"When you get those rare moments of clarity, those flashes when the universe makes sense, you try desperately to hold on to them. They are the life boats for the darker times, when the vastness of it all, the incomprehensible nature of life is completely illusive. So the question becomes, or should have been all a long... What would you do if you knew you only had one day, or one week, or one month to live. What life boat would you grab on to? What secret would you tell? What band would you see? What person would you declare your love to? What wish would you fulfill? What exotic locale would you fly to for coffee? What book would you write?"

Wednesday, January 20, 2010

Stereotyping and “Cultural Awareness”

Classes started today. Well, yesterday really, but today I have seen all my classes (I have two). They seem to be pretty much what I expected. My Psychiatric mental health class Lecture seems to be a lot more interesting than I would have expected, but still hard. She told us she was the "APA Paper grading queen". Needless to say that's not good. But everything she taught today I agreed with wholly so I think I will like her, in terms of nursing and being a good nurse.

"Culturally Competent", "Practice good, cultural awareness", "Know your patients culture, their beliefs and practices".

These are all phrases I've been hearing the past…three courses in my Nursing program. Except today. All this time we have been taught to professionally accept each and every culture, each patient for who they are. Which is all good and well, however, the way we've been taught is to read their chart, see they are of a certain culture/ethnicity (sometimes it doesn't list their culture per say) and we have to reference a book, or a chart of some kind, to plan how we are going to act or what we might say when with our patients. All this time I've done what I was told, whatever, I need to get the grade, right? In my recent experience, my last clinicals (Peds and OB), I had a patient of my own each week. First things first, people naturally look at names and make assumptions. I try not to, I really do, but everyone does. Second, it lists their primary language. I can't help but groan when it says something other than English. But I consider that understandable…it will be hard to communicate with my patient for the entire day. OK so then we have to make a plan for them based on their culture. But sometimes (more than not), I consider their culture to be….American! Is that such a thing? I meet them and they practice nothing out of the ordinary…no specific religious beliefs or practices, no specific foods they eat or health practices specific to them, no anything. Another time I had a patient that was from the Congo and moved here when she was 16, now she is mid-twenties. I thought, while reading her chart that boy, I am going to have an interesting day. But I met her and low and behold, perfect English, was just as "American" as you or me.

The point I'm trying to make here ( I promise there is one) is what my teacher pointed out…Exactly what I've been thinking all this time. That patients cannot be categorized by culture! I can't look at a chart and see "Asian" and plan my whole day based on if they think it's rude or not to make eye contact, be in personal space, eat certain foods, etc. She made the point that yes, keep it in mind, all those lovely things, but never act on them until you get verification from the patient. Meaning, meet your patient, make your assessment, ASK THEM if you haven't already figured it out, what they eat, if they have any specific cultural practices, if they need certain special needs met. Nurses can't be mind readers. Yes, we are naturally good at picking things up in our assessments but we can't automatically know. Thing is, if we see someone is Indian let's say, even if I know everything about the specific Indian culture (which I don't, trust me), I can't be positive that he/she even agrees with his own culture! You have to ask not assume.

I guess I consider myself American, as much as I squirm when I say that. No, I'm not unpatriotic; I love my country, most of the time. However the term "American" in other countries generally brings about a bad name, bad reputation. Yes, I have eaten McDonalds in my life, yes, I have a cell phone, an ipod, a laptop, whatever. I guess it depends who you ask, but Americans are usually portrayed as "Lazy, fat, want things done without having to do them, etc.". If I travelled to another country and needed healthcare, and they saw I was American, how would they treat me? I certainly wouldn't want them to base anything after any stereotype they might have, before they met me and then made their plan of care.

That's another point. I hate Western Medicine. Western is generally deemed what we practice here in America. Doctors are very different here, things are different in general. How we do things, how we come to diagnoses, how we do procedures, how doctors dish out drugs first thing without solving the initial and primary problem ( I really hate that). Eastern medicine (Europe, Asia, etc.) does things very differently and I can only pray America can learn, or so help me I'm moving across seas. They solve problems holistically, they approach things differently. They treat the body as a whole, not systemically. They turn to alternative methods before procedures, unnecessary tests, drugs…And as for the medical portion, I consider them to be far ahead in terms of research.

Well I need to research this topic before I say anything else. It bothers me a lot and is very important to me. I have to go switch my laundry now, but I might go back and edit this and add more later on…Til then, toodaloo!

~A Writer in A Nurse's Body

No comments: