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Cultural Sensitivity in Healthcare

I chose to interview a friend from Saigon, Vietnam, primarily because of the cultural contrast which meets the requirements of this task. For confidentiality purposes, I will refer to her as T.N. – a pseudo name. Nonetheless, despite the many years, she has lived in the country, she still fosters most of her Vietnamese culture. Primarily, she identifies herself as a Buddhist and observes the Chinese New Year. Moreover, she is inclined to the food prepared according to her culture. However, over time, she has learned to speak proper English, and her Vietnamese accent has slowly disappeared. For me, I identify my culture based on my American roots. Being a U.S. citizen is what defines my beliefs and perceptions. I have known T.N. my entire life, and as she is a very close family friend. She was introduced into the family by my sister as they were friends and colleagues before her death. Considering we already had a relationship, I asked her out and interviewed her at a picnic table on Portland Adventist Medical Center’s grounds.

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Interview

The interview took over two hours as we spent some time chatting since we had not seen each other for quite some time, making it possible for us to talk about my sister and rekindle some memories. Through the interview, I employed an open-ended technique in conversing with her to encourage her to discuss the underlying issues in detail despite being rather sensitive.

Purnell’s Cultural Domains

The Purnell Model for Cultural Competence is a circle, with an outlying rim which represents global society. There is another rim representing a community and a third rim representing a family. The inner rim represents the person. Purnell believes that individuals can expand their awareness of cultural diversity (2000). These factors emanate from one’s culture, which is pertinent to health assessment that impacts the delivery of care (Kearney-Nunnery, 2020). As such, T.N. presents the following six domains which can affect care delivery.

Spirituality

This domain relates to an individual’s religious practices, which define their behaviors and give their lives meaning, including a core source of strength. T.N. is a Buddhist, and annually, she observes Chinese New Year celebrations with her friends. Nonetheless, due to many years, she has spent in the U.S., she has slowly started celebrating Christmas, though when I was younger, she never took part in the celebrations. She says that her religion gives her hope and helps her to understand herself better. It is her source of strength, and it is what has molded her over time to become the person she is today.

Family Roles and Organization

According to Purnell, the factor includes gender roles and household heads, age roles, and child-rearing practices. It extends to views on marriages, parenting, and divorce, which define families (Purnell, 2000). T.N. has never been married, and she even lives with another family renting a room in the house. However, she says that she had a friend of a friend arrangement with a man she refers to as Mr. California, who finally got married to someone else. This depicts that she is, to an extent, not yet ready for commitment despite her age.

Communication

This domain deals with dialects and dominant languages, including the willingness to share feelings and thoughts. Through the interview, I realized that my friend’s English had improved significantly compared to when I was a teenager and I could barely understand her. Nonetheless, she is very selective when it comes to sharing her thoughts (Purnell, 2000). For instance, she was reluctant to give details about her engagement in the Vietnamese war and her country, which all belonged to her past. She says, “I am not supposed to discuss it.” Nonetheless, she shares details about her interactions with the people from her home country, limited by the U.S. government. The issue saddens her though she does not share most of her thoughts about how she feels.

Heritage/Overview

The domain relates to issues unique to the country of origin, its relationship to a current residence, and reasons for migration. The part is evident in T.N.’s life, primarily in how she lives her life (Purnell, 2000). Firstly she is comfortable living with another family, which is often the case in Vietnam as several families live together in single housing units. Additionally, from the interview, it is clear that the Vietnam War had a massive role in her migration and probably because of the socioeconomic conditions. She says that she faces many difficulties as she tries to send medication to her family members, which is often unsuccessful. This shows that she was raised in a low-income family, and the health status of her home country is not good. It affects the way she lives her life.

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Workforce Issues

This aspect deals with such concepts as assimilation, ethnic communication styles, individualism, and acculturation originating from one’s country of origin. T.N. has a very high work ethic, and she has probably never missed work. The situation influences this in Vietnam, where opportunities are limited. Therefore, she maintains high standards to ensure that she is not faulted because of her background (Purnell, 2000). Additionally, her status as a lady might be one of the driving forces though she does not explicitly mention this in the interview.

High-Risk Behaviors

This factor looks at the continued use of drugs, tobacco, and alcohol and a lack of physical activity. The domain extends to high-risk sexual activities, which can lead to undesired sexually transmitted infections (Purnell, 2000). Her relationship with Mr. California demonstrates the given nature of her indulgence in an activity that could potentially lead to such illnesses.

Application to Practice

The domains and other factors identified in the interview are critical in providing quality nursing care in an increasingly culturally diverse world. It identifies specific facts essential in tailoring care for the Vietnamese and expands awareness on how to approach them to ensure patient-centred care. Therefore, such domains are imperative in nursing, and underpin given unique applications, mainly to minority groups.

Communication

Through the interview, I learned that T.N. is still not comfortable discussing her past. As a result, I was tactical in changing the conversation to her current world, which she was more at ease discussing. Moreover, I experienced the essence of reading through one’s non-verbal cues, which depict tension or relaxation to a great extent (Kearney-Nunnery, 2020). T.N. got nervous whenever I asked her something that she was not comfortable which made me feel somewhat sympathetic. However, I realized that the key to a successful conversation was ensuring that her nerves were calm, that is why I fetched some hot water to prepare tea for her which is something I knew she liked. This helped to gain her trust and made me increasingly confident and comfortable asking specific invasive questions.

Beliefs and Practices

My beliefs and practices differ significantly from those of my colleague. The primary difference comes in the spirituality domain, wherein she is a Buddhist, and I am a Christian. As a result, we also have contrasting celebrations and holidays. The other contrast is in the heritage/overview domain because she believes that living with another family is normal. Personally, this would be very uncomfortable due to the insecurities I feel. Moreover, living with total strangers under one roof is one thing that I feel is risky. The final factor of difference is the high-risk behavior where T.N. engages in relationships with her friend. I believe that such connection is dangerous, and I prefer total commitment or none at all. These differences can make me discriminatory or even judgmental in the course of my practice (Kearney-Nunnery, 2020). Moreover, they may lead to a contravention of specific ethical standards due to the different views and approaches.

Recommendation

It will be essential for nurses to partner with Vietnamese community organizations to offer culturally sensitive nursing care to Vietnamese patients. This helps them acknowledge the care challenges within this cultural community and narrow the health gap (Tran et al., 2019). As a result of the partnership, both patients and medical staff learn about the limits, especially in decision-making and customizing care to balance a patient’s and health provider’s cultural differences.

Conclusion

Interviewing T.N. was pivotal in enhancing my understanding of how to approach clients from culturally diverse backgrounds. I can now relate to the adversities that some of the people from minority groups face in their home countries. Moreover, it has helped me to not assume any client information. Instead, I had to ask. Therefore, individuals need to be aware of their culture as it is one area that has been greatly ignored. Additionally, training needs to be done to educate people on intercultural communication and encourage them to avoid ethnocentric beliefs. The development of these areas will be integral in developing cultural sensitivity and ensuring quality nursing care to a culturally diverse world.

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References

Kearney-Nunnery, R. (2020). Advancing your career: Concepts of professional nursing (7th Ed.). F.A. Davis Company

Purnell, L. (2000). A description of the Purnell model for cultural competence. Journal of Transcultural Nursing, 11(1), 40-46. Web.

Tran, Q., Dieu-Hien, H., King, I., Sheehan, K., Iglowitz, M., & Periyakoil, V. (2019). Providing culturally respectful care for seriously Ill Vietnamese Americans. Journal of Pain and Symptom Management, 58(2), 344-354. Web.

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