Introduction
The transcultural nursing theory that was developed by Madeleine Leininger is one of the nursing theories that have become widely relevant in modern society. Cowden and Cummings (2012) define the Trans-cultural nursing theory as a cognitive specialty in nursing that focuses on comparative cultural caring and nursing phenomena. According to Huang and Coker (2011), the role of nurses in modern healthcare facilities is slowly transforming. The days when nurses were specifically expected to work under the instructions of the doctors are gone. Nurses currently find themselves in situations where they have to make critical decisions to save the lives of their patients in cases of emergency. According to Palumbo, Mclaughlin, Mcintosh, and Rambur (2011), the role is changing from that of assistants to the doctors to that of partners who are expected to play active roles in decision making in the medical facilities.
That is why several theories have emerged to help in guiding the nurses. In administrative practice, nursing theories play a critical role in guiding the activities of the nurses in various settings. Hewlett and Winn (2014) say that these theories help the nurses to understand how they should approach different tasks and how to improve the quality of their services. The theories define the relationship that should exist between the nurses and the administrators, nurses and patients, and nurses amongst themselves. If applied correctly, this theory may help in improving the workplace environment for nurses by defining how they can deal with diversity (Miller, Tyler, Rozanova, & Mor, 2012). The theory helps in creating an accommodative workplace environment in situations where people are of different backgrounds. In this paper, the researcher will use the Trans-cultural nursing theory to help explain how nurses can manage the issue of diversity in their workplace environment.
Description of Issue or Concern
Issue of Concern
According to Krinsky, Illouise, and Johnson (2014), people from all over the world still prefer immigrating to the United States because it is seen as a country of opportunities. As such, it is common to find cases where people staying within a given locality have highly diversified cultural practices. Diversity is very important to society, especially when people get to appreciate the uniqueness of the people living around them. According to a report by Hewlett and Winn (2014), religion and socio-economic factors define people’s behavior when getting medication. These people will need medical services from time to time, and it will be necessary for the nurses to offer them care, especially when they are in-patients who spend a lot of time under the care of nurses. Phillips and Beverly (2014) say that in most cases doctors may not have problems in handling patients from a diversified background as long as their problem can be diagnosed and are ready to undergo all the medical procedures. However, to the nurses, there is the issue of dealing with different cultural practices among the patients. Several studies have indicated that socio-cultural diversity is an issue that nurses struggle to cope with in hospitals (Palumbo et al., 2011). Nursing is a very noble profession because it involves handling emotional patients who may be undergoing psychological and physiological pain. According to research by Palumbo et al. (2011), these patients are very sensitive to the events happening around them, and nurses are always expected to be in a position to meet their unique needs.
Reasons Why Nurses Should Care About This Concern
According to Cowden and Cummings (2012), nursing goes beyond helping the patients take their medication and ensuring that the environment within which the patients are is hygienic and habitable. Nursing involves making the patients feel comfortable and at home when they are in the hospitals. It involves making the patient feel cared for and addressing all their emotional and physical needs as much as is professionally possible. Phillips and Beverly (2014) suggest that it may require the nurses to understand the socio-cultural practices of the patients and their personal beliefs. Understanding patients’ practices and beliefs are possible if the nurses handle a given population with a similar socio-cultural background. In a highly diversified community, it is almost impossible to understand the cultural diversity of the patients. It is the scenario that nurses in most parts of the United States find themselves in as they try to offer quality medical care.
Nursing Literature
Scholars have conducted studies on how to deal with socio-cultural diversity in the nursing environment and the need to offer patients spiritual nourishments. The challenge may arise because what one patient considers pleasing may be annoying to the next patient. A good example of diversity based on faith can be explained using Comfort Theory (Eun & Chang, 2012). Numerous nursing theories such as Katharine Kolcaba’s Comfort Theory have suggested that it may be important to allow patients to have access to spiritual nourishments when they are in the hospitals. Prayers help in calming them and making them feel loved and cared for by the people around them (Cameron, Harbison, Lambert, & Dickson, 2012). However, allowing a Christian preacher into a ward full of religiously diversified patients may cause disenfranchisement in the hospitals.
Patients who do not profess that faith will not only feel uncomfortable but also be looked down upon by the nurses and the administrators. Wall (2012) argues that to classify the nurses into different departments based on their faith or any other demographical classification may also be seen as a form of discrimination which is not acceptable under the nurses’ code of ethics. It means that the nurses have to deal with this delicate problem in a very diligent manner to ensure that the interest of every patient is met in the best way possible. Eun and Chang (2012) say that the occurrence of this problem is very common in many hospitals around the country, especially in cases where patients have to share the same room. Sometimes friends and families, when they come to visit their loved ones in hospitals, may engage in prayer and worship just to make their patients feel better (Eun & Chang, 2012). In their interest to serve their patients and the patients’ loved ones, the nurses may allow such prayers to take place. However, sometimes they affect the other patients, causing them discomfort.
The Affected Stakeholders
The issue of socio-cultural diversity in hospitals affects various stakeholders in healthcare settings. Nurses are the most affected parties by this problem (Eun & Chang, 2012). It is the responsibility of the nurses to ensure that patients are satisfied. Palumbo et al. (2011) say that it is always to the satisfaction of the nurses to see their patients happy and contented with the care offered to them. It is so because they are always expected to care for these patients. The patients may complain to them demanding some adjustments in the way things are run to ensure that they get the best care. The administrators are also significantly affected by this problem (Wall, 2012). According to Eun and Chang (2012), the administrators are sometimes under pressure to find solutions to the diversity problem without creating a scenario that can be seen to be discriminatory. The simplest solution would be to have departments for people from different social backgrounds. However, American society is struggling to find ways through which the society can be integrated despite the diversity. As such, Wall (2012) says that hospital administrators have the moral obligation to ensure that integration is promoted even within their hospitals. The patients and their loved ones are also affected. When the practices of their fellow patients are seen to negatively affect them, then they have to sacrifice their comfort for the duration that they will be hospitalized.
Application of Selected Nursing Theory to Issue or Concern
Transcultural Nursing Theory
According to Cowden and Cummings (2012, p. 1651), the primary aim of Madeleine Leininger’s Trans-cultural nursing is to “enhance the quality of culturally congruent, competent, and equitable care that results in improved health and well being for people”. The theory appreciates that in the society in which we live, diversity is an issue that we not only have to appreciate but also embrace as a way of life, especially in a healthcare institution. The theory reminds the nurses that they must care for their patients in the best way they can irrespective of their cultural diversity. According to Eun and Chang (2012), this theory is very helpful in administrative practice. It provides a clear understanding of the nature of diversity that is expected in healthcare facilities, and what nurses can do to ensure that they remain flexible and able to manage challenges that come their way when handling patients from different social backgrounds. The theory will be very helpful in solving the problem of diversity that nurses in the United States are currently faced within their daily practices.
Strategy Useful In Resolving the Issue
In resolving the diversity issue in hospitals, nurses and nursing administrators may need to work very closely to ensure that the unique needs of their patients are met in a way that does not affect their comfort or other patients sharing the facility with them. When using this strategy, Wall (2012) suggests that it may be necessary to make compromises for the sake of ensuring that there is a peaceful co-existence. For the nurses, it will be necessary to be very flexible to meet the different needs of the patients. The nurses have to be sharp and understand every patient that they handle in terms of their culture, personal likes and dislikes, and any other issue that may define their level of comfort.
How the selected theory can help solve the issue
Transcultural nursing theory is useful in resolving this issue. The theory emphasizes the need for the nurses and administrators to offer culturally congruent services to their patients at all times (Hewlett & Winn, 2014). When applying this theory, nurses and administrators will have to determine the level of compromises tolerable to promote the comfort of patients. For instance, if it is about making a prayer, the nurses may guide the loved ones to ensure that the voices are kept as low as possible to avoid affecting other patients negatively. For the nurses, the theory holds that they should always be flexible and ready to meet the changing needs of their patients.
Strategy to be used
The strategy will help the administrators to work closely with the nurses to create an environment that is accommodative to patients from varying backgrounds. First, the administrators will have to empower the nurses so that they can make personal decisions based on pre-determined patterns. To do this, it will be necessary to develop a response pattern that should be followed by the nurses in cases of emergency (Wall, 2012). The nurses will, therefore, be able to address some of the needs of the patients without necessarily having to contact the administrators. In this strategy, nurses will have the power to monitor the situation at hand and come up with an appropriate solution that meets that specific issue.
How to implement the strategy
When implementing this strategy, Palumbo et al. (2011) suggest that nurses should work closely with their patients to understand their socio-cultural background and other personal issues that may affect them. It means that the nurses may need to ask these patients about their personal preferences and the nature of the environment that they may desire.
Suggestions for future research
The issue of diversity remains one of the biggest challenges that nurses and administrators have to deal with when handling patients from different cultural backgrounds (Wall, 2012). Transcultural nursing theory helps nurses to understand how to deal with a diversified environment. However, it is still necessary to find additional solutions to this problem. Future researchers should try and enhance the existing solutions to the problem that is partially solved by this theory.
Conclusion
The trans-cultural theory is currently one of the most important nursing theories that nurses and administrators are using to address the problem of diversity in healthcare institutions. This theory holds that it is the responsibility of nurses to provide culturally congruent nursing care to the patients at all times irrespective of their cultural backgrounds. Nurses in the United States have to work closely with the patients to understand their individual needs and find a way of meeting these needs in the best way possible.
References
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