, experience, and skills to provide client organizations with needed expertise. Please send your curriculum vitae or resume to Pat Niederlitz, opportunity‘” program manager, AORN, 2170 S Parker Rd, Suite 300, Denver, CO 80231 or telephone (800) 755-2676 x 8243.
746 AORN JOURNAL