Cultural sensitivity in nursing care for Native American patients

Professional Communication: Cultural Sensitivity Among Native Americans

In nursing school, we are normally taught that we should respect the dignity and rights of all clients. As the "world becomes reduced" and societies and individuals become more mobile, we are progressively able to network with people that are from other cultures. Cultural respect and competence for others becomes particularly significant for us as nurses and patient supporters. Applying the principles and theories of communication is important for sufficient patient care. A lot of various communication methods are executed and have diverse focuses. Small groups use mechanisms such as objectives, standards, cohesiveness, behaviors, and therapeutic issues. Duty, process and midrange groups are separate categories. Orientation, tension, cohesion, working and dissolution are stages groups go through. Successful personal and professional communication profits the patients and other health professionals; however, the lack of applicable communication can lead to poor patient results and a hostile and fruitless work setting (Doane, 2004). However, the cultural group targeted in this paper is the Native Americans because this group has become a challenge for public health nurses.

Cultural Sensitivity in Counseling: A Perspective on Native Americans

Even though many nursing schools are beginning to integrate cultural sensitivity into their curriculum and mission statements, it still can remain a challenge for particular cultural groups. Why is it that many Native Americans fail to benefit from nursing? Why is there such a huge "burn-out" rate among nurses who work with this group of people? These questions over time have become more and more significant in the nursing profession.

There has been ma lot of studies on practices and competencies and in multicultural nursing. One such study although dealing primarily with career nursing (Vespia, Fitzpatrick, Fouad, Kantamneni, & Chen, 2010), reinforced the requirement for training in progressing a nurse's ability with cultures that are diverse. Another study which shared specifically with psychotherapy and nursing (Lambert, Smart, Campbell, Hawkins, Harmon, & Slade, 2006), echoes this feeling. Nevertheless, the cause of ineffectiveness may not essentially be the ineffectiveness of counselors and nurses, but their leaning to use unacceptable approaches which fail to respect the distinctive cultural heritage of Native Americans. These culturally- indifferent approaches can sometimes force clients to disturb basic personal criterions. For instance, Native Americans place great stress on a corresponding co-existence with nature. If a counselor advocates individual responsibility for mastering the environment, he is, in fact, asking his Native American client to disregard a part of his client's cultural belief system.

Take the case of Robert Red Elk (this is not his real name), a White Mountain Apache, who was employed at a manufacturing plant in Phoenix, Arizona. Robert's supervisor had seen a lot of instances where Robert's fellow workers asked to split his lunch or finish their work assignments (Yu, 2008). Robert never declined and enthusiastically overworked himself (to the point of making himself sick) concluding the tasks of others. Ultimately, after numerous nonappearances from work, Robert was mentioned to a nurse by his supervisor. The nurse, after an initial valuation, enrolled Robert in assertiveness training. The nurse, however, failed to comprehend one very vital aspect of Robert Red Elk's value system: Native Americans are not distinctive. Their culture places great value on service and sharing.

There are over 500 federally documented Indian tribes all across the United States. Each tribe has its own traditions, beliefs, and customs. A lot of Native Americans have left the reservation and know very regarding their tribal culture, having integrated into the White society. There are, nevertheless, many shared threads running throughout Native American culture and viewpoint, which if misunderstood can open an infringement between nurse and client that can be problematic to heal. For the reasons of this paper, we will be dealing chiefly with Native Americans raised and living within traditional Indian reservation societies. These people have kept much of their cultural identity, as dissented to those who have progressed into the cities and have been transformed westernized into the White culture.

Almost every tribe has wide-spread social and personal issues which are intimidating lives and generating broken people and broken homes. Compared with other ethnic and racial groups, Native Americans have more life-threatening problems with mental and physical health disorders (Olson & Wahab, 2006, p. 19-33). For example, on the Pine Ridge Reservation of the Lakota Sioux, around 50% are living below the poverty level. In 2007, the suicide rate there was 4.2 times that of those that are Whites, between 50% and 90% were without a job, and the death rate due to alcoholism was around 7 times that of the national average (Diller, 2007).

Nurses employ many approaches in an effort to help Native American clients heal from their physical and mental wounds. This investigation will examine why nurses are having such a hard time when it comes to Native Americans. First, however, there is a need to discover the normal Native American value system.

The Native American Value System

Freedom and Honor

Nurses when evaluating their patients would also need to understand that Native American societies value honor way above freedom. Honor is the interior guide for approximately everything they do. The emphasis is more on what is right, instead of focusing on what is wrong. This is one intention why Native Americans have a problematic time accepting the notion of sin. Furthermore, honor is something that cannot be taken away. If one loses his freedom, he still retains his honor. These views of freedom and honor are very different from those held by western peoples. In the White world, honor means paying homage to or admiring an individual's accomplishments (Yu, 2008). To the Native American, honor means knowing and doing what is right for oneself and for one's community. It has no relation to laws or the desire to avoid penalty. To Native Americans freedom only becomes significant after one has been "chained up," either factually or by the representation of rules and restrictions (Nerburn, 2002).

Culturally Supportive Approaches to Nursing

According to Ryan (2000) in his article which basically talks about how nurses have to meet their patients where they are it is important to incorporate concepts for culturally focused nursing care and experiences. With that said, as understanding and familiarity of cultural beliefs and practices grows, holistic methods to counseling and nursing are becoming more predominant in practices and clinics in which the mainstream of clients are Native American. There are numerous methods which are illustrating great potential in helping these clients.

Conclusion

To be effective nurse within the Native American community, it is not just enough that we increase our knowledge of physical and mental health and our skills in the nursing area. We need to submerge ourselves in the cultural matters relevant to each individual client and the society which has shaped them. This comes by being empathetic to the cultural contexts and belief systems and, regulating what approaches can and cannot work based upon these strictures. To be effective nurses within the Native American community, it is not just enough that we enlarge our knowledge of health and our skills in nursing. We need to immerse ourselves in the cultural issues pertinent to each individual client and the community which has shaped them. This comes by understanding belief systems and cultural contexts, and determining what methods can and cannot work based upon these parameters.