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Cultural awareness Practical Nursing september 13 2016


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Cultural Awareness In Nursing Practice and IN Nursing Education

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Cultural awareness Practical Nursing september 13 2016

  1. 1. Cultural Awareness Practical Nursing September 13th , 2016 1330-1500 Greg Riehl RN BScN MA
  2. 2. Why am I here? • I ask myself this every day, and I also ask those who I am working with from time to time
  3. 3. Stories • I will use some of my experiences working in health, in the north, and as a nurse, often an outsider, working in different situations. • You are a part of the story.
  4. 4. Objectives  To broaden the understanding of the Platinum Rule.  To describe how to apply the Platinum Rule.  Compare the Golden and Platinum Rules.  To explore cultural aspects of nursing care.  To identify the unique challenges faced by care providers working with diverse clients.
  5. 5. We Don’t SeeThings AsThey Are, We SeeThem As We Are Anaïs Nin “It has been well said that we do not see things as they are, but as we are ourselves. Every man looks through the eyes of his prejudices, of his preconceived notions. Hence, it is the most difficult thing in the world to broaden a man so that he will realize truth as other men see it.”
  6. 6. I try to be skeptical (question things) and not cynical (dismiss ideas & find fault with them)
  7. 7. Invisible Backpack “all of us carry an invisible ‘backpack’ of our culture, experiences, beliefs, values and morals.Whenever we encounter another person, our backpack is present with us and influences how we interact with our patients and their families”. Scott Harrison Invisible Knapsack Peggy McIntosh
  8. 8. Invisible Backpack
  9. 9. Invisible Backpack
  10. 10. What is Culture? • Behaviour is what you do… • Culture is how you do it…
  11. 11. What is Culture? • More than just the 3 or 4 F’s?
  12. 12. Everything is about CULTURE • Everybody knows about it • Everybody does it • Nobody talks about it • Kathleen Bartholomew, RN, MN
  13. 13. Culture is a world view • North American culture sees health as an individual problem, but we live in dynamic, intercultural communities. • Culture can be a barrier to caring for our clients. • We learn about disease models of health • We need to focus on wellness and resilience models of health • Health is multifaceted with issues related to mental, spiritual, emotional, and physical health.
  14. 14. Cultural Competence is a part of the Platinum Rule • Cultural Awareness • Cultural Sensitivity • Cultural Knowledge • Cultural Competence • Cultural Humility • Cultural Safety
  15. 15. Cultural Awareness Is really concerned about acceptance
  16. 16. Cultural Sensitivity Is about respecting differences and often uses neutral language, and neutral communication
  17. 17. Cultural Sensitivity Is about respecting differences and often uses neutral language, and neutral communication
  18. 18. What happens if a bird poops on you? • Bird poop brings good luck!There is a belief that if a bird poops on you, your car or your property, you may receive good luck and riches.The more birds involved, the richer you'll be! So next time a bird poops on you, remember that it's a good thing.
  19. 19. Cultural Knowledge Familiarization with selected cultural characteristics, history, values, belief systems, and behaviours of the members of another ethic group
  20. 20. Cultural Competence Is about understanding, knowledge skills and attitudes, working effectively in cross cultural and intercultural situations, this is the application of knowledge, creates the environment of cultural safety
  21. 21. Cultural Humility Focuses on self reflection and acknowledges power differences, and privilege.
  22. 22. Cultural Safety Stresses the importance of relationships and partnerships, power shifts to the client, to decide what is safe and what is not
  23. 23. An environment that is safe for people; where there is no assault, challenge or denial of their identity, of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience, of learning, living and working together with dignity and truly listening. (Health Q. F., 2012) Cultural Safety
  24. 24. Physical Mental Emotional Spiritual My perspective is that each of these four parts can be treated as its own body. Each requires its own form of sustenance and exercise to be healthy
  25. 25. Seven Directions! East South West North Life Above the Earth Life Below the Earth Life on the Earth (and within ourselves)
  26. 26. Direction and Hierarchy • The more vertical an organization or a culture is in its hierarchy, the more complicated communication becomes.
  27. 27. Classroom Seating Position and College Grades • Studies show that students who sit in the front and center (middle) of the classroom tend to achieve higher average exam scores. • One study discovered a direct relationship between test scores and seating distance from the front of class: students in the front, middle, and back rows of class scored 80%, 71.6%, and 68.1% respectively
  28. 28. • Cultural safety stresses the importance of reflection & acceptance of differences. • We should not treat everyone the same. • We do need to recognize and acknowledge our blind spots.
  29. 29. Standards and Best Practices • One of the problems with “best practices” are that they are inflexible, especially for social sciences, and they may not reflect the diversity of human worldviews or the underlying differences between Indigenous worldviews.Typically, this proposition creates oppression and discrimination. • Indigenous wise practices vsWestern educational system best practices
  30. 30. Good Hunters vs BadTipi Builder
  31. 31. Bronze Silver Gold Platinum Rules • Bronze • Do unto others as they have done unto you • Silver • What you do not want done to yourself, do not do to others • Gold • Do unto others as you would have them do unto you. • Platinum • Do unto others as they want done unto them
  32. 32. Bronze silver gold platinum rules The culture ofWestern medicine places diagnosis as a central goal Aboriginal medicine, see diagnosis as less central and pay more attention to finding a safe environment in which the patient may recover. For conditions such as mental disorders, this latter approach may prove more effective than struggling to attach a label to the disorder.
  33. 33. Bronze rule Do unto others as they have done unto you
  34. 34. Silver What you do not want done to yourself, do not do to others
  35. 35. Gold Do unto others as you would have them do unto you.
  36. 36. Platinum Do unto others as they want done unto them
  38. 38. Nursing Process and the Medicine Wheel
  39. 39. Imbalance Creates Illness  Holistic approach to address issues and factors that impact illness targeting not just the disease, but also the social determinants of health and economic circumstances.  It is recognized that the whole family (broadly defined) is as impacted by disease and needs healing just as the individual who is ‘sick’ requires care, treatment and support.
  40. 40. Lateral Kindness • Please be kind to each other • Respectful and responsible relationships, there are no apps for that. • Be Grateful • Be Great!
  41. 41. Discussion, questions, comments!!! Thank you for your participation
  42. 42. WhereYou Sit In Class And What It Says About Your Personality • 8) In the back row.“I really don’t want to be here, so I’m going to sit in the very back where I can fall asleep, or surf Facebook without anyone looking over my shoulder at the screen.” • 7) In the front row.“I want the professor to see my face everyday and know who I am. That way, he’s more likely to bump up my grade when I need an extra half point. At least, that’s what the article in Seventeen Magazine told me.”
  43. 43. WhereYou Sit In Class And What It Says About Your Personality • 6) Close to an aisle.“I don’t care if people have to shuffle over my knees just to get in and out, I just want a quick exit when this class is over.” • 5) Right in the middle.“I’m most comfortable when I’m surrounded by people. Also, if this lecture hall is anything like a movie theater, I’ll have the best view in the house.”
  44. 44. WhereYou Sit In Class And What It Says About Your Personality • 4) Uncomfortably close to someone else. “I choose this desk right next to you, even when there’s two dozen other desks available just because I like to assert my dominance this way. Also, you smell nice.” • 3)Taking up two or more desks. “I need room for my laptop, my gigantic bag, my books, my purse, and my coat. And damn anyone who thinks I don’t deserve the extra space.”
  45. 45. WhereYou Sit In Class And What It Says About Your Personality • 2) In a different classroom. “I read the schedule wrong.” • 1) In your bedroom. “I don’t feel like going to class today.”
  46. 46. Contact information Greg Riehl RN BScN MA Aboriginal Nursing Student Advisor Aboriginal Nursing Student Achievement Program Saskatchewan Polytechnic Regina Campus Email:
  47. 47. Statement of Commitment to Co-workers As your co-worker with a shared goal of providing excellent service to people and families, I commit the following: I will accept responsibility for establishing and maintaining healthy interpersonal relationships with you and every member of this staff. I will talk to you promptly if I am having a problem with you. The only time I will discuss it with another person is when I need advice or help in deciding how to communicate with you appropriately. I will establish & maintain a relationship of functional trust with you and every member of this staff. My relationships with each of you will be equally respectful, regardless of job titles or levels of educational preparation. I will not engage in the '3B's (bickering, back-biting and bitching) & will ask you not to as well. I will not complain about another team member & ask you not to as well. If I hear you doing so, I will ask you to talk to that person. I will accept you as you are today, forgiving past problems, & ask you to do the same with me. I will be committed to finding solutions to problems rather than complaining about them or blaming someone, & ask you to do the same. I will affirm your contribution to quality service. I will remember that neither of us is perfect, & that human errors are opportunities not for shame or guilt, but for forgiveness and growth. (Adapted from Marie Manthey, President of Creative Nursing Management in Caroline Flint's Midwifery Teams and Caseloads 1993; p. 138)