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Analysis of cross-cultural client interview
Reflective essay on cross-cultural client experiences in your own practice (mental health nurse)
The purposes of this assignment are to assist you to reflect on your cross-cultural communication skills and to improve your knowledge and understanding of another culture.
write a Reflective essay describing and analysing a series of actual clinical encounters with a client from a culture different to your own culture (I’m African) or multiple clinical encounters with different clients from different cultural backgrounds. You will provide a brief description of the specific individual encounters (more than one) and a detailed analysis of these encounters from a cross cultural point of view, not generic commentary based on your overall clinical experience.
Critically analyse these incidents including reflection on areas of strength and strategies for improvement.
Use a reflective practice framework eg: Gibb’s (1988) Reflective Cycle Model to guide your writing.
INTRODUCTION
Cultural competence is considered as an essential component that supports the nurses in rendering effective and socially reactive services to culturally diverse clients and patients. Thus, in the contemporary scenario, nurses face difficulty as well as issue while rendering services to mentally ill patients as professional nurses sometimes do not focus on managing diversity and ethnic background of the patient while rendering services (Marshall et al. 2015). The NMBA Code of Professional Conduct that is the Nursing and Midwifery Board has stated that nurses should act following the code, using an ethical and lawful outline to ensure patient wellbeing and respect confidentiality. Nurses must act in a fair, non-discriminatory way that respects customs, values and beliefs of an individual, providing care which demonstrates sensitivity.
The present essay focuses on drafting the reflective essay on assessing the cross-cultural client experiences while delivering mental health practices to the different patient. Along with this, the essay will also focus on using the reflecting practice framework that is Gibbs cycle so that if in future nurses get along with the experience they may change their activities.
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MAIN BODY
Analyzing series of actual clinical encounters
While working as mental health nurse, I have engaged in series of clinical encounters that has supported me in enhancing my knowledge and skills towards maintaining cross-culture among the clients. However, the involvement of nurses plays the significant role in the mental health unit that supports the clients with care to overcome multiple mental health problems and the health issue. I have been encountered with different experiences in the setting the foremost example is of Albert 45-year-old male who is one of the patients at mental health rehabilitation. With the help of implementing Gibbs reflective cycle, I may easily measure the client experience so that in future if such situation regarding cross-culture arises within the setting, then I must easily engage in imparting effective solution (Morgan et al. 2017). Along with this, Gibbs reflective cycle allows me to have the systematic analysis of the event and experience that I have encountered in the mental health unit.
The first step in the Gibbs reflective cycle is the description that ensures depiction of the event. As mental health nurse I have been treating Albert a 45 year old man suffering from paranoia (Fear) schizophrenia. Fear results in the events of misunderstandings that are mainly escorted by illusions as well as the disturbance in their perception. Apart from this all the fear events result in causing destructive and irrational behaviour. Albert was eventually an African patient that somehow leads to results in racial discrimination within the setting.
With the help of describing the event another step in the reflective cycle includes assessing feeling. While, working as mental health nurse I was feeling biased within the setting as nurses who were treating Albert was discriminating on the basis of race that results in imparting ineffective treatment and services to the patient. Along with this due to paranoia (Fear) schizophrenia, he was showcasing destructive behaviour towards the doctor and practitioners. Through reviewing this situation, I was aware that nurses within the mental health rehabilitation must focuses on enhancing their knowledge towards managing culture so that it may not result in the situation of cross-culture issue.
The third step in the reflective cycle includes the evaluation that clearly showcases the positive as well as negative aspect regarding the situation. Through reviewing the case of Albert was engaging in destructive and irrational behaviour towards the doctors and practitioners that lead to impact the communication process among them (Price, 2006). Positively I was enhancing my knowledge towards the different race, background and culture of the patients so that in future I may easily assist the African patients and impart services on the fair basis.
After evaluating the situation of Albert in mental health rehabilitation, I must engage in analysis of the event that is concluding the event. If Albert was my patient in that situation, I would engage in delivering effective services that will support the patient to have proper treatment so that it may positively benefit their health. It has been further analysed that team working must be indulged in mental health nursing as it may ensure that success and failure of care and treatment.
However, the last step in the reflective model is creating the action plan so that I may easily assess the actions that I must implement within the setting so that I may easily deal with the similar situation in the future.
Along with this, I have also encountered with the other experience in which female patient from India suffering from mental health problem has been admitted in the setting. The patient was residing in Australia but she was not fluent in speaking English. Thus, language difference, as well as culture difference, has resulted in worsening the situation. However, she is comfortable with the female nurse as compared to the male practitioners or therapist thus it also results in impacting their health condition (Tetley & Draper, 2010). However, practitioner and other nurses were trying little forcefully so that she could get up and at least try to move, but repeated communication in English was annoying the lady and she was not participating in the treatment process. Along with this, an obvious communication gap she did not understand the information and prescribed by the nurses. In this situation as the nurse, I must assist her in understanding the information and message that is provided by the practitioner. Along with this, to culturally manage the patient I have engaged in using body language and posture so that I can easily communicate with her.
However, it has been assessed that one of my patient Maria 36 year old has visited mental health setting as she was feeling fatigued, dizzy and high-level anxiety for several months. However, her anxiety was increasing day by day because of loneliness. In this case I was unable to meet the requirement of Maria due to language barrier along with continuous negative stigma related with mental illness etc. all these cultural factors negatively impact in denying the treatment. In this situation, I would engage in understanding her mindset and providing them required healthcare services so that I can easily overcome her mental problem. Apart from this, with the help of constant communication, I can also impart effective actions as well as therapy that would change her mindset and negative stigma related with mental illness.
On the other hand, I have also experienced in the mental health unit that some of the healthcare providers mainly engage in preferred characteristics among the cross-culture clients to whom they would impart quality services (Bramhall, 2014). The preferred characteristics are patients speaking same languages, being same racial and ethnic group, same gender, being open to different treatments etc. Thus, the preferred characteristics impact their healthcare services while they are delivering services to other patients as they are not likely to give standard and quality services to the patient. However, it has been assessed that unsafe cultural practice encompasses different actions that diminish, demeans or disempowers the cultural identity and wellbeing of patients using health or educational services. Along with this, it may also negatively impact my services within the healthcare that results in poor patient adherence along with imparting miscommunication and mistrust that negatively affect patient health and well-being.
Concluding to this, I have comprehended that each and every person with a mental health condition are different, and each of them is addressing different backgrounds and features their own belief and values etc. thus, applying the same methods and patient care approaches it may not result in attaining the desired outcome. Therefore, I must engage in managing the culturally diverse patient so that I may easily impart quality care and services to the different patient.
Standards of practice for Culturally Competent Nursing Care
Along with this, there are different standards as well as practices that need to be performed by the competent nurses within the setting so that they may easily manage the client of cross-culture. The key standard of practices for professional nurse include that they must the engage in promoting social justice among their all clients (Bramhall, 2014). With the help of applying principles of social justice in the setting it support me in taking decisions related to the patient, family and other health care professionals so that I may not engage in performing wrong activities. However, through imparting this standard of practices it will assist the other nurses in developing their leadership skills to advocate for social policies. I have been encountered with the situation in setting that is patient suffering from mental illness has been treated as disadvantage and vulnerable and practitioners were not been cooperative with them as well as their family members. In this situation I have engaged in rendering care and treatment to the patient suffering from mental health problem and provided them required environment that support in assisting their health and well-being.
As per the view of Price (2006), nurses those who are providing care to the mental health patient must also focuses on patient advocacy and empowerment so that they may easily include the patient’s cultural beliefs as well as practices in the dimensions. With the help of patient empowerment they have been provided with the choice towards selecting the services that they are more comfortable with. This standard of practice has supported me in enhancing my nursing care to the culturally diversified clients and patients.
In addition to this, another standard that support me in managing the cross-cultural patients is engaging in multicultural workforce. I shall be actively involved in the work so that I may easily ensure establishing multicultural workforce within the health care settings. One of the key measures to accomplish the multicultural workforce within the mental health setting is through consolidating the recruitment and retention effort in the hospital. Apart from this, with the help of multicultural workforce in the setting it will assist me in gaining information regarding different background people that require healthcare practices and services (Morgan et al. 2017). However, the ultimate goal is to enhance the health care system as well as enabling capable workforce that results in delivering the high quality care and services to every patient without engaging in the discrimination activities related with race, lifestyle, gender, age, cultural background etc. With the help of reviewing client experience in my own practices I have assessed that prevalence of cross-cultural client in the setting is high in number that requires quality and standard services from the nurses.
In order to deliver quality services to the culturally diversified patient I have also engage in performing evidence based practice and research that has supported me in serving culturally diverse patients (ZHAO & CHEN, 2015). However, area that lack the evidence of efficacy in that case I must engage in investigating and testing different interventions that effective in overcoming the inequalities in health outcomes. I have been encountered with the situation where two patients from different background are admitted in the hospital both the patients are suffering from high depression. But in the case one patient engage in calm behavior and activities while other patient behaves weird activities in the setting. Through reviewing the activities of both the patients I have imparted same services and care to both of them that support me in performing standard of practices that manages the culturally diverse patients.
Moreover, to impart standard practices among cross-cultural clients I have been engaged in undertaking the education and training activities so that I may easily impart culturally competent care to the patient. With the help of this standard practice I have been prepared to endorse and provide culturally compatible health care among the patients. However, it has been further assessed that I must feature effective knowledge and skills that are necessary for reassuring that nursing care is ethnically compatible with the global healthcare agenda (Choi, & Lee, 2017). Along with this, it also support in further educating different practicing nurses so that they may impart the clinical practices. Moreover, education for imparting the culturally competent care mainly comprises of knowledge related with the cultural values, beliefs as well as health care practices of individuals to those clinical services has been provided. However, I may engage in preparing or drafting the activities within the setting so that I may render proper services to each of the individual.
While working as mental health nurse I must engage in using teaching methods and strategies within the setting so that it may results in understanding the diverse culture and people those who are diagnosed with the different mental health problems. Along with this, another strategy focuses on contributing towards professional development practices so that I may enhance the knowledge of other staffs and nurses within the setting.
Strategies for ensuring culturally safe clinical practice
In order to implement the standard within setting that to ensure culturally safe clinical practice I must engage in using a systems viewpoint and a socially experienced approach within the practice. With the help of considering the patient as part of family nurses may engage in knowing their perception and beliefs (Riner, Bai & Larimer, 2015). This approach will enables the nurses to identify the patients’ community, religious, political aspects as well as family resources that would support me rendering effective services that result in patient’s continued wellness, recovery as well as rehabilitation. It has been stated that with the help of cultural understanding I may easily gain information regarding the different cultural background patient along with their perception and beliefs towards undertaking the services rendered by nurses.
Another strategy for ensuring culturally safe clinical practice includes engaging in effective cross-cultural communication strategy. With the help of implementing this strategy it support me in performing proper diagnosis and treatment of patients those who are suffering from mental health conditions so that I may easily provide them comfortable environment and tools so that I may easily communicate with the different background and diversified patients those who speak different language.
In addition to this, for ensuring culturally safe clinical practice I must also engage identifying key risks that are associated with imparting nursing care so that in future it may not results in arising the situation of the ineffective clinical services (Batista, et al. 2016). The key associated risk mainly include individual factor, cultural factor as the social factor that impact the overall services of nurses. With the help of determining all the associated risk I would easily assure that cultural, values and beliefs of all the patients has been understood and then services has been imparted.
Along with this, another strategy that is imparted for ensuring that clinical practices are culturally safe is through focusing on person centred approach I have demonstrated that it support me knowing the patient as individual and empowering them to take decision by their own. Furthermore, with the help of implementing person centred approach I have also engaged in respecting the individual values and beliefs as I was accountable for supporting the patient, their family members as well as carers (Brito Vidal Batista, et al. 2016). In addition to this, with the help of implementing the legislation I have ensure proper management of activities and equipment so that it may not harm or impact the health of patients and employees. Furthermore, there are certain legislations framed by the government for enabling adequate management of culture within the setting.
Therefore, enabling such legislation and regulations would support me and other nurses in managing the cultural practices within the setting. Along with this, implementing legislation also ensure that patients are safe at the workplace. Moreover, implementing standards within the healthcare also ensure proper controlling and guidance of the activities so that it may engage in effective treatment and services to all the culturally diverse patients and their family members (Hurley, et al. 2014). On the other hand, cultural accountability also assists the nurses to transform their practices related with imparting quality care accordant with the requirement and need of the patient. While working in healthcare I was not imparting standard services as I was not aware regarding the standard. Therefore, with the emergence of professional accountability I was able to determine whom I am accountable for. Thus, it help me in transforming my nursing practices that results in improving the health condition of the patients.
In addition to this, through demonstrating cultural accountability I would engage in transforming my nursing practices by enabling pateint safety. As in the past I was unable to maintain patient safety while providing them care and service that lead to affect their confidentiality and moral aspect. Furthermore, with the help of all the such practices it support me in maintaining culturally diverse environment within the setting so that patient my not feel discriminated within the place (Watkins, Masano & Chambers, 2016). Apart from this, I have also engaged in creating a forum at their place of employment to examine cultural safety and service delivery, and the challenges of providing respectful interactions with their patient population.
Thus, creating forums within the workplace would support me in understanding the different ground of culture and beliefs so that I may engage in imparting quality and standard services. Along with this, creating forums would also support me in addressing the problem or issues that arises among the patient that were related with cultural diversity and discrimination occurs at the workplace. Therefore, as the mental health nurse I would make sure that mentally ill patients and people in the care home should not been discriminated.
Although, mentally ill patients would be provided with the proper care and treatment so that they may feel connected towards the society. However, they are not equally treated in the community so with the help of imparting proper education and learning service users and practitioners may easily engage in activities that allows management of cross cultural clients and patients in the setting.
CONCLUSION
From the above essay it has been concluded that nurses face difficulty as well as issue while rendering services to mentally ill patients as professional nurses sometime do not focuses on managing diversity and ethnic background of patient while rendering services. It has been further stated that with the help of using an ethical and lawful standards by the nurses would ensure the patient wellbeing and respecting their culture.
REFERENCES
Bramhall, E. (2014) ‘Effective communication skills in nursing practice’, Nursing Standard, 29(14), pp. 53–59. doi: 10.7748/ns.29.14.53.e9355
Brito Vidal Batista, J., Carlotto, M. S., Nunes de Oliveira, M., Lacet Zaccara, A. A., de Oliveira Barros, E., & Costa Souto Duarte, M. (2016). Mental disorders in university teachers: study in a service of medical investigation. Revista de Pesquisa: Cuidado e Fundamental, 8(2).
Batista, J. B. V., Carlotto, M. S., Oliveira, M. N. D., Zaccara, A. A. L., Barros, E. D. O., & Duarte, M. C. S. (2016). Mental disorders in university teachers: study in a service of medical investigation. Revista de Pesquisa: Cuidado é Fundamental Online, 8(2), 4538-4548.
Choi, Y. O., & Lee, J. (2017). Impact of Stroke Knowledge, Fear of Recurrence on Health Behavior in Patients with Ischemic Stroke. Korean Journal of Adult Nursing, 29(3), 302-312.
Hurley, J., Browne, G., Lakeman, R., Angking, D., & Cashin, A. (2014). Released potential: a qualitative study of the Mental Health Nurse Incentive Program in Australia. International journal of mental health nursing, 23(1), 17-23.
Marshall, D. A.-L., Crown, W., Padula, W. V., Wong, P. K., & Osgood, N. D. (2015). Selecting a dynamic simulation modeling method for health care delivery research—part 2: report of the ISPOR Dynamic Simulation Modeling Emerging Good Practices Task Force. Value in health. 18 (2), 147-160.
Morgan, H. M., Entwistle, V. A., Cribb, A., Christmas, S., Owens, J. & Skea, Z. C. (2017). We need to talk about purpose: a critical interpretive synthesis of health and social care professionals’ approaches to self?management support for people with long?term conditions. Health Expectations , 20 (2), 243-259.
Price, B. (2006). Exploring person-centred care, Nursing Standard, 20 (50), pp.49-56.
Riner, M. E., Bai, J., & Larimer, S. (2015). Intercultural global health assessment and reflection framework for teaching study abroad courses. Journal of Nursing Education and Practice, 5(5), 65.
Tetley, J. & Draper, J. (2010). ‘Slaying the myth’ of the over-qualified nurse: The graduate nurse and older people, International Journal of Older People. 2(1). pp. 33-53.
Watkins, L., Masano, N. R., & Chambers, B. (2016). The Development and Progression of Service Learning Throughout the Nurisng Curriculum.
ZHAO, N., & CHEN, J. (2015). Indicator system for internal service quality of community health services.
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