Dr. Brent Williams: Cultural Competence In Nursing

Cultural competence plays an important in medicine. It allows for smooth interaction with patients and their families. “Culture is often described as the combination of a body of knowledge, a body of belief and a body of behavior. It involves a number of elements, including personal identification, language, thoughts, communications, actions, customs, beliefs, values, and institutions that are often specific to ethnic, racial, religious, geographic, or social groups.” ("Cultural Respect", 2017) Many providers and healthcare staff still struggle with cultural competence because they don’t take the time and effort to learn about the different backgrounds that flow in and out of hospital around the country. In the case of Dr. Brent Williams,

his lack of knowledge and unwillingness to learn is straining his relationship not with his patients but his staff.

His interaction with the first patient is a prime example of how a provider and patient interface should go. He takes his time with the mom and makes sure she understands why the child needs the CPAP and he listens to his staff and their concerns. His interaction with the second and third patient differs from the first and it’s all wrong. His remarks about the African American family comes off as racist and his remarks about the Asian family shows that he doesn’t care about other cultures or their belief. He is showing that he doesn’t care about their culture and how they view illness. Dr. Williams poor communication skills and how he presents himself is driving patients away and causing a rift between him and his staff. He isn’t aware that not all culture believes in western medicine and some culture believe in a higher calling when it comes to dealing with sickness and illness. Dr. Williams should have asked for help from his nursing staff or other providers who is familiar with Sudanese culture or Asian culture. His disturbing behavior and lack of culture competence lead to patient not trusting and

leaving his practice.
Culture, ethnicity, race, and socioeconomic status influence how patients and their families comprehend health concepts, and what decisions they need to make that is related to their health.

Without appropriate the training and education, healthcare providers and staffs are delivering medical advice that goes against people belief and cultural practices. Disparities such as race and socioeconomic plays a huge role medicine. It would be a lie to say medicine is even across the board and there are no disparities among minorities and other racial group when it comes to treatment. Dr. Williams’ scenario is an example of the unfairness that patients experience when they go to clinics and hospitals. Millions of minorities group receive subpar medical care due to race and ethnicity or economic background. “There is evidence that socioeconomic status (SES) affects individual’s health outcomes and the health care they receive. People of lower SES are more likely to have worse self-reported health, lower life expectancy, and suffer from more chronic conditions when compared with those of higher SES. They also receive fewer diagnostic tests and medications for many chronic diseases and have limited access to health care due to cost and coverage.” (Aprey, Gaglioti & Rosenbaum, 2017) Families of a different race and culture will always experience inequalities in healthcare because of disparities in the systems. The outcome for many families when they experience negative visits turns to

distrust of western medicine and the medical staff. When families experience a negative visit because their race or culture, they have seconds thought about going to hospitals and clinic. They will turn to alternative methods of healing and getting better.
Reducing health disparities is a major goal of Health People 2020. Healthy People 2020 describes “disparities as particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.”("Disparities | Healthy People 2020", n.d.) In healthcare, most of us refer to disparities as gender, age, or race but there are other factors that lead to disparities in healthcare. One of the biggest disparities is income. “People with lower incomes typically have less money to spend taking care of themselves, whether paying for visits to the doctor, medicine, or healthy food. Stress associated with a lower income, especially during childhood, increases risk for heart disease, stroke, cancer, and diabetes.” (Kincaid, 2015) One unusual factor the influence health disparity is location. People don’t realize that location greatly affects your health. “Many rural minorities are employed in occupations that involve exposure to environmental hazards and injury. These problems are compounded by a shortage of health care providers and limited access to health care. The shortage of health care providers is an even greater issue when addressing rural racial and ethnic disparities as there is evidence that a black or Hispanic patient is more likely to seek care from a clinician of their own race because of personal preference or language, and not only because of geographic proximity.” (Morgan, 2014) There are hundreds of factors that influence disparities in healthcare but income is the most common barrier and location is an uncommon barrier and people don’t realize that it does their healthcare.