Transcultural Nursing Care

The primary premise of transcultural nursing care is based on the comparative study and assessment of different cultures and ethnicities. It is also a branch of nursing. The factors which are considered and examined for the different groups touch on the care behavior, nursing health, disease, values, philosophies, and patterns of behavior. It remains a fact that no culture is completely similar to another since each has its own way of dealing with aspects such as death, distress, and illness. Some cultures have a high tolerance for pain while others are in the contrary. As such, it is important for the nurse to provide the appropriate care that involves a consideration of one’s culture and belief system (Smith & Parker, 2015).

            The theory of cultural care diversity and universality has developed into a critical caring theory with a particular focus on how nursing can be a method of helping one to understand and assist cultures.  The factors associated with cultural based care function as a significant influencer on human expressions connected to health, disease, quality of life and death. As such, Leininger postulates that the element that makes people human and offers them dignity and helps in healing is human care. As such, she stated that there can be no curing without caring, but the latter can exist without healing.

            As such, this theory gave rise to transcultural care that has been legitimized as a formal area of research and practice with a focus on cultural care and values. The role of transcultural nurses is to become the link between cultural communities and healthcare. In this regard, nurses can take up the role of carrying out different responsibilities to ensure that the patient has become culturally oriented as much as possible. In some instances, the nurse has to enter into negotiations and educate while also remaining respectable to the cultural beliefs of the patient to ensure the delivery of high quality care.

Case Study

            In this case study, the patient named Mrs. Franklin-Jones is described as a person who has her origins from Jamaica. She has been diagnosed with high blood pressures and recent diagnoses point to an acute myocardial infarction. However, her recovery has as was expected. The study also mentions the fact that her mother died from hypertension and even though she has been trying to adhere to her medications for hypertension, she has become forgetful on a number of occasions.

            On the other hand, she mentions that her sister would soon arrive from Jamaica with bush tea which she presumes will help in treating her hypertension condition. It is a cultural fact that Jamaicans have a high affinity for herbal tea, or as is described by Mrs. Franklin-Jones in this case, bush tea, augmented by the fact that she strongly believes that this herbal tea will cure and give remedy for her ailment and disease.

            Accordingly, in the process of Nurse Hernandez planning to discharge Mrs. Franklin-Jones from hospital, she must educate the patient on herbal tea. In this case, she must inform the patient on the fact that herbal tea is a form of hot or cold beverage and is not necessarily a cure of ailments and diseases. Furthermore, there exist some herbal teas that contradict the medications given at the pharmacy and the nurse should compassionately inform Mrs. Franklin-Jones to report to her doctor the kind of herbal tea she plans on using. In this line, there have not been any proven research that has highlighted the medicinal benefits of using herbal tea in the treatment of cardiac diseases. The implication is that it would be a more preferable option for the patient to adhere to her medications as was prescribed by her doctor and seek advice from her doctor on the best tea that is appropriate for her health.

Importance of the Cultural Care Diversity and Universality

            The theory of culture care diversity and universality has become a vital ingredient in healthcare. The reason is its birthing of transcultural nursing which has morphed into a fundamental requirement for nurse in practice today due to the rise in multiculturalism in the American populace. As such, the U.S Bureau of the Census reported that around 38% of the population is composed of other ethnicities other that non-Hispanic whites. The implication of this statistic is that the United States has transformed into a highly multicultural population today. In the same line, the proportion of persons who will comprise of non-Hispanic whites will consist of 50.3% of the population by 2045 (Brookings Institution, 2018).

            However, even though there has been a significant change in the demographic characteristics of the U.S population, the homogenous aspect of nurses has remained largely the same. In this line, it is an issue that around 76.3% of the registered nurses are White has escalated the need for addressing the issue of transcultural nursing (Data USA, 2018). Since there is a rise in multiculturalism in the U.S, transcultural nursing is important for nursing care which requires nurses become culturally competent in their practice. Having cultural knowledge that help to identify cultural patterns of a patient will help the nurse in formulating individualized care plans that will help in meeting the agreed upon healthcare objectives for the patient.

            Another important aspect of culturally based care is the fact that provision of care has to be holistic. Such an approach involves addressing the physical, mental, social, and psychological needs of a patient. Since holistic care involves a plan of care for meeting the individual needs of a patient, there is a need for nurses to take into consideration any cultural differences in their care plans. As such, this mandates nurses to offer holistic care since their care plans have been premised on the individual needs and cultural aspects of the patient. Furthermore, this underscores the importance of culturally based care because it makes nurses culturally competent for optimal provision of care.

Nursing Care Plan

Assessment

            Subjective. The patient reports of surprising pains in the chest.

            Objective. Being restless, grimacing, fatigue, difficulty in breathing, pain scale of around 8/10, and a weakened pulse.

Diagnosis

            Acute myocardial ischemia due to coronary artery occlusion which prevents the flow of blood to a location in the myocardium and necrosis of the myocardium.

Planning

            After one hour, the patient will have an improvement in chest comfort evidenced by:

STG. The chest pain rating will be lower, reduced tension and increased rest.

LTG. The patient will report more control over her present condition after two days of the intervention.

Intervention

     INDEPENDENT. Assess the extent of pain and require the patient to rate pain on a pain scale, obtain familial history of cardiac problems, allow patient to use bush tea at particular periods, and prepare for medication.

     DEPENDIENT. Get a 12-lead ECG when admitted, administer analgesics, and administer beta blockers as per doctor’s instructions.

Rationale

Pain is an indication of myocardial infarction and collaborating with the patient can help in distinguishing between various kinds of pain. Mrs. Franklin-Jones will also have to bring her bush tea to the hospital so the doctor can see what it contains.

Strength and Limitations.

One advantage of the culture care theory is that it makes nurses become culturally sensitive thus responding to the patient’s needs more effectively. The theory can be highly generalized due to the abstraction of the relationships between nurses and patients. Leininger’s theory postulates that care is the core of nursing, a contrast to other theories that focus on people and the environment. On the other hand, weaknesses include the fact that it can have some errors due to the misperception of the outcomes and the value patients place on the results. There is also the possibility of Leininger’s theory causing cultural shock to nurses and also the theory does not highlight the aspect of the disease, symptoms or treatment.

Assumptions of Transpersonal Caring Relationship

            The assumptions that inform Jean Watson’s theory of human caring form the groundwork for the theory of caring. The first assumption is that they only way caring can be practiced effectively is interpersonally. As such, personal contact is key for the occurrence of caring. Secondly, caring is composed of carative factors responsible for meeting particular human needs. Thirdly, effective caring is responsible for the promotion of individual and family growth which in turn can add on to the overall wellbeing of the patient and the patient’s family. Fourthly, the care response consider a person now and in the future. The fifth one is a caring environment that promotes development and the chance for the patient to make choices about their health. The sixth one is that caring is healthier than curing and acts as a complementary. The final seventh one is caring is core to nursing practice thus to improve the health and wellness of patients, nurses must practice caring.

            The mode of application of Watson’s theory is through the ten carative factors. As such, the implication is that a practicing nurse engages their emotions in the caring relationship thus they are not averse to new spiritual and emotive experiences while delivering care. In essence, this highlights the role of the nurse under Watson’s theory. Furthermore, Watson’s theory defines love as honoring the rituals, wishes, and needs of a person. In this case, the nurses asked Jean-Baptiste about his customs and beliefs and how they could honor them and is further encouraged to bring food and spiritual items to share in his culture with the nurses.

            One way that nurses can creatively use self to create a healing environment is by using role play. In this case, presenters cane share the significant of caritas processes by acting out interactions between nurses, nurse and patients, and nurses and physicians. It can also involve authentically being present and listening to the patient reminisce and a colleague nurse sharing in the concerns of their colleague (Caruso et al., 2008).

            Some of the strengths of Watson’s theory is the fact that is it easily understandable thus help in providing holistic care. Watson’s theory also uses nontechnical and fluid language to describe her concepts. Furthermore, the carative factors are premised on wide assumptions that offer a supportive framework. On the other hand, a weakness in Watson’s theory is that it does not offer a clear direction on the steps to take in offering caring-healing relationships that are authentic (Watson & Woodward, 2010).

References

Brookings Institution. (2010). The US will become ‘minority white’ in 2045, Census projects. Retrieved from https://www.brookings.edu/blog/the-avenue/2018/03/14/the-us-will-become-minority-white-in-2045-census-projects/

Caruso, E. M., Cisar, N., & Pipe, T. (2008). Creating a healing environment: An innovative educational approach for adopting Jean Watson’s theory of human caring. Nursing Administration Quarterly, 32(2), 126-132.

Data USA. (2018). Registered Nurses. Retrieved from https://datausa.io/profile/soc/291141/

Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice. FA Davis.

Watson, J., & Woodward, T. K. (2010). Jean Watson’s theory of human caring. Nursing theories and nursing practice, 3, 351-369.