Running Head: CULTURAL COMPETENCY 1

Cultural Competency in the Field of Nursing

Daniel M. Meyers

Brigham-Young University
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Cultural Competency in the Field of Nursing

Only seventy three percent of the United States population is the traditional white

American. That means that nearly ninety million U.S. citizens belong to another ethnicity and

hold a wide array of religious, cultural, and medical practices that may differ vastly from this

American society. As a nurse it is imperative that cultural competency be attained to provide the

most beneficial health care possible. While a nurse should be culturally competent with many

ethnicities there are three that this essay is intended illuminate: The Asian, African heritage, and

American Indian or Native Alaskan. As this essay proceeds, the medical, death, religious, and

interaction practices of these cultures should become evident. However, this essay is not meant

to be an all-encompassing script that elaborates every practice of these four aforementioned areas

of medical, death, religious, and interactive practices. Rather, it is to make apparent how cultural

competence and sensitivity to these four areas, or others, are vital to a nurse’s success.

Asian Heritage

Individuals who descend from Asian heritage may have vastly different customs in

comparison to the traditional white American customs. For example, in the book entitled

Physical Examination and Health Assessment (Jarvis, 2016) common medical practices and

beliefs of those with Asian heritage are discussed. In this book it states that Asians more

commonly practice herbal medicine, and that they believe health is a balance of the body and

often relate emotional experience into physical symptoms. For example, in Chinese culture the

heart is the center of emotion. So, in turn an Asian American may complain of cardiac like

symptoms but in reality, be struggling with a recent death in his family. As a nurse it is important

that one understands these cultural cues so that the real medical and emotional needs of the

patient can be met (p. 17). Also, many Asian Americans use herbal medicine in treating their
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ailments, and it is important to take this into account so that there is not a contraindication

between the prescribed medications and their herbal ones. Another medical practice discussed in

Fundamentals of Nursing (Yoost, Crawford, 2016) that illustrates the importance of cultural

competence is cupping. Many Asian cultures practice cupping which inevitably leave bruises

along the body. A culturally ignorant nurse may assume abuse (p. 407), while a culturally

competent nurse would realize that they may be marks induced from this culturally common

medical practice. Along with these medical practices there is also drastic differences in how

many Asian cultures communicate. In the book Fundamentals of Nursing (Yoost, Crawford,

2016) it discusses how, in some Asian cultures, it is considered disrespectful to make direct eye

contact with those who are an authority (p. 402). For a nurse this is an important cultural practice

to understand. If a nurse lacked this knowledge they might consider their patient to be

indifferent, depressed, or possibly anxious and by doing so, treat their patient in a different

manner or ask them questions that do not aid in their care.

African Heritage

Along with Asian culture, there are also large discrepancies between the traditional

American culture, and those who are American that descend from African roots. Once again, as a

nurse it is imperative to understand these differences of cultural and religious practice among

different patients. Once again in Fundamentals of Nursing (Yoost, Crawford, 2016) medical

beliefs and practices are addressed. Older African Americans within the southern United States

will commonly consult folk medical practitioners rather than a typical primary healthcare

provider because of an inherent mistrust that has been developed because of poor treatment that

was prior received. As a nurse in the South this may be a very important concept to understand

so that if given the privilege of treating a patient with this disposition and culturally inherited
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practice they can understand that trust needs to be developed. By realizing this, a nurse can have

a better direction and understanding of how to interact with and treat these patients. While

understanding common medical practices amongst this culture is important it is also of value to

understand common religious practices within different cultures. In the scholarly article African

Culture and Values (Idang, 2015) it discusses how, for those of African descent, it is a very

common belief that the soul does not die with the body (p. 21). In turn one may ask how this has

any relevance or implication within the field of nursing. It applies to the field of nursing because

of potential emotional response to the death of family members. If a large degree of sadness is

not portrayed it should not be assumed that this individual is experiencing flat affect but rather

they handle grief, and hold religious values, that change the way they may respond to death.

Cultural practices for those with African heritage can be prodigiously different from a typical

American especially in the area of illness causation beliefs. In the text Physical Examination and

Health Assessment (Jarvis, 2016) it is common for individuals with African heritage to believe

that evil spirits, voodoo, or hexes, were responsible for their illness (p. 19). Within the typical

American society, it is more common to believe in the scientific causations of illness. This once

again illustrates why it is imperative to be a culturally competent nurse. For many, if an

individual attributed their sickness to evil spirits one might assume that this individual was

psychologically ill. As a nurse this has tremendous implications. It would be so vital in a

scenario with an individual of African heritage to realize that they have cultural practices such as

these that in no way connotate an imbalanced mind but are simply cultural beliefs. One last area

of African culture that exhibits the importance of nurses with cultural awareness is perception of

time. Many people of this ethnic heritage may have a different standpoint on time then a nurse is

used to. In Fundamentals of Nursing (Yoost, Crawford, 2016) it states that African Americans
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commonly hold the belief that time is flexible and that arriving to an appointment thirty, or even

sixty minutes late is an acceptable practice. As a nurse who is used to effective time management

this behavior may cause resentment and distaste. However, it is important for one to realize that

this is a practice of culture, and not character, and therefore should not illicit ill feelings towards

the individual. A nurse needs to have developed cultural understanding in order to have this kind

of recognition and act accordingly.

Native American and Alaskan Native Heritage

The last culture, and its relevance to healthcare, that will be discussed is that of the

Native American and Alaskan Native. This culture, commonly found near areas where large

Indian reservations exist, has many societal and cultural practices that are important for nurses to

know and understand. Practices such as medical assistance from a shaman, consumption of

alcohol, the use of a sweat lodge in healing, and the use of plants and plant extracts to treat

illness. As a nurse it is vital to be culturally sensitive to a patient’s request for a Shaman. In the

text Physical Examination and Health Assessment (Jarvis, 2016) it states that it is common for

people of this culture to visit a shaman (p. 19). Even in precarious situations, where a patient

may have need of isolation, it can be of great importance to that individual to involve their local

shaman in the healing process. As a nurse it may not be fully understood why these individuals

are of such importance, but it is key to respect this belief and practice. Within this same book it

also discusses how people of this ethnic heritage also have the highest rates of fetal alcohol

syndrome, and alcohol-related motor vehicle accidents (p. 13). While alcohol is not necessarily

an important part of this culture it has become very prevalent for individuals of this heritage to

consume alcohol. For a nurse the implication is education. When receiving patients of this

manner it can be very important to inform these individuals on the dangers of alcohol especially
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while pregnant. In terms of sweat lodges, and plant extract, these fall within the same category of

health safety. In Fundamentals of Nursing (Yoost, Crawford, 2016) it states that plant extracts

are commonly used amongst individuals of this culture (p. 398). In combination with this, the

book Physical Examination and Health Assessment states that sweat lodges are also frequently

used as a healing tool (p. 19). As a nurse the implications of both cultural practices hold great

value. Both cultural practices may affect or direct the care that needs to be given by the nurse

depending upon the illness.

Conclusion

At this point, it should be apparent that as a nurse it is one’s privilege to treat and care for

a vast variety of individuals with different cultural practices and beliefs. It is of the utmost

importance that recognition, and understanding of these different cultures is developed so that a

nurse can provide culturally competent, and sensitive care to all of his or her patients. While this

essay is not all encompassing of the vast cultural practices that a nurse should be aware of, it is

meant to exhibit how understanding even a few of these cultural beliefs discussed, can drastically

change a nurse’s ability to provide quality health care.

References

Idang, G.E. (2015). African Culture and Values. Retrieved from

http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1561-

40182015000200006

Jarvis, C. (2016). Physical Examination and Health Assessment. Retrieved from

https://online.vitalsource.com/#/books/9781455728107/cfi/6/10!/4/2/2@0:0

World Population Review. (2018). United States Population 2018. Retrieved from

http://worldpopulationreview.com/countries/united-states-population/

Yoost, B.L., Crawford, L.R. (2016). Fundamentals of Nursing. Retrieved from

https://online.vitalsource.com/#/books/9780323295574/cfi/6/74!/4/2/4/2@0:0