Professional Communication: Cultural Sensitivity Among Native Americans In nursing school, we are normally taught that we should respect the dignity and rights of all clients. As the "world becomes reduced" and societies and individuals become more mobile, we are progressively able to network with people that are from other cultures. Cultural respect and competence for others becomes particularly significant for us as nurses and patient supporters. Applying the principles and theories of communication is important for sufficient patient care. A lot of various communication methods are executed and have diverse focuses. Small groups use mechanisms such as objectives, standards, cohesiveness, behaviors, and therapeutic issues. Duty, process and midrange groups are separate categories. Orientation, tension, cohesion, working and dissolution are stages groups go through. Successful personal and professional communication profits the patients and other health professionals; however, the lack of applicable communication can lead to poor patient results and a hostile and fruitless work setting (Doane, 2004). However, the cultural group targeted in this paper is the Native Americans because this group has become a challenge for public health nurses.

Cultural Sensitivity in Counseling: A Perspective on Native Americans

Even though many nursing schools are beginning to integrate cultural sensitivity into their curriculum and mission statements, it still can remain a challenge for particular cultural groups. Why is it that many Native Americans fail to benefit from nursing? Why is there such a huge "burn-out" rate among nurses who work with this group of people? These questions over time have become more and more significant in the nursing profession.

There has been ma lot of studies on practices and competencies and in multicultural nursing. One such study although dealing primarily with career nursing (Vespia, Fitzpatrick, Fouad, Kantamneni, & Chen, 2010), reinforced the requirement for training in progressing a nurse's ability with cultures that are diverse. Another study which shared specifically with psychotherapy and nursing (Lambert, Smart, Campbell, Hawkins, Harmon, & Slade, 2006), echoes this feeling. Nevertheless, the cause of ineffectiveness may not essentially be the ineffectiveness of counselors and nurses, but their leaning to use unacceptable approaches which fail to respect the distinctive cultural heritage of Native Americans. These culturally- indifferent approaches can sometimes force clients to disturb basic personal criterions. For instance, Native Americans place great stress on a corresponding co-existence with nature. If a counselor advocates individual responsibility for mastering the environment, he is, in fact, asking his Native American client to disregard a part of his client's cultural belief system.

Take the case of Robert Red Elk (this is not his real name), a White Mountain Apache, who was employed at a manufacturing plant in Phoenix, Arizona. Robert's supervisor had seen a lot of instances where Robert's fellow workers asked to split his lunch or finish their work assignments (Yu, 2008). Robert never declined and enthusiastically overworked himself (to the point of making himself sick) concluding the tasks of others. Ultimately, after numerous nonappearances from work, Robert was mentioned to a nurse by his supervisor. The nurse, after an initial valuation, enrolled Robert in assertiveness training. The nurse, however, failed to comprehend one very vital aspect of Robert Red Elk's value system: Native Americans are not distinctive. Their culture places great value on service and sharing.

There are over 500 federally documented Indian tribes all across the United States. Each tribe has its own traditions, beliefs, and customs. A lot of Native Americans have left the reservation and know very regarding their tribal culture, having integrated into the White society. There are, nevertheless, many shared threads running throughout Native American culture and viewpoint, which if misunderstood can open an infringement between nurse and client that can be problematic to heal. For the reasons of this paper, we will be dealing chiefly with Native Americans raised and living...

These people have kept much of their cultural identity, as dissented to those who have progressed into the cities and have been transformed westernized into the White culture.
Almost every tribe has wide-spread social and personal issues which are intimidating lives and generating broken people and broken homes. Compared with other ethnic and racial groups, Native Americans have more life-threatening problems with mental and physical health disorders (Olson & Wahab, 2006, p. 19-33). For example, on the Pine Ridge Reservation of the Lakota Sioux, around 50% are living below the poverty level. In 2007, the suicide rate there was 4.2 times that of those that are Whites, between 50% and 90% were without a job, and the death rate due to alcoholism was around 7 times that of the national average (Diller, 2007).

Nurses employ many approaches in an effort to help Native American clients heal from their physical and mental wounds. This investigation will examine why nurses are having such a hard time when it comes to Native Americans. First, however, there is a need to discover the normal Native American value system.

The Native American Value System

Silence and Talking

The 21st century brings a new set of happenstances to the continuing development of the nursing occupation. In the United States, for instance, census data reflect an extraordinary situation in that non-Western cultures are redesigning the national population. The main Euro-American culture has moved to a more mixed one (Barker, 2009). As a result, nursing is challenged with an advanced and challenging undertaking to determine the professional philosophies of nursing as well as to appraise whether the United States has an operative healthcare system for the current social order, particularly when it comes to Native Americans (Barker, 2009). On that note, it is important that nurses would need to understand that Native Americans believe that listening is the best way to learn.

According to Native Americans, nurse will have to understand that there are a lot "voices" to listen to, not just from other people, but from the wind, the earth, the sky, and the animal kingdom. Nurses would need to understand that Native Americans listen not only with their physical ears, but they also believe it should be done with their whole being in an outlook of "watch, listen and then act" (Nerburn, 2002). They believe that it is unwise to say anything before totally expressing one's thoughts. They comprehend the power of words, and so they speak cautiously, choosing words sensibly. In most non-native societies, communication with others must be occupied with words and language that can sometimes become confrontational. However, in most Native American cultures, just the opposite is true. When asked a question, there will usually be a silence before answering any questions, because any question that they deem worthy of responding to is worth bearing in mind. When they conclusively do speak, it is anticipated that the person that is doing the hearing will listen. Interrupting is thought to be rude and a sign of unawareness. This practice of silence has a tendency to unsettle someone who is unaccustomed with it, and in history, Caucasians have considered it as a sign of stupidity.

Freedom and Honor

Nurses when evaluating their patients would also need to understand that Native American societies value honor way above freedom. Honor is the interior guide for approximately everything they do. The emphasis is more on what is right, instead of focusing on what is wrong. This is one intention why Native Americans have a problematic time accepting the notion of sin. Furthermore, honor is something that cannot be taken away. If one loses his freedom, he still retains his honor. These views of freedom and honor are very different from those held by western peoples. In the White world, honor means paying homage to or admiring an individual's accomplishments (Yu, 2008). To the Native American, honor means knowing and doing what is right for oneself and for one's community. It has no relation to laws or the desire to avoid penalty. To Native Americans freedom only becomes significant…