Culture and Diversity
What is Acculturation?
Assimilate to dominant culture
When an individual or group transitions from one culture and develops traits of another culture.
How can nurses develop culturally competent practices?
· Reflect on his/her past learning about health, illness, race, gender, and sexual orientation
· Develop greater self-knowledge about personal biases
· Recognize consciously the multiple factors that influence his/her own background
What is beneficence?
· Taking positive actions to help others
· The agreement to act with beneficence implies that the best interests of the patient remain more important than self-interest.
· It implies that nurses practice primarily as a service to others, even in the details of daily work.
What is negligence?
· A nurse is negligent when he or she had a duty of care that is breached, and a patient is physically harmed.
· A reasonably prudent nurse under similar circumstances would have provided care differently. The law establishes the standard of care to protect others against an unreasonably great risk of harm
· Negligent acts, such as hanging the wrong intravenous solution for a patient, often result in disciplinary action by the State Board of Nursing and a lawsuit for negligence against the nurse and his or her employer. Most lawsuits allege negligence.
What are the zones of personal space (0-18 inches)
Intimate Distance (0–18 inches)
• Holding a crying infant
• Performing physical assessment
• Bathing, grooming, dressing, feeding, and toileting a patient
• Changing a patient’s surgical dressing
What is stereotyping?
Associating a characteristic with a specific group
· Avoid stereotypes or unwarranted generalizations about any particular group that prevents an inaccurate assessment of an individual’s unique characteristics, talents, challenges reflected in the places they live, their socioeconomic circumstances, ethnic heritage, religion, language, abilities, characteristics, and world views
What is the first step toward developing these skills?
begins with awareness of your own cultural beliefs and practices
What is nonmaleficence?
· Avoidance of harm or hurt
· It is the foundation of medicine's Hippocratic Oath.
· It is also critical to the nursing profession.
· Decisions about the best course of action can be difficult and uncertain precisely because nurses agree to avoid harm at the same time as they commit to promoting benefit.
What are the criteria points to meet malpractice?
· (1) the nurse (defendant) owed a duty of care to the patient (plaintiff)
· (2) the nurse did not carry out or breached that duty
· (3) the patient was injured due to the breach in duty
· (4) damages or remedies are allowed under state law to “make the person whole” in the eyes of the court
· Even though nurses do not intend to injure patients, some patients file claims of malpractice if nurses give care that does not meet the appropriate standards
What are the zones of personal space (18 inches–40 inches)
· Personal Distance (18 inches–40 inches)
• Sitting at a patient’s bedside
• Taking a patient’s nursing history
• Teaching an individual patient
What is ethnocentrism
Circular to own culture
What is cultural competence?
a dynamic, fluid, continuous process whereby an individual, system, or health care agency finds meaningful and useful care strategies based on knowledge of the cultural heritage, beliefs, attitudes, and behaviors of those to whom they render care”
What is autonomy?
Individuals have the right to determine their own actions and the freedom to
-make their own decisions; from external control
-Autonomous decisions based on:
Individual values
Adequate information
Freedom from coercion
Reason and deliberation
Essay Question
Free
What are the zones of personal space (4–12 feet)
Social Distance (4–12 feet)
• Giving directions to visitors in the hallway
• Asking whether families need assistance from the patient doorway
• Giving verbal report to a group of nurses
What are the social determinants of health?
the conditions in which people are born, grow, live, work, and age
· Economic Stability
· Social & Community Context
· Neighborhood & Environment
· Healthcare
· Education
What are nursing skills regarding cultural competencies?
Physical & psychosocial assessment skills, sensitive interviewing skills, active listening skills, neutral body language (use of touch, eye contact, speech, slang, pauses), self-awareness
What is justice?
What is fidelity
· Fairness and the distribution of resources, access to health care, including the just distribution of scarce services and resources
· Faithfulness or the agreement to keep promises, Key foundation for the nurse-patient relationship, As a nurse you have a duty to be faithful to the patients you care for, to the institution you work for, and to yourself
What are major causes of negligence in nursing?
· Failure to follow the standard of care (e.g., not implementing a pressure injury or fall prevention protocol)
· failure to communicate important information to another health care provider
· failure to document appropriately
· failure to assess and monitor a patient
· inappropriate delegation of nursing tasks.
· Failure to use equipment in a responsible manner
· Failure to act as a patient advocate
What are the zones of personal space (12 feet and more)
· Public Distance (12 feet and more)
• Speaking at a community forum
• Lecturing to a class of students
• Testifying at a legislative hearing
What are external influences that affect a person’s health
· Past experience
· Communication patterns
· Personal space norms
· Role expectations
· Values
· Ethnocentrism
Who is at risk for health illiteracy
· Elderly, immigrants
· Low-income patients
· Less than high school degree
· Mental health issues
· Chronically ill
What are the steps in following an ethical dilemma?
· Step 1: Ask: Is this an ethical problem?
· Step 2: Gather information relevant to the case. Patient, family, institutional, and social perspectives are important sources of relevant information.
· Step 3: Identify the ethical elements in the situation by clarifying values and recognizing the principles involved. Distinguish among fact, opinion, and values.
· Step 4: Name the problem. A clear, simple statement of the problem is not always easy, but it helps to ensure effectiveness in the final plan and facilitates discussion.
· Step 5: Identify possible courses of action. Access others for their input and be creative in identifying different options.
· Step 6: Create and implement an action plan. Gather support from others and identify an alternative action if the chosen one does not achieve resolution.
· Step 7: Evaluate the action plan to determine whether further action is needed or if lessons learned in this experience can be applied forward.
What does the nurse practice act do?
· state laws intended to protect citizens, make nurses accountable, and ensure that care is consistent with best practice within the scope and standards of nursing
· The State Board of Nursing investigates, suspends, and/or revokes a license if a nurse’s conduct violates the Nurse Practice Act.
Where do nurses most often practice?
· Nurses frequently move into patients’ territory and personal space because of the nature of caregiving.
· You need to convey confidence, gentleness, and respect for privacy, especially when your actions require intimate contact or involve a patient’s vulnerable zone.