Individual assessment is essential to the definition of the main cultural factors in every situation for each individual patient (Hibbard, 2004). Individual culture is influenced by many factors, such as nationality, race, religion, gender, social status and financial situation and, in particular, professional and life experience (Heaslip, 2008). The influence of these factors is individual and may vary significantly (Rubenfeld & Scheffer, 2010). Besides that, culture is dynamic. It changes and evolves over time as individuals change over time. An individual usually reacts to cultural differences automatically, without thinking and making arbitrary decisions, and constructs the dynamics of the relationship with a nurse or a patient according to these reactions (Hibbard, 2004).
A nurse’s culture is influenced by personal beliefs as well as by nursing’s professional values. The nurse is responsible for assessing and responding appropriately to the client’s cultural expectations and needs.
Importance of Cultural Background in Nursing
One of the primary tasks for a nurse is to enhance the knowledge of a different culture by means of culturally applicable questions (Rubenfeld & Scheffer, 2010). Basing on their cultural backgrounds and communicating with patients and colleagues from different cultures can widen the understanding and perception of different cultures (Hibbard, 2004).
Rubenfeld and Scheffer (2010) present in their book a universal schematic model which can be successfully applied to reveal the thinking habits of both the nurse and a patient. It is obvious that the questions set out in this manual would be answered differently by the nurses and patients from different cultures.
Thus, for a nurse originating from Indian culture, the question of authority is essential. An Indian tradition usually puts emphasis on the present and values contemplation. As it relies on authority, Indian culture seldom encourages an individual to be confident of his reasoning ability. Traditional medicine in India relies on the traditions that count more that a thousand years. This tradition may present an obstacle to demonstrate flexibility and creativity in many cases. At the same time, Indians are rather inquisitive people who often lack private space. Seeking the truth differing from their beliefs can be problematic for them. Reflecting on the bias and sticking to a task are also characteristic for a representative of Indian culture.
American culture offers a quite different approach. American culture is mostly future oriented, which also means being creative, flexible and future oriented. At the same time, for an American nurse some tasks requiring durable concentration can be difficult.
As an example of a patient from a different culture, an Arabian patient will be examined. Arabic culture has a wide range of restrictions. For instance, providing nursing care for an Arabian female patient can be rather problematic for a male nurse. It is also typical for such patients to spend time reflecting on thinking and actions.
Examples from the Nursing Practice
Behaviors, which can be evaluated as a response to illness, such as, anxiety, fear and pain are also predetermined by the cultural background. Most obvious these differences become when defining the sick role. For instance, in American culture the sick role is no longer valid after the symptoms disappear (Clancy, 2008). A perfect example of this is a client with diabetes mellitus who is experiencing problems with urinary incontinence. When the diabetes mellitus is under control, the need for a special diet, medication, and timed voiding is not evident. Thus, the ongoing need for care presents a challenge when teaching patients whose symptoms have subsided or who have chronic conditions.
Nurses have to gain knowledge of different cultural customs and habits, in particular, the specific beliefs and practices the patients desire to be used in their care (Rubenfeld & Scheffer, 2010). The patient's perception of the illness and its cause will help the nurse to assess and prioritize caring needs and to incorporate cultural beliefs into the plan of care. It is necessary to demonstrate respect for the patient and all family members by using titles, not addressing them by first name, and pronouncing their names correctly. Besides that, a nurse should use materials and techniques that are culturally relevant for the patient and family. Conformity will be greater when the plan of treatment takes into account the patient's cultural values and beliefs (Clancy, 2008).