Cultural competence and rural nursing practice in diverse communities

¶ … Cultural Diversity in Rural Settings for Nurses

On a continuum of cultural awareness to cultural relativity, how do you view yourself and your interactions with others?

As a nurse practitioner, it is easy to see the patient simply as a patient, as a sick person needing treatment, rather than a well person who perceives his or her body as only temporarily ill, but sees his or her person as permanently a part of a family and culture outside of the hospital. As Small and Dennis (2003) counsel, the increase in immigration has resulted in greater diversity of both patients and practitioners within the United States, rather than in traditional urban locations. Thus Small and Dennis remind the nurse that it is not simply enough to treat the patient, but the patient must also understand his or her illness in culturally comprehensible terms. A nurse must be able to communicate to the patient, and also act as a cultural bridge and advocate to a hospital environment that may not understand the patient's cultural mindset. This is why a culture-specific assessment is so critical when explaining models of health and illness to the patient, and setting an appropriate course of treatment with the doctor.

What rational support these beliefs and behaviors?

As even nurses in rural areas are more affected by diversity, it is important to keep in mind one interesting idea proposed by Small and Dennis, that nursing itself is a culture in dialogue with other cultures, that of the heath care system and the patient's culture, as well as the nurse's own cultural background. Today, the health care system has not always met the demands of the changing populace, and nurses must stand at the forefront of instigating changes, as they always have in the past, as noted by the new position statement of the ANA. The impact of culture as a causative influence on the perceptions, interpretations and behaviors of persons in specific cultural groups in terms of whether treatment will be carried out, after the patient is released from the hospital, especially in areas where follow-up care is necessary.