2013 Winning Essay
A. The movie "A Nurse I Am" provides a wealth of insights and approaches to be considered by future nurses, new nurses and seasoned nurses. According to Joyce Newman-Giger, "When nurses consider race, ethnicity, culture, and cultural heritage, they become more sensitive to clients.” Considering this statement, what two nurses in the film seem to best portray or consider the importance of culture in their approach to patient care? Explain why.
B. The United States thrives as an expanding multicultural pluralistic society. As a nurse, how and why will you step forward to offer culturally competent care?
There are many essential skills that a nurse must possess in order to provide total holistic care to his or her patients. Cultural competence, though often underestimated, is extremely important in this process. As a nurse, one of our primary responsibilities is to advocate for our patients. How can we advocate effectively for a patient without having an adequate understanding and respect for their background, beliefs, and experiences? As I look forward to a career in nursing, I believe it is of utmost importance to be a nurse who practices good holistic care, treating the whole person, not just the disease. The film, “A Nurse I Am,” provides excellent role models. I was particularly impressed by Mona Counts and Bob Wilkinson. Both demonstrated tremendous cultural competence: Mona excelled in her work with an indigent population, and both Mona and Bob showed incredible skill in dealing with the cultures of different age groups.
Cultural competence takes more than simply knowledge of various cultures. True cultural competence is a multifaceted process, which begins with a personal awareness of one’s own culture, and most importantly one’s own prejudices. As open minded as we all would like to believe we are, I think it is inevitable that as we grow and learn through our own experiences we develop certain biases, perhaps without realizing. My first step towards culturally competent nursing practice will be to recognize my own biases, and to work diligently to make sure they do not interfere with my practice. By remembering this I will be more open to considering other beliefs. In addition to learning about other cultures it is important to avoid a sense of dominance, and let go of that feeling that “my way is superior.” I think Mona provides an excellent example of this. At one point in the film she is interviewing a patient, Roxie, who reveals quite a bit of information about her background. She shares that she has a sixth grade education, as well as a lengthy list of health problems and risk factors. Mona may not understand or agree with some of Roxie’s decisions regarding her health, but she never acts judgmental or demonstrates a sense of superiority. In fact, not once in the film do we see Mona act with an air of superiority. She works with her patients to address the problems important to them, in a way they can manage. She speaks to her patients as equals, as friends, always at eye level, even if this requires sitting on the floor. She allows them to interrupt her family breakfast, invites them into her life, and shows interest in theirs.
Other crucial aspects of cultural competence in nursing involve asking patients when you don’t know about a cultural practice or belief, being sensitive to things you don’t understand, and being flexible and open to things you may not be familiar with. A nurse must do his or her best to find a way to accommodate the beliefs or practices of a patient. Doing this will allow for much better relationships with patients. If we consider age as culture we can look again at Mona, who was sensitive to the wishes of her elderly patient who wanted to remain in her home. She provided home visits and many alternative interventions to keep that patient in her home. Bob works with youths battling cancer, and while he cannot necessarily provide them alternatives to hospitalization, he does his best to accommodate both his patients and their parents. He sings, jokes, and distracts with stories, questions, and toys. Bob cannot guarantee these children a cure, and he probably cannot understand how a child perceives illness, but whether it is asking about Steak ‘n Shake or gifting a special action figure, he finds a way to provide comfort. Bob and Mona are both truly remarkable nurses.
Living in Boston my entire life, I hope to be able to give back my home by working in one of its many hospitals. Like most cities, Boston is incredibly diverse, with many converging cultures, subcultures, and socioeconomic backgrounds. As a nurse I will endeavor to emulate the nurses featured in the film by striving to provide culturally competent care, and to remember how incredibly valuable cultural knowledge and sensitivity are in building a trusting relationship with my patients. I will strive to always remember to ask when I don’t know, be open minded when things are unfamiliar, and to try to find a way to accommodate my patients’ beliefs.