Personal Philosophy of Nursing --

Personal Philosophy of Nursing -- Cultural Understanding

As professional nurses, we have varied obligations that include clinical responsibilities as well as non-clinical responsibilities in connection with counseling and educating patients. Especially in the contemporary era of health management organizations, nurses must devote specific efforts to the patient counseling and education role because physicians are working under such time pressure that it is simply no longer possible for many of them to fulfill these roles the way their predecessors may have previously. Today, patients may spend only a few minutes with their physicians and most of that time is, necessarily, spent by the physician soliciting information about symptoms rather than dispensing healthcare information or instructions to patients.

That dynamic shifts the burden of ensuring that patients understand medical instructions and that they receive informative answers to their questions from nurses rather than from their physicians. As professional nurses, we have traditionally spent the majority of our educational and career development focus on clinical aspects of patient care. Modern healthcare in the United States now requires that nurses shoulder the bulk of the responsibility to counsel and educate patients and to respond to their questions and concerns.

Within that framework, it becomes more important for nurses to recognize the importance of cultural differences. That is because the cultural influences of environment and experience of patients and their families typically plays a significant role in determining how (and whether) patients receive and respond to medical instructions dispensed by their healthcare professionals. In that regard, even the best clinical instructions and the best counseling information is useless to whatever extent patients reject it because it conflicts with their cultural perspective and their worldview. Therefore, fulfilling the obligations associated with patient counseling and education in contemporary nursing absolutely requires that nurses make a commitment to developing their ability to understand and communicate with patients from a broad spectrum of social cultures and environments so that they can tailor their counseling and patient education efforts to all of their patients' needs equally.

In some cases, cultural sensitivity may pertain to clinical instructions or nutritional advice that poses potential conflicts with religious dietary laws that nurses cannot necessarily rely on patents to mention. By recognizing the cultural or religious significance of dietary issues, nurses can make the necessary inquiries to create work-around solutions to situations that might otherwise become barriers to achieving the most successful clinical outcome of medical interventions. In other cases, cultural sensitivity may mean understanding relationships, hierarchies, gender-specific, and generation-specific rules or expectations that are implicit in some families as well as particular communications dynamics within families. In many instances, failing to appreciate the significance of these types of culture-dependent dynamics can seriously undermine the clinical effectiveness of even the best medical information and instruction.