Introduction
In this day and age of globalization, people from all over the world come to this country in search of a better life. Consequently, there is a significant increase in the cultural and ethnic groups that need health and medical services. Health professionals like nurses who frontline in the delivery of health services are often besieged with issues related to cultural competence. Cultural competence refers to the ability to understand the cultural systems or all factors surrounding the culture of any given individual (Quine, Hadjistavropoulos, & Alberts, 2012). Being competent in dealing with various issues pertaining to the culture of a patient enables the health professional to maintain his or her understanding, composure and responsiveness towards the patient who deserves respect and quality care just like everyone else.
The Affordable Care Act (P.L. 111-148 and P.L. 111-152) included provisions that authorize education and training programs for health professionals under Title VII and VIII of the Public Health Service Act. The Association of American Medical Colleges (AAMC) (2015) explains that through these programs, the Health Resources and Services Administration (HRSA) are enabled to provide grants to health professional schools to improve and innovate on their teachings on cultural diversity, adequate distribution of the supply of health professionals skilled in primary care and interdisciplinary education and training (Association of American Medical Colleges, 2015, para. 7). Hence, there is a prevalent awareness that health professionals need to be competent in dealing with cases involving cultural diversity.
However, the ever changing and growing ethnic communities and racial diversities pose a challenge to nurses and other health professionals who have not received any training in handling patients coming from cultures vastly different from theirs. Patients also feel more comfortable being under the care of a nurse who comes from their own cultural group because they can understand their situations better. The National League for Nursing’s (2015a) Public Policy Agenda for 2015-2016 reports that the organization will support government efforts in the promotion of ethnic, cultural and gender diversity as well as the representation of minorities among nurses and nurse educators. In addition, the organization shall also propose that the federal government provide additional investments in enrichment resources for nurses to be culturally competent in their practice such as addition of courses and programs in Nursing education or additional professional training for practicing nurses in cultural competence. Such recommendations are believed to lead to a higher quality of healthcare delivery to a more culturally diverse population of patients (National League for Nursing, 2015 a).
All these policies are consistent with the Making the Education for Nurses Dependable for Schools (MEND) Act (Bill #S.629) which was passed to provide updates to the Centers for Medicare and Medicaid Services (CMS) about the regulations that allow “hospital-based nursing school programs to continue meeting the highest accreditation standards while remaining in compliance with governmental requirements without losing vital federal funding” (NLN, 2015 b, para.1).
Being aware of the status of policies surrounding cultural competence of nurses, a policy visit to a key person in the MEND Act is planned to communicate the need for intensive cultural competence training for nurses and the need for a more culturally diverse workforce in the nursing profession. This is to be able to cater better to the needs of patients who come from various cultural and ethnic backgrounds.
Key Strategies in Policy Visit
Policy Visit Plan
A visit to Senator Rob Portman, who originally sponsored the ‘Making the Education for Nurses Dependable for Schools (MEND) Act’ (Bill #S.629), is planned. He is believed to be amenable to the proposals made in connection with his bill because it monitors the kind of training and education hospital-based nursing school programs provide. A thorough presentation of the need for nurses to receive intensive training in cultural competence shall be done in his office at a time and day most convenient for him to listen intently to the purpose of the visit.
Message
The message to be conveyed to the good senator is to allot federal funding to government-sponsored hospital-based schools for intensive nurse training in cultural competence. Nursing schools all over the country are also recommended to include courses on cultural competence so that nursing graduates are equipped with skills in managing culturally diverse patients in their future practice. Upon completion of the cultural competence training, practicing nurses may be assigned to a more culturally diverse patient pool with confidence in their delivery of health care services. Nursing graduates who have undertaken such cultural competence courses in their undergraduate study shall first be evaluated on their skill in this area as part of their hiring procedure. Should they pass the evaluation, they will have no more need to take the initial intensive cultural competence training for practicing nurses. Another message to the senator will be the openness of hospitals to assign nurses with the same or similar cultural background with their patients so that the patients will be more at ease with the person caring for them. This means that nurses from minority groups will be commissioned to care for patients from their own cultural or ethnic origins. In cases where this is not possible, well-trained culturally competent nurses from other cultural backgrounds are also adept to care for culturally diverse patients.
Recommendations
It shall be recommended that the cultural competency training be given on a more regular basis and that nurses who complete the training should be evaluated regularly to check if they are practicing what they have learned. It will be part of the basis for promotion or merit increase in pay. On the other hand, nurses who despite their training, still cannot manage patients from cultures different from theirs will be penalized by re-taking the training again or being demoted. This decision will be determined by the hospital administration.
Analysis to Support Proposed Policy
The policy visit is worthwhile in consideration of the importance of cultural competence. Campinha-Bacote (2010) emphasizes the significance of culturally sensitive services because it enables the nurses to develop a positive relationship with their patients making them more cooperative in following medical procedures. This helps the nurses make a more accurate assessment of the patients and create more specific and customized interventions which respect the patients’ rights and needs. This leads to a higher quality of health service provision bringing the patient closer to healing and recovery.
Being culturally competent makes nurses act as advocates for their patients because they can better understand their health beliefs and issues. Nurses can better support the patients’ decisions especially if such decisions are based on their cultural practices, even if such decisions go against established institutional standards (Larsen & Reif, 2011). Hence, it is justified that nurses undergo intensive training in cultural competence.
The approach strategy of presenting a well-planned argument to the senator supplemented by weekly follow-ups, is most likely to be considered and granted. This is if the senator is persuaded on the importance of cultural competence of nurses and its corresponding positive impact on the delivery of high quality healthcare services.
Impact of Successful Visit to Nursing Profession
Successfully communicating the cause for fine-tuning the policy on cultural competence is a big leap in the nursing profession. Not only does it make nurses more competent, efficient and professional but also significantly improves the quality of patient care, benefitting more people from various cultural and ethnic backgrounds. For example, patients whose culture dictates them to refuse operation or being resuscitated or even given blood transfusion, need to be respected for their decisions. A simpler example is for nurses to know how to address certain patients according to their titles or cultural names. This makes the patient feel special and unique.
Conclusion and Summary
Globalization brings about both positive and negative consequences in health care. People from different cultures may have different beliefs and ways of treatment of their illnesses. Healthcare professionals such as nurses need to be more aware of such practices and beliefs and give the due respect patients deserve even if they may not agree with it. Some patients can be very sensitive to nurses’ reactions to their cultural practices which may affect their rapport with each other and eventually, their response to care and treatment. Hence, it is imperative that nurses learn more about their patients’ profiles and backgrounds in order to provide the highest quality of care they can give. It is recommended that nurses go through cultural competence training so they are more adept in dealing with patients from various backgrounds and beliefs. It is hoped that policies to integrate such training be implemented in the near future.
References
Association of American Medical Colleges (2015). Title VII and Title VII reauthorization. Web.
Campinha-Bacote, J. (2010). Cultural competence in psychiatric mental health nursing: A conceptual model. Nursing Clinics of North America, 29, 1-8.
Larsen, R., & Reif, L. (2011). Effectiveness of cultural immersion and culture classes for enhancing nursing students’ transcultural self-efficacy. Journal of Nursing Education, 50(6), 350–354.
National League for Nursing (2015 a). Public policy agenda 2015-2016, Web.
National League for Nursing (2015 b). Legislative Action Center, Web.
Quine, A., Hadjistavropoulos,D., & Alberts, N. M. (2012). Cultural self-efficacy of Canadian nursing students caring for Aboriginal patients with diabetes. Journal of Transcultural Nursing, 23(3), 306–312.