ANA's Position on Cultural Diversity of Nursing Practice
In its official position statement, the American Nurses Association recognizes the importance of cultural diversity in all levels of nursing practice (ANA Board of Directors, 2011). Approaches to the practice will not be effective if the indigenous and diverse cultural health and nursing needs are not addressed and met. This is today's reality for all nurses, whether in the clinical setting, in schools, research or administration. Cultural diversity focuses on racial and ethnic differences. Each experience is unique. The very concepts of illness, wellness and treatment modes derive from a cultural perspective or world view. Culture is a concept on which nursing itself is founded and defined. Nurses, therefore, need to learn how cultural groups understand life processes; perceive health and illness; believe as the cause of illness; do to maintain health and wellness; how their healers extend care for their people; and how the nurse's cultural background influences the provision of care. Nurses must consider the specific cultural effects of their care on individual clients. They should also recognize that each client must be assessed for care according to their cultural differences. Changing demographics has increased the level of cultural diversity in the U.S., as predicted by census. What used to be minority groups are continuously becoming a national majority (ANA Board of Directors).
Nurses likewise incorporate their personal cultural dynamism and cultural and philosophical views into the professional care they extend (ANA Board of Directors, 2011). Their interaction with patients consists of the nurse's culture, the client's culture and the culture of the setting of the care. Patients need to choose from available delivery systems and, therefore, access should be improved by providing more culturally-relevant and responsive services for them. In clinical practice, nurses can apply their knowledge of cultural diversity in extending culturally sensitive care. By recognizing cultural diversity, incorporating their cultural knowledge, and acting in a culturally appropriate way will allow them to be more effective in assessing and serving as client advocates. In pursuing this intention, all nursing curricula should be attuned to the provision of diverse health care, beliefs, values and practices. Educational programs should show to nursing students how their cultural beliefs and practices are essential part of the nursing process and function as psycho-social factors in care. Nurse administrators should design policies and procedures that will insure access to care that caters to cultural beliefs. They have to be sensitive to the level of cultural diversity among providers and consumers. Nurse researchers, on the other hand, need to tap and use cross-cultural data that will answer pertinent questions posed. They will discover that, while cultures differ, similarities exist among diverse groups. Overall, nurses are in a vantage position to influence professional policies and practice, which better respond to cultural diversity (ANA Board of Directors).
Impact of Cultural Diversity on Professional Nursing Practice
Studies show that genetics is a major component in certain diseases and that these diseases develop in significantly high levels among ethnic groups (Paniagua & Taylor, 2008). These diseases and ethnic groups include sickle cell anemia among African-Americans and Hispanic-Americans; cystic fibrosis and phenylketonuria among white Americans; and Tay-Sachs among Ashkenazi Jews also in the U.S. (Nussbaum, McInnes, & Willard, 2007 as qtd in Paniagua & Taylor). Single-gene disorders, such as the Mendelian disease, are found in high rates among racial and ethnic groups. These single-gene disorders develop from the mutation of single genes. Healthcare providers and professionals must be aware of these connections among specific population groups as risk factors (Paniagua & Taylor).
The U.S. Census Bureau reported in 2007 that the largest minority groups in the U.S. are the Hispanics, the Black or African-Americans, the Asians, the American Indians or Alaskan Natives, and the Native Hawaiians or other Pacific Islanders (Paniagua & Taylor, 2008). Health care providers and practitioners must, therefore, view them according to their culture. They need to understand these cultural differences in order to extend sensitive and effective care. The Department of Human Health and Services (2007) defines cultural sensitivity as "the ability to adjust one's perceptions, behaviors, and practice styles to effectively meet the needs of different ethnic or racial groups." The acquisition of baseline knowledge of the beliefs of different ethnic groups on genetic causes will provide essential understanding of these groups' widely varying perceptions of these genetic causes. At the same time, it will help healthcare professionals provide culturally sensitive care to these patients (Paniagua & Taylor).
The lack of awareness or consideration of ethnically different or diverse health practices and beliefs, such as the causes of disease and birth defects, is likely to hamper or decrease effective patient care (Paniagua & Taylor, 2008). Ethnic and cultural beliefs directly influence the information shared during counseling of the patient (Weil, 2001 as qtd in Paniagua & Taylor). The effectiveness of care may also be limited by the patient's lack of basic knowledge of body structure and function, the use of inappropriate community health practices or certain expectations about medical treatment and practitioners. It is, hence, quite important that care professionals learn and understand the connection between racial ancestry, culture, healthcare values and behaviors in transmitting information concerning disease condition and care (Paniagua & Taylor).
The incorporation of foreign cultures has been an ongoing process long before the United States became a nation (Lowe & Archibald, 2009). The mingling of cultures has not been as recognized as it is today. Cultural diversity within health care is, thus, a fiery and highly complex issue that requires much time and consideration to incorporate and implement. It is expected to be frustrating in the process. In 1986, ANA came out with its official position statement and its intention to strengthen culturally diverse programs in the nursing curriculum. Nursing as a discipline, which incorporates, assimilates and permeates cultural diversity continued to be challenged and assessed. The progressive changes in the cultural composition of the population continue to challenge nurses on a daily basis as to their provision of quality care to clients' diverse cultural needs. The shortage of qualified nursing staff crisis presents as additional pressure. Findings say that without adequate attention to cultural diversity, the volume and quality healthcare practices will suffer and diminish. At the same time, heath disparities will widen (Cook, 2003 as qtd in Lowe & Archibald).
The Department of Human Health Services targets the elimination of health disparities as one of its two primary goals (Lowe & Archibald, 2009). Similarly, the goals of the Healthy People 2011 inhere the principle that every person in every community deserves equal access to adequate care. This is regardless of age, gender, race, income, education, geographical location, disability or sexual orientation. Nursing commits itself to assisting with the resolution of problems as they relate to healthcare, while recognizing the needs of clients as culturally diverse. Society expects nurses to be culturally versed in extending care in the continually increasing level of diversity in American society. The U.S. Census reported that minorities have reached over 100 million population and a third of them are minorities. Moreover, one international migrant enters the U.S. every 27 seconds. The U.S. Census Bureau predicted that the four major minority groups will increase by 48% in 2050, thereby switching places with the current majority white population (Servonsky & Gibbons, 2005 as qtd in Lowe & Archibald).
ANA formally expressed its intention to responding to the situation by becoming a culturally diverse profession. Not only is the present workforce becoming more and more culturally diverse. The provision for culturally competent and sensitive health care becomes a current need as a standard rather than only as an ideal. Competence demands that nurses develop behaviors and execute actions, which are culture-specific. These should be acceptable to both…