Cultural Safety and the Family Systems Model applied in Nursing
Cultural Safety and the Family Systems Model are concepts that have been incorporated into today’s nursing practice. This paper supports the view that all nursing care goes beyond the individual patient (client). Nursing Care must ensure equality in all groups of people and must include the family unit when caring for a client.
Andrew is a 1 year 10 month old boy. He was born premature and was hospitalized after birth with RSV (Respiratory Syncytial Virus). Recently, he has been brought back to the hospital by his mother Rachel. She is a post-partum doula and has a strong belief system which includes; not immunizing children, and adhering to natural and herbal remedies only. In
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The first concept, Cultural Safety, is relatively new. It emerged in New Zealand and has been incorporated into the Canadian Health Care Systems. Dr. Irihapeti Ramsden developed the concept to promote awareness of cultural differences and to recognize the inequities present in health care. (Ramsden, 2002).
“Cultural Safety is a term used to describe a way of working with people of different cultural backgrounds that does not diminish, demean or disempower someone” (Nursing Council of New Zealand, 2009). Cultural Safety allows a nurse to examine their beliefs, values and culture, and to understand how these might affect the client with their different cultural understandings. Cultural Safety supports partnership relationships and helps to diminish power struggles that can occur within healthcare service institutions. The goal is to make these power struggles evident so that both parties can negotiate how they can work together and ensure that the client receives the appropriate respectful care (Nursing Council of New Zealand,
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“The Family Systems Model is a theory introduced by Dr. Murray Bowen that suggests that individuals cannot be understood in isolation from one another, but rather as a part of their family, as the family is an emotional unit” (Family Systems Theory, 2018). What happens to the family as a whole affects each individual family member, and what happens to individuals affects the entire family unit. Focus is on the circular interactions among members of the family system, resulting in functional or dysfunctional outcomes. Family members affect each other's thoughts, emotions, words, and actions. Even when we try not to be affected by our families, we often are still influenced by them. When family members get tense, the anxiety becomes contagious. This can lead to family members becoming overwhelmed, isolated, or feeling out of control. That anxiety can lead to other problems such as alcoholism, and physical illness (Family systems theory,
Family systems have been studied since psychologists began studying people and their behaviors. The family is a dynamic system—a self-organizing system that adapts itself to changes in its members and to changes in its environment (as cited in Sigelman & Rider, 2009). Allowing the focus of a family system to grow beyond the mother and child relationship did not happen overnight. For many years, there was no connection made between other members of the family and the developmental issues of the children involved.
McClimens, A., Brewster, J., & Lewis, R. (2014). Recognising and respecting patients ' cultural diversity. Nursing Standard (2014+), 28(28), 45.
In a study, Li writes, “Healthcare team performance may be hindered due to the different cultural backgrounds of the nurses” (2014, p. 316). A report mentions that the IENs have less confidence in providing culturally competent care to the patients of the different culture due to lack of understanding of health beliefs, values and behaviors of that culture (Lampley, 2008). For instance, in Philippines, most of the decisions are made by the doctors. Nurses just follow doctors’ order in decision making (Tregunno, et al., 2009). But in Canada nurses are required to be more assertive and actively involved in decision-making and have more responsibility and accountability regarding patient care. Further, Canada is a multicultural country and
...ir personal encounters with Aboriginal classmates that they might have had in high school. Life experiences, parental upbringing, ethnic roots, social status and education all shape nursing practices. Nurses and other health care professionals are trained in institutions that fail to recognise the socio-political injustices that occur in health care settings. In addition to this, their experiences in their work and in their personal lives and communities, they already have opinions about certain groups of people. “Cultural safety would encourage nurses to question popular notions of culture and cultural differences, to be more aware of the dominant social assumptions that misrepresent certain people and groups, and to reflect critically on the wider social discourses that inevitably influence nurses’ interpretive perspectives and practices” (Browne, 2009, p. 21).
In understanding others, one must first understand our own family background and how it affects our understanding of the world. Conversely, family systems draw on the view of the family as an emotional unit. Under system thinking, one evaluates the parts of the systems in relation to the whole meaning behavior becomes informed by and inseparable from the functioning of one’s family of origin. These ideas show that individuals have a hard time separating from the family and the network of relationships. With a deeper comprehension of the family of origin helps with the challenges and awareness of normalized human behaviors. When interviewing and analyzing the family of origin, allow one to look at their own family of origin
Issues of culture are often controversial. LaBorde (2010) has noted that culture is always a factor in conflict. Ironically, conflict can provide nurses with an excellent opportunity for developing compassion that will lead nurses unto a place of meeting in which there is a deep respect for differences and equally intentional openness to the possibility of connection. Healthcare practitioners are confronted in a daily basis with the practical manifestation of these issues. In particular, nurses are more confronted by cultural issues than the other healthcare providers because nurses spend majority of their time with patients. However, some nurses are reluctant to confront and discuss the cultural issues because of lack of knowledge in dealing with patients of diverse cultures (Tjale & Villiers, 2004).
As a nurse, I am obligated to care for all cultures, and try to understand their values, beliefs, spirituality, gender roles, and language. Cultures can range from different families, environments, disabilities, or even genders. It is a very broad topic, and I hope to recognize these cultures in my nursing career. Some barriers may exist that can make it challenging to work with people of a different culture, but it is possible to overcome these with the resources within the health care system. The Health Policy Institute identifies that “[t]he goal of culturally competent health care services is to provide the highest quality of care to every patient, regardless of race, ethnicity, cultural background, English proficiency or literacy” (“Cultural Competence”, 2004). Additionally, cultural competence is an ongoing process that involves both the client, and health care professional to work together that best suits the client’s
Integrating the framework will enable nurses to become culturally competent health care providers. First and foremost, the framework permit patients’ the opportunity to express their concerns and perception of their problem (Campinha-Bacote, 2011). Additionally, it focuses on incorporating the patients beliefs, values, and needs into the plan of care. The framework further give nurses an opportunity to better understand and evaluate their patients’ concerns. Campinha-Bacote (2011) reported that continuous encounters with culturally diverse backgrounds will lead nurses to validate, refine, or modify what they know of existing values, beliefs, and practices of a cultural group. This in turn, will develop into cultural desire, cultural awareness, and cultural knowledge. With the end result, being cultural
Since the 20th century, researchers have sought out solutions to help assist families and the individual components that make up family systems overcome the challenges and schisms that can inhibit individuation and stability. Two theoretical perspectives, the family-systems theory and the family-development theory, were conceived to gain as Balswick & Balswick (2014) noted, gain “a wide-angle view of family life” (p. 22). Though these two theories have merit, one I found to be more advantageous in gaining a better understanding of the family as an actively metastasizing organism, which needs to be approached more adaptively.
Providing culturally competent care is a vital responsibility of a nurse’s role in healthcare. “Culturally competent care means conveying acceptance of the patient’s health beliefs while sharing information, encouraging self-efficiency, and strengthening the patients coping resources” (Giddens, 2013). Competence is achieved through and ongoing process of understanding another culture and learning to accept and respect the differences.
Cultural competence can be defined as using the ability of one’s awareness, attitude, knowledge and skill to effectively interact with a patient’s many cultural differences. Madeline Leininger, a pioneer on transcultural nursing describes it this way; “a formal area of study and practice focused on comparative human-care differences and similarities of the beliefs, values and patterned lifeways of cultures to provide culturally congruent, meaningful, and beneficial health care to people” (Barker, 2009, p. 498). The importance of cultural diversity in healthcare allows for the delivery of appropriate cultural autonomy. Showing respect for others will lead to trust between nurse and patient which in turn improves healing and health.
Transcultural nursing requires us to care for our patients by providing culturally sensitive care to a broad spectrum of patients. The purpose of this post is to describe cultural baggage, ethnocentrism, cultural imposition, prejudice, discrimination, and cultural congruence. I will also give an example of each term to help you understand the terminology related to nursing care. I will define cultural self-assessment and explain why it is valuable for nurses to understand what their own self-assessment means. Finally, I will describe the five steps to delivering culturally congruent nursing care and how I have applied these concepts to my nursing practice.
In health care, there are many different approaches throughout the field of nursing. When considering the field of family nursing, there are four different approaches to caring for patients. This paper will discuss the different approaches along with a scenario that covers that approach. The approaches that will be discussed include family as a context, family as a client, family as a system, and family as a component to society. Each of these scenarios are approach differently within the field of nursing.
As a nurse strive to provide culturally sensitive care, they must recognize how their client's and their perceptions are similiar as well as different. Nurse enhance their ability to provide client-centered care by reflecting on how their beliefs and values impact the nurse-patient relationship. To provide appropriate patient care, the nurse must understand her/his culture and that of the nurse profession. Cultural biases can be particularly difficult to identify when the nurse and client are of a similar cultural backgroup. When we recognize and know a culture, we will know what is right for our patient, and thus may impose our own values on the client by assuming our values are their values. Recognizing differences a present an opportunity not only to know the other, but also to help gain a greater sense of self. In this paper, I will explain more about diversity and cultural competence in case study.
Madeleine Leininger is a nurse who realized that cultural care was an important concept in nursing. In the 1950s she found that behavioral issues in children stemmed from a cultural basis due to nursing having a lack of knowledge in a variety of cultural awareness (Buschur-Betancourt, 2015). The purpose of this paper is to identify the eight reasons Madeleine Leininger states transcultural nursing is necessary. I will describe the cultural diversity and how it relates to my field of nursing. I will also provide three ways that I have incorporated culturally sensitive care toward my patients.