In the contemporary world, it is important to note that a more holistic approach is preferable, seeing the patient as more than their disease, and advocating for that patient's proper care and assistance when they are unable. In the model of both nursing and anthropology, and in synergizing the concept of care and the challenges of both financial management and the changing demographic nature of nursing, Leininger's model presupposed that the basic practical knowledge of theoretical nursing is already part of the skill set, but that through a gradual improvement and ease of the technical matters, experience will lend itself to a relaxed, caring focus.
Nursing Theory and Leininger
The world of contemporary nursing is a complex, yet rewarding, career choice. Far from the outdated paradigm of the Nurse being just the Doctor's assistant, the contemporary nursing professional takes on a partnership role with both the doctor and patient as advocate caregiver, teacher, researcher, counselor, and case manager. The new model of health care holds that the predominant focus be quality patient care - which comprises three important factors -- 1) sound theoretical knowledge of the latest medical procedures, information and innovations; 2) superior communication skills that are multi-culturally based; and, 3) the ability to empathize appropriately with the patient and family to buttress the role of caregiver (Brown, 200). One of these, the Multicultural Nursing Paradigm of Madeleine Leininger, allows for the changes in demographics, psychographics, and indeed, multiculturalism within the field is that of humanistic and transcultural nursing.
Theory into Practice -- In the contemporary world, it is important to note that a more holistic approach is preferable, seeing the patient as more than their disease, and advocating for that patient's proper care and assistance when they are unable. In the model of both nursing and anthropology, and in synergizing the concept of care and the challenges of both financial management and the changing demographic nature of nursing, Leininger's model presupposed that the basic practical knowledge of theoretical nursing is already part of the skill set, but that through a gradual improvement and ease of the technical matters, experience will lend itself to a relaxed, caring focus. This may, in contemporary culture, mean being more ethno-sensitive, learning to explore ways of communication in languages other than English, and even understanding different cultural phobias and mores that may seem obvious to some. Regardless of the geographical location of the nurse, Leininger also emphasizes that one needs to think globally, but continue to act locally. Use the care model to provide an effective blend of theory and practice, especially in the new approaches to pain control, child-rearing, and mental health practices (Leininger, 2002).
Leininger's theory is designed to maximize the carative aspects of a changing demographic basis in the modern world of HMO and complex medicine. Her model focuses on the patient as a hole being (holism), on the interaction and interconnectedness of the health care community, and less on the idea of disease causation and more on education and prevention (Curtis, 2000). Today's patient universe, however, is quite diverse. There are people from all types of cultures, demographics, and communication styles. In the field of nursing Madeline Leininger's definition of culture is "the learned, shared, and transmitted values, beliefs, and patterned lifeways that assist, support, facilitate, or enable another individual or group to maintain well-being and health, to improve their human condition and lifeway, or to deal with illness, handicaps, or death (Leininger, McFarland, 2010). This definition sparked a movement toward understanding the needs of a patient by understanding their culture through transcultural nursing (Leininger, 2002.
The defining attributes of culture basically has three components. The first is that culture is universal, culture is dynamic, and culture is a learned behavior (Leininger, 2002). An example of culture as being universal would be the American Indians ideas of what causes disease. They believed disease was caused by human agency, supernatural forces, unfulfilled dreams, and natural causes. Culture is also dynamic but not stagnant. Because people change so does the nature of their culture. Traditions, ideas, and basic beliefs can change from generation to generation according to what works for the culture. One example would be in transcultural nursing which looks at all aspects of culture including values, ethnocentrism, ethnic and racial differences (Paterson and Zderad, 2007). Culture as a learned behavior is exhibited by man and animals. Although, the term culture is unique to man because unlike animals we do not inherit the ability to build our own shelter, make our own clothing and search out food to survive. All of our ideas, values, how we act, how we exhibit emotion are a byproduct of learned behavior through a process of enculturation (Maier-Lorentz, 2008).
Synergizing the concept of care and the challenges of both financial management and the changing demographic nature of nursing, Leininger's model presupposes that the basic practical knowledge of theoretical nursing is already part of the skill set, but that through a gradual improvement and ease of the technical matters, experience will lend itself to a relaxed, caring focus. This may, in contemporary culture, mean being more ethno-sensitive, learning to explore ways of communication in languages other than English, and even understanding different cultural phobias and mores that may seem obvious to some. Regardless of the geographical location of the nurse, Leininger also emphasizes that one needs to think globally, but continue to act locally. Use the care model to provide an effective blend of theory and practice, especially in the new approaches to pain control, child-rearing, and mental health practices (Leininger, 2002). Leininger also wishes to remind us that a larger number of modern medications are directly a result of herbal remedies, many collected through contact with indigenous peoples (Lundberg in Pieroni and Vanderbroek, 2007).
Leininger Cultural Theory into Case Analysis
Clinical Case -- Our clinical setting is the ER of a medium-sized suburban hospital. The patient is a female, 62 years of age, indicating she has pain in her left breast area, which had been present for over a month. A "rotting flesh" odor emanated from the patient. The patient indicated she was seeing an herbalist who gave her tablets and an herbal tea to treat the condition. Examination showed a fist-sized hole in the left breast area, apparently being eaten away by cancer. The patient had Stage-4 cancer, and obviously in denial prior to seeking standard medical treatment.
Leininger's theory holds that care should be focused on "doing the caring." That caring model gives empathy and the presence of the Nurse in the here and now. For some, this is the focus of the conflict between Eastern and Western medicine. Leininger would likely see this differently, rather than a black and white template, there needs to be movement from all aspects towards the center in order to find a better, more appropriate, conclusion for the patient -- most specifically to allow the patient the highest quality of life during this serious health crisis (Juntunen, 2001). The dominant theme of course is physical and psychological nourishment. In the case study above, Leninger's theory might be applied thus:
Issue
Carative Paradigm
Discussion
Current medical protocol (herbs)
Respect for multiculturalism, diversity and other care systems
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