Largely, nursing practices and patient care require strong professional qualities, theoretical knowledge, qualifications, and working experience of healthcare practitioners. However, the modern reality and extension of migration processes impose new requirements to medical services and performance of nurses. In this light, the cultural competence becomes of paramount importance for the efficient treatment and patient care. The problem is especially urgent in case of working with the refugees when the lack of cultural awareness and knowledge can lead to serious conflicts and highly deteriorate the quality of nursing practices. Therefore, the task of the Chief Nursing Officer (CNO) is to provide a clear and thorough plan of actions to avoid intercultural conflicts and improve nurses’ comprehension and knowledge of other cultures. With this purpose, the analysis of the potential conflicts and resolutions is considered in the given paper. In general, it is possible to state that sufficient educational programs and intercultural trainings are efficient MSN interventions to prevent intercultural conflicts and guarantee a high performance of nurses in their work with refugees.
Types of Cultural Conflicts in Nursing Care
Working in the multicultural and international environment poses additional risks and challenges in the nursing profession. The essentials of professional qualifications and competences become insufficient for the appropriate patient care and require additional knowledge and awareness of cultural differences and social diversities (Almutairi, McCarthy, & Gardner, 2015). The situation gets even more complicated when nurses have to deal with the refugees, as this interaction causes both cultural and socio-political obstacles in the patient care. In the described case, the following types of cultural conflicts are likely to emerge and the following resolutions should be considered.
To start with, nurses might experience a cultural conflict of stereotyping patients. Commonly, the lack of intercultural awareness and knowledge leads to the generalization of ethnical and national minorities, imaginations about their physical appearance and patterns of behavior. This may lead to the preconceived treatment, problems in communication and care. This type of conflict is the result of the popular social beliefs, biases, and prejudices, which stereotype people in accordance with their ethnical, national or any other affiliation (Almutairi, McCarthy, & Gardner, 2015). To resolve this conflict, the CNO should emphasize and promote the cultural knowledge as an essential element of a competent nursing care. This component presupposes the increase of nurses’ competence and comprehension of cultural diversities and prevention of harmful stereotyping of people. Besides, cultural knowledge as a part of professional nursing care is responsible for the appropriate communication and interaction with refugees, which does not harm their values, identity, and cultural implications.
Secondly, a conflict in the vision of care by patients might occur. People from different societies and cultures impose different expectations toward nursing practices and a concept of successful patient care. For instance, in the US, nurses regard the successful patient care as the one which pays enough the attention to existing regulations, implementation of broad communicative and educative techniques, and orientation on the central decision-making (Van Keer, Deschepper, Francke, Huyghens, & Bilsen, 2015). At the same time, patients from Cuba may view the successful patient care in the obtainment of exhaustive information and their participation in the process of making important treatment decisions (Van Keer et al., 2015). This controversy may lead to the miscommunication and misunderstanding of each other during the delivery healthcare services (Truong, Paradies, & Priest, 2014). As a result, the next action for the CNO is to ensure that nurses collect data and information about culture-specific visions on patient care before collaborating with the refugees. Opportune and sufficient communication with patients and their families is also one of the ways to resolve this cultural conflict, as it is a good chance to share different perceptions of treatment and express multiple expectations from this process.
Thirdly, there can appear a conflict in communication and verbal interaction with the patients. The matter is that different cultures use different notions and terms to denote the same objects and phenomena (Van Keer et al., 2015). What is considered as acceptable in one society can be inappropriate or offensive in another one. The example is the usage of the term “Americans” to denote the nationality or ethnical affiliation of patients. Commonly, in the US, this term refers to the citizens of the US, who bear its nationality and citizenship. However, it is also equally correct to use this term to denote people from Central and South America, as they are living on the same continent. Therefore, nurses should be culturally competent to use appropriate linguistic means and verbal tools to communicate with the refugees (Van Keer et al., 2015). Respectively, the CNO should introduce the cultural diversity trainings as a part of the culturally competent patient care to provide healthcare practitioners with the possibility to learn cultural differences and aspects of the intercultural communication.
Furthermore, a prominent conflict in the multicultural patient care is related to the choice of the treatment methods and medication. Nowadays, a great attention is paid to the health disparities, which show that people of some ethnicities and nationalities are more vulnerable to health problems and diseases, in comparison with others. Often, vulnerable groups include indigenous people, less fortunate social classes and people from areas with social, political or military conflicts (Truong, Paradies & Priest, 2014). When speaking about refugees, it is important to remember that they are facing not only cultural but also social, political, and medical obstacles (Almutairi, McCarthy, & Gardner, 2015). Correspondingly, it is crucial for the CNO to ensure that nurses are aware of the peculiarities of refugees’ treatment with the consideration of their lifestyle, dietary, medical history, and individual health characteristics. Overall, nursing practices in the intercultural background might encounter multiple conflicts, connected with the patient care and communication with patients. The task of the CNO is to prevent those conflicts by empowering nurses with the relevant tools and methods of working in the multicultural settings.
Finally, it is important to remember that the healthcare systems of the US and Cuba are different, meaning that expectations and imaginations of citizens related medical services also vary. Not surprisingly, the refugees from Cuba may misunderstand the healthcare system of the US and demonstrate resistance or dissatisfaction. Notably, in such cases, it is difficult for nurses to realize the causes of the misbehavior and complains of the patients since the reasons consist merely in cultural differences (Hart & Mareno, 2014). Thus, before working with the refugees, the CNO should implement a range of courses and trainings for the nursing personnel, explain them the peculiarities of the healthcare system in the country of migrants. This strategy will help to avoid interpersonal miscommunication and conflicts and set realistic objectives for the culturally competent patient care.
MSN Interventions in Case of Cultural Conflicts
In order to resolve the emerging conflicts in the intercultural nursing environment, the following MSN interventions can be utilized. To start with, the introduction of the educational programs, cultural trainings, workshops, and informative seminars will be of a great value for the formation of cultural competencies of nurses and maintenance of the culturally competent patient care. This intervention assists in improving nurses’ cultural knowledge and skills, decreasing stereotyping and labeling of patients, ameliorating employees’ communicative and interactive skills and awareness of culturally diverse treatment (Truong, Paradies, & Priest, 2014). Additionally, the introduction of such educational interventions will help to maintain favorable relations between nurses and patients, leading to the improvement of treatment and patient care quality.
Truong, Paradies, and Priest (2014) inform that this intervention strongly contributes to the quality improvement of nursing practices and resolution of various conflicts. In case of working with the refugees, the implementation of educational programs empowers nurses to behave professionally and sensitively, in accordance with the expectations and views of the new patients. Apart from that, such programs also help to overcome the language barrier and provide the staff with the basic understanding of the languages of the patients (Truong, Paradies, & Priest, 2014). As a result, nurses gain additional competencies and skills to collaborate with refugees and provide relevant patient care.
Other interventions may include innovations in the healthcare system, adoption of the medication prescription to the demands and needs of refugees or reshaping of the process of treatment and medical examination. In all cases, the preliminary condition for the successful cooperation in the intercultural nursing settings is the sufficient cultural competence of nurses and their readiness to work with the social and individual diversities.
To sum up, cultural competence is an essential component of the efficient nursing practices and patient care of the high quality. When working with the refugees, it is important for nurses to be aware of the cultural differences and diversities and possess sufficient tools and practices to cooperate with them efficiently and competently. Nevertheless, the intercultural conflicts are a frequent occasion in the nursing practice, which result from the lack of cultural awareness, knowledge, and skills. Therefore, the CNO should introduce a clear plan of actions, aimed at the reduction of cultural incompetence and promotion of intercultural cooperation and communication. In these terms, a special role belongs to the educational interventions, which are capable of preventing the intercultural conflicts and improving the competence level of the employees.
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