Nursing: Cultural Competence, Sensitivity and Empowerment Cultural Competence, Sensitivity and Empowerment: Nursing

The changing demographics of the modern-day multicultural world are increasingly challenging healthcare professionals to consider cultural diversity as a priority in the health sector. Being able to deliver effective care to patients from diverse backgrounds begins with understanding the values, beliefs, and customs associated with different cultures. This text summarizes the writer's experience in a Native American powwow, and explores the effect of the Native American culture on the nursing profession.

Nursing: Cultural Competence, Sensitivity and Empowerment

Diversity is a word that perhaps means something different to each and every individual (Campinha-Bacote, 2003). What is for sure, however, is that the changing demographics of the modern-day multicultural world have, and continue to challenge healthcare professionals to consider cultural diversity as a fundamental concern in the health sector. The U.S. population is projected to reach 400 million by 2050, and estimates show that by then, no single ethnic group will constitute a majority of the country as a whole (Cooper, 2012). These statistics present a vivid picture of the importance of cultural competence and sensitivity among stakeholders in the key sectors of the economy, including the health sector. To be able to deliver quality care to people from diverse backgrounds, healthcare professionals will need to understand the values, beliefs, customs, and practices associated with different cultures, and how the same relate to the delivery and provision of care. This is the first step towards delivering culturally-competent care in a rapidly-evolving environment (Campinha-Bacote, 2003). This thirst for cultural competence was the motivating factor behind my decision to attend the August edition of the Native American powwow ceremony in Arlee, Montana late last year. The experience increased my awareness of the Native American culture, and changed my worldview about diversity and Aboriginal communities. The subsequent sections of this text describe the powwow ceremony, and the cultural lessons learnt as self, and as a prospective caring nurse generalist.

Description of the Cultural Event

Native American powwows are the Native American's way of meeting together to join in singing and dancing, as well as to meet up with old friends, and meet new ones. The main aim of the event is to renew the culture of Native Americans and preserve American Indians' rich heritage. Sources give different views about how the powwow was started. Some believe that when the Native American tribes were forced into reservations, the government also gave them the authority to hold cultural dances, which the public could come and watch. Other sources, however, suggest that the powwow originated from the war dance societies of the Southern Plain Tribes such as the Ponca.

What happens in a powwow is that people from various Native American tribes sing, dance and share their songs, which range from religious to social, and war. The main activities include singing and dancing contests, feasting, encampments, powwow princess contests, parades, softball tournaments, horse races, and hand games (McCluskey, 2009). The scheduled activities differ from powwow to powwow, depending on the type and location (McCluskey, 2009).

In the Arlee Powwow, dancing is the primary activity. The event begins with the Grand Entry (McCluskey, 2009). In the Grand Entry, the eagle staff is carried into the circle, accompanied by the American, Canadian, state and tribal flags (McCluskey, 2009). The title holders from tribal pageants then make their way into the circle together with other invited dignitaries. The male dancers registered to take part in the ceremony then follow the dignitaries, beginning with the traditional dancers, the green dancers, and finally, the fancy dancers. The women follow in the same order as the men, and then finally, the little boys and girls' traditional and fancy dancers make their way into the arena (McCluskey, 2009).

The dancers dance clockwise around the arbor, showing their outfits and dance steps, and giving the audience a feel of what to expect in the main event (McCluskey, 2009). The dancers' outfit is authentic, consisting of a headdress, apron, moccasins, and rattles/bells (McCluskey, 2009). The term 'outfit' is used in place of 'costume' as the latter is considered derogatory (McCluskey, 2009). All dancers are required to register for prize money, and to take part in the Grand Entry.

The Grand Entry lasts about half-an-hour, after which a flag song (an equivalent of the national anthem) is sung to mark the start of the ceremony. An invocation is said to bless the gathering, and the eagle...

The positioning of the eagle staff above the American flag signifies the first nation. The announcer then extends a welcome to the attendees, which is followed by brief speeches from selected dignitaries (McCluskey, 2009). Once this portion of the event is completed, the dancing begins.
The dancing begins with the men's traditional dance, which is usually a dance held over from times when hunters would return to the village and dance their story of tracking a prey/enemy, or when war parties would dance out their story upon returning from battle (McCluskey, 2009). Traditional dancers' outfits are decorated with quill work and bead, and are often more subdued in color than those of other dancers (McCluskey, 2009). These dancers usually wear a circular bustle of eagle feathers around their waists, signifying unity and continuity (McCluskey, 2009). They often carry honor staffs, weapons, and shields to signify their status as warriors (McCluskey, 2009). The traditional dance competition is divided into five age groups: little boys (nine and under), junior boys, teen, men, and 50 plus (McCluskey, 2009). The dancers are judged based on how well they follow the beat of the drum, how well they keep to the music, and whether or not they stop when the music does, with both feet on the ground (McCluskey, 2009).

Then follows the men's fancy dance, which takes off from the traditional dance with fancy footwork, varied body movements, acrobatic steps and motions, and increased speed (McCluskey, 2009). This is a freestyle kind of dance, where dancers are allowed to do anything to keep up with the music (McCluskey, 2009). It is danced mostly by the young men and boys, and is divided onto four categories: little boys, junior boys, teen boys, and men (McCluskey, 2009). Fancy dancers, like their traditional counterparts, are expected to follow the beats of the drum and have both feet on the ground when the music stops.

The grass dance is the last dance in the men's competition (McCluskey, 2009). It was borrowed from the Omaha tribe, with the dancers' outfits, including the eagle-bone whistle, the crow-belt, and the hair roach, mostly representing the emblems of the Omaha society (McCluskey, 2009). The grass dance's step involves tapping the ball of one foot on one beat, placing it down flatly with the next, and then repeating the action on the opposite foot without missing a beat (McCluskey, 2009). Dancers are required to keep their heads moving up and down with the beat of the drum (McCluskey, 2009). Like all other dancers, they must follow the drum beats, and must stop with both feet on the ground (McCluskey, 2009). This dance competition is divided into four categories: little boys, junior boys, teen boys, and men (McCluskey, 2009).

The men's s dances are followed by the women's traditional dance (McCluskey, 2009). Traditional female dancers' outfits are mostly decorated with shells, elk's teeth, and ribbon work, and usually include necklaces, chokers, earrings, hair ties, concho belts, knee-high leggings and moccasins (McCluskey, 2009). The dancers mostly carry feathers, and the dance basically involves remaining stationary and bending the knees up and down slightly (McCluskey, 2009). The calmness inherent in the dance is symbolic of the times when women waited calmly for their husbands to return from war (McCluskey, 2009). The rules are similar to those governing the men's competitions (McCluskey, 2009). Moreover, like the men, the traditional women dancers are categorized into four: little girls junior girls, women, and 40 plus (McCluskey, 2009).

Immediately following the traditional dance is the fancy shawl dance (a new addition to the competition) (McCluskey, 2009). The outfit in this case consists of a decorated knee-length doth dress, a fancy shawl, beaded moccasins with matching leggings, and various pieces of jewelry (McCluskey, 2009). The dance is significantly similar to the men's fancy dance, with the style moving towards spinning and more movement (McCluskey, 2009). The competition is divided into three categories: women, junior girls, and little girls, with the rules being the same as those of the men's competitions (McCluskey, 2009).

The final dance in the dance competition segment is the jingle dress dance, synonymous mostly with the Ojibway community (McCluskey, 2009). The outfits are made from cloth covered with hundreds of jingles or metal cones (McCluskey, 2009). The competition is categorized into two: junior girls and women, and the rules are similar to those that govern the male dancers -- keeping in line with the music and stopping when the music does, with both feet on the ground (McCluskey, 2009).

As the judges deliberate and cast their ballots to determine the…