NR 394 Week 2 Discussion: Reflection on Cultural Awareness (Graded)

Purpose

The purpose of this reflection is to apply cultural awareness to communication in practice.

Course Outcome

This discussion reflection enables the student to meet the following course outcome:

CO 2: Communicate effectively with culturally diverse individuals, families, and organizations. (PO 3)

Due Date

During the assigned week (Sunday the start of the assigned week through Sunday the end of the assigned week):

Posts in the discussion at least two times, and
Posts in the discussion on two different days

Points Possible

50 points

Directions

Reflection is an activity that involves your deep thought into your own experiences related to the concepts of the week. Answers should be detailed. In reflections students:

Demonstrate understanding of concepts for the week
Engage in meaningful dialogue with classmates and/or instructor
Express opinions clearly and logically, in a professional manner

Use the rubric on this page as you compose your answers.
Scholarly sources are NOT required for this reflection
Best Practices include:

Participation early in the week is encouraged to stimulate meaningful discussion among classmates and instructor.
Enter the reflection often during the week to read and learn from posts.

Select different classmates for your reply each week.

Reflection Question

  As nurses, we work with patients, providers and healthcare team members whose native language is not English. This diversity may lead to challenges with communication and the nurse being “caught in the middle.” Consider how to apply cultural awareness to nursing practice.

Reflect on how to apply cultural awareness to communication in your current clinical practice.

Share an example of miscommunication that occurred as a result of this diversity and whether an adverse outcome resulted.
Describe how the miscommunication could have been and will be prevented in the future.

Grading

To view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric. See Syllabus for Grading Rubric Definitions.

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Happy Week 2! This week we will be reflecting on diversity, communication, and cultural awareness in nursing practice. I look forward to our discussion on this process.

This week’s graded topics relate to the following Course Outcome (CO):

CO 2: Communicate effectively with culturally diverse individuals, families, and communities. (PO 3)

Please let me know if you have any questions. I am here to facilitate your success.

Hello class,

Cultural awareness goes beyond just knowing the details of another individual’s culture, but acknowledging and appreciating it. A lot of times, we subconsciously apply our cultural background onto others actions. For example, in Chinese culture, constant eye contact can be construed as defiance or “attitude” whereas in Western culture, eye contact is a sign of respect and attentiveness. So when communicating with patients, providers and healthcare teams, it is imperative we are culturally aware to prevent offending one another, improving communication for optimal patient care delivery.

An example of miscommunication that occurred as a result of cultural differences is when a coworker who was offended that a coworker was continuously barking orders at her rather than asking nicely. Because of this, when these two coworkers would work together, they would constantly have tension and argue. They were inefficient in their teamwork because they would refuse to help one another.

Eventually management stepped in as mediator. The coworker who felt she was constantly barked at explained that she did not mean to offend the other coworker but she explained that in her native county, it is not the norm to say “please” to do their job because “please” implied begging. However, in the United States, the term “please” is used very freely just to be polite. This miscommunication could have been better alleviated had both partitions acknowledged the tension early on rather than let it go on for months. This simple cultural difference interfered with patient delivery for an unnecessarily extended amount of time.

Thank you.

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Thank you for your post this week.  You bring up an excellent example with regard to eye contact.   I also appreciate the example you provided regarding the word “please”.  I have had similar examples with the term “thank you”.  How can we as nurses educate ourselves and others to communicate more effectively and take into consideration all these factors?  Julie

Thank you for your response. Communication is so important, especially in healthcare. As nurses we must be mindful of the way we communicate both verbally and physically. Just the way we cross our arms or stand can change how the other interprets it. We must also be mindful to not take everything to heart and seek clarification. For example, if you feel a coworker may be rude to you, rather than complain to others or be petty, consider speaking to the person directly involved instead. Discuss feelings and resolution, because often times it will have been a minor miscommunication blown. 

I agree with what you have written.  Direct communication and transparency really helps to improve communication, trust and fosters good teamwork.  I try every day to be a role model to others in this regard.  There are so many opportunities to communicate well and impact people and co workers positively.  Julie

I didn’t even think about ways that cultural competence can affect the work environment with other coworkers.  I think when I think of cultural competence I always would think of how it impacts patients.  You brought up some great points.  I now working in skilled as I am now, that we have quite a few CNAs from different areas of Africa and there have been tensions that I have had to mediate that sort of stemmed from quarreling neighboring countries.

   Thank you for sharing.  This happens all the time in a field of nursing that I am close too.  I was not aware that the reason could possible be saying “please” is begging.  I didn’t even think to ask because I thought it would be rube and I would be yelled at, but maybe this is just a huge misunderstanding.  Thank you for opening up my eyes, I guess that is what this class is all about.  I really just let it go because I figured that’s the way they are, but really talking to them

It is imperative that we apply cultural awareness to communication in our current clinical practices. I understand that in the business of life and our workday it can be very easy to forget this skill, but we must do our best to uphold these standards. One way to do this is to simply ask questions. One of the ways that I accomplish this is actually through our admission process. Thankfully, we are required to ask every new patient if they have any religious or cultural practices that they would like known to staff so that we can ensure they are upheld. This simple question works wonders for many of our staff members. By simply asking the question, I believe that this can help us to avoid miscommunications that could possibly occur.

Unfortunately, I was told by my coworker of a miscommunication that has often occurred. She is from Morocco and is of the Muslim faith. She told me that when she is out in public with her husband and they meet new people, men often attempt to shake her hand when introducing themselves. Within her cultural and religious background, this is unacceptable as women are not allowed to shake hands with men. Unfortunately, there have been times where she attempted to explain why she could not shake their hands, but the individual was offended and did not allow her to communicate her reasoning. 

This instance is very difficult to prevent as in our American culture it is almost standard to shake someones hand or hug them when greeting. With this challenge, I believe one of the best prevention methods would simply be more self-education, humility, and again asking questions. There is so much that we can learn from one another. I believe by being open-minded we can indeed grow into excellent nurses with a strong sense of cultural tact and respect. 

Cultural awareness is so important today, in the multiracial world we are living in today .From my stand point I think it is imperative, that nurses have  cultural   awareness  classes, in order for us to manage our patients appropriately .communication is  very important .It is very difficult when  you are not understand. Interpreters should be  at hand to assist in manage individuals of foreign . languages.  culture is the foundation of most of our live .Indeed  communication is fundamental in cultural awareness.

Miscommunication is something that happens a lot and for the most part, culture has something to do with it. I have a patient that only speaks Italian and that makes communicating with her difficult. Effective communication between patients and health care providers is a critical element to quality health care. Becoming aware of patients’ attitudes, beliefs, biases, and behaviors that may influence patient care can help clinicians improve access to and quality of care. 

Professor and class,

There is a large Hispanic population in my area, and I have many Hispanic patients.  My husband is Hispanic, yet I was ignorant of the importance of interpreters in communication.  I have always offered to have an interpreter present when needed to communicate with a patient, but I did not realize the significance of the age and gender of the interpreter (Chamberlain University, 2021).  I have always been reluctant to use family members to translate, because they may translate information in a way that they feel may be better for the patient instead of translating the true meaning of the conversation. 

I responded to a rapid response in the middle of the Covid pandemic.  When I arrived, the patient was a Hispanic gentleman that did not speak English that was very short of breath.  We have Spanish interpreters in the building, but it took several minutes to find one to interpret. In the meantime, I needed to assess the situation.  The patient was unable to keep his mask on due to the severity of his shortness of breath and he was grabbing his chest.  One of the few things I can ask in Spanish is “do you have chest pain?”. 

He responded that he did.  When I went to listen to his lungs, I noticed the writing on his shirt said, “I survived Covid”.  Needless to say, this got my attention.  I pointed to his shirt and he shook his head yes.  However, without an interpreter, I was unable to clarify when he had Covid.  EMS was on their way by the time the interpreter arrived.  I used the interpreter to find out when the patient’s symptoms started and when he had Covid, but I was getting inconsistent information. 

When EMS arrived one of the paramedics spoke Spanish and was able to get more accurate information from the patient.  Ultimately, the patient’s symptoms started suddenly after coughing.  He spent 12 weeks in the hospital with Covid and he was discharged just the week prior to this episode.  Ultimately, the inability to communicate did not change how I treated him but being able to communicate early on during this encounter would have made things run more smoothly. Ultimately the information from my non-verbal communication with the patient provided more meaningful information than the verbal communication with the interpreter.  This encounter demonstrated how non-verbal signals are an effective form of communication (MasterClass, 2020).

This particular episode did result in a process change.  Now an interpreter is required to respond to all rapid responses in the building.  If it is determined an interpreter is not needed, they are able to leave. 

References

Chamberlain University. (2021). Healthcare interpreter and translator [Lesson]. Chamberlain College of Nursing. https://chamberlain.instructure.com/courses/77751/pages/week-2-lesson-communication?module_item_id=11070827

MasterClass. (2020, November 8). 8 Important types of nonverbal communication. https://www.masterclass.com/articles/important-types-of-nonverbal-communication#what-is-nonverbal-communicationLinks to an external site.

This is a great example of the importance of cultural awareness.  It is fantastic that your organization moved forward with a positive process change to allow for