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Nursing culture and care
Nurse EducattcwzTcdq (1991) II, 405-406 @ Longman Group UK Ltd 1991
EDITORIAL
Nursing culture and care
‘While ethnic diversity has been an accepted feature of society in the UK throughout the 20th century, it is only in the 1980s that the British nursing profession has begun to recognise that skills discovering and blending cultural knowledge are essential to nursing practice’.
So wrote Susan Dobson in this journal (1986). She argued that small scale projects based on ethnographic research methods can help to provide the experience needed for developing cultural awareness and sensitivity amongst nurse learners. I do not know how many teachers have taken up her suggestion (if you are using this approach in teaching it would be nice to hear from you). An ethnographic project may be more interesting and appropriate than some field work experience currently used in teaching research methods. There is certainly a great deal more information available to help people from ethnic and religious minorities and their carers. The work of people like Sampson, Henley and McGilloway has been supplemented by a growing number of informative articles, packages and videos. However, better information does not necessarily ensure culturally sensitive practice, no matter how well-intentioned the practitioner. Educational, as well as health, policies perpetuate the dominant culture so that, except where a minority group is large or demanding, the implications of cultural or racial differences are largely unrecognised in practice. This is evident in some nursing texts. There may be a picture, even a case history, of an Asian mother and child but no indication of the importance of family or religious understanding, and no advice on recognition of distress signals described as a ‘red rash’, ‘pallor’, or ‘flushed skin’ in patients of different race. English trained psychiatric nurses, on the other hand, may recognise the
cultural differences between English and Scottish patients which must be understood if they are to be effective practitioners, but nursing texts have little to say on the subject. As nurse teachers we need to take more responsibility for preparing students to give appropriate, culturally sensitive care and notjust in the major cities. We should help them to distinguish between cultural and racial (biologically based) differences where this might be important in providing quality care. The importance of transcultural approaches to care is widely recognised among the health professions. It is far less easy to accept or discuss the possibility that discrimination on the basis of racial or cultural differences is still present among us, or that we ourselves may be guilty of it. Discriminatory practices often result from ignorance; once we are made aware of the need for change needed action can be taken. Discrimination due to prejudice is often hidden or denied but, nevertheless, must be tackled. Surely we could do more to encourage entrants to nursing from minority groups and to facilitate their progress and career development. We need their contributions at every level in nursing.
References Dobson S 1986 Ethnography: a tool for learning. Nurse Education Todav 6.2: 76-79 Henley A 1986 Nursing care in a multiracial society. Senior Nurse 4,2: 18-20 McGilloway 0, Myco F (eds) 1985 Nursing and spiritual care. Harper and Row, London Sampson A 1982 The neglected ethic: cultural and religious factors in the care of patients. McGraw-Hill, Maidenhead
JEAN F. WALKER 405
406
NURSE EDUCATION
The Editor 1990-1991:
wishes to thank
TODAY
the following
referees,
Professor
J Robinson
Dr E Shanley
Dr S Holmes Mrs E James
Dr R Mander Dr K Melia Professor
K Morle
Mr P Morrison
Professor
J Orr
Dr E Perkins Mr W Reynolds Miss A Robertson
Lecturer in Nursing Studies, University of Surrey Lecturer, Department of Nursing and Health Visiting, University of Ulster Lecturer, Department of Nursing Studies, University of Edinburgh Lecturer, Department of Nursing Studies, University of Edinburgh Professor, Department of Nursing, Uniiersity of Liverpool Lecturer. School of Nut-sine Studies, University of Wale; College of Medicine Head, School of Nursing, Queen’s University of Belfast Research, Training and Development, Nottingham Lecturer, Highland College of Nursing and Midwiferv Lectu&, Department of Nursing Studies, University of Edinburgh
Professor
R Schrock
Miss H Sinclair
Professor
L Smith
Mr 0 Sulhunt Miss V Tickner MS P Walter
Dr R Watson Miss R Weir
Professor
V Wood
Head, Department of Nursing, University of Nottingham Senior Lecturer, Department of Nursing Studies, University of Glasgow Department of Nursing and Social Sciences, Osnabruck University Head of Department of Nursing Studies, University of Edinburgh Department of Nursing Studies, University of Glasgow Lecturer in Nurse Education, University of Stirling Director of Education, Royal College of Midwives Lecturer, Department of Health and Community Studies, South Bank Polytechnic Department of Nursing Studies, University of Edinburgh Director, MSc Nurse Education Programme, University of Edinburgh Faculty of Nursing, University of Western Ontario
EDITORIAL
Nursing culture and care
‘While ethnic diversity has been an accepted feature of society in the UK throughout the 20th century, it is only in the 1980s that the British nursing profession has begun to recognise that skills discovering and blending cultural knowledge are essential to nursing practice’.
So wrote Susan Dobson in this journal (1986). She argued that small scale projects based on ethnographic research methods can help to provide the experience needed for developing cultural awareness and sensitivity amongst nurse learners. I do not know how many teachers have taken up her suggestion (if you are using this approach in teaching it would be nice to hear from you). An ethnographic project may be more interesting and appropriate than some field work experience currently used in teaching research methods. There is certainly a great deal more information available to help people from ethnic and religious minorities and their carers. The work of people like Sampson, Henley and McGilloway has been supplemented by a growing number of informative articles, packages and videos. However, better information does not necessarily ensure culturally sensitive practice, no matter how well-intentioned the practitioner. Educational, as well as health, policies perpetuate the dominant culture so that, except where a minority group is large or demanding, the implications of cultural or racial differences are largely unrecognised in practice. This is evident in some nursing texts. There may be a picture, even a case history, of an Asian mother and child but no indication of the importance of family or religious understanding, and no advice on recognition of distress signals described as a ‘red rash’, ‘pallor’, or ‘flushed skin’ in patients of different race. English trained psychiatric nurses, on the other hand, may recognise the
cultural differences between English and Scottish patients which must be understood if they are to be effective practitioners, but nursing texts have little to say on the subject. As nurse teachers we need to take more responsibility for preparing students to give appropriate, culturally sensitive care and notjust in the major cities. We should help them to distinguish between cultural and racial (biologically based) differences where this might be important in providing quality care. The importance of transcultural approaches to care is widely recognised among the health professions. It is far less easy to accept or discuss the possibility that discrimination on the basis of racial or cultural differences is still present among us, or that we ourselves may be guilty of it. Discriminatory practices often result from ignorance; once we are made aware of the need for change needed action can be taken. Discrimination due to prejudice is often hidden or denied but, nevertheless, must be tackled. Surely we could do more to encourage entrants to nursing from minority groups and to facilitate their progress and career development. We need their contributions at every level in nursing.
References Dobson S 1986 Ethnography: a tool for learning. Nurse Education Todav 6.2: 76-79 Henley A 1986 Nursing care in a multiracial society. Senior Nurse 4,2: 18-20 McGilloway 0, Myco F (eds) 1985 Nursing and spiritual care. Harper and Row, London Sampson A 1982 The neglected ethic: cultural and religious factors in the care of patients. McGraw-Hill, Maidenhead
JEAN F. WALKER 405
406
NURSE EDUCATION
The Editor 1990-1991:
wishes to thank
TODAY
the following
referees,
Professor
J Robinson
Dr E Shanley
Dr S Holmes Mrs E James
Dr R Mander Dr K Melia Professor
K Morle
Mr P Morrison
Professor
J Orr
Dr E Perkins Mr W Reynolds Miss A Robertson
Lecturer in Nursing Studies, University of Surrey Lecturer, Department of Nursing and Health Visiting, University of Ulster Lecturer, Department of Nursing Studies, University of Edinburgh Lecturer, Department of Nursing Studies, University of Edinburgh Professor, Department of Nursing, Uniiersity of Liverpool Lecturer. School of Nut-sine Studies, University of Wale; College of Medicine Head, School of Nursing, Queen’s University of Belfast Research, Training and Development, Nottingham Lecturer, Highland College of Nursing and Midwiferv Lectu&, Department of Nursing Studies, University of Edinburgh
Professor
R Schrock
Miss H Sinclair
Professor
L Smith
Mr 0 Sulhunt Miss V Tickner MS P Walter
Dr R Watson Miss R Weir
Professor
V Wood
Head, Department of Nursing, University of Nottingham Senior Lecturer, Department of Nursing Studies, University of Glasgow Department of Nursing and Social Sciences, Osnabruck University Head of Department of Nursing Studies, University of Edinburgh Department of Nursing Studies, University of Glasgow Lecturer in Nurse Education, University of Stirling Director of Education, Royal College of Midwives Lecturer, Department of Health and Community Studies, South Bank Polytechnic Department of Nursing Studies, University of Edinburgh Director, MSc Nurse Education Programme, University of Edinburgh Faculty of Nursing, University of Western Ontario