Personal Essay On Autoethnography Of Culture And Diversity

Autoethnography of Culture and Diversity

“Questioning the ostensibly unquestionable premises of our way of life is arguably the most urgent of the services we owe our fellow humans and ourselves” (Bauman, 1998, p. 5). As a result, my way of life and the health care services I provide are shaped by my personal assumptions and beliefs while influenced by my father, mother, and their ancestors. Consequently, this paper will evaluate my personal assumptions and beliefs regarding my culture, religion, and diversity and how these factors influence how I view myself, patients, members, and my community. Lastly, an assessment and plan of care for specific individuals, groups, and communities, using appropriate epidemiological principles will be presented.

More specifically for this assignment, these personal assumptions and beliefs will be explored when dealing with a specific population group, members diagnosed with multiple sclerosis, MS. According to the World Health Organization, MS usually begins between the ages of twenty and fifty with the disease twice as common in women as in men (World Health Organization, 2008). In 2013, about 2.3 million people were affected globally with rates varying widely in different regions and populations (World Health Organization, 2008). Furthermore, MS is the most frequently seen

demyelinating disease with the prevalence varying considerably as the highest rates are in North America and Europe and the lowest rates are in Eastern Asia and sub-Saharan Africa (Leray, Moreau, Fromont, & Edan, 2016).
Assessment
My personal assumptions and beliefs regarding ethnicity, culture, and religious background was influenced by my father, mother, and their ancestors. For example, my mother’s and father’s ancestors, my great, great grandparents emigrated from central Europe to the United States. This ethnicity will play out in my disproportional health position, a Caucasian female of European descent diagnosed with multiple sclerosis at age twenty-six.
However, to assess my personal assumptions and beliefs regarding culture and diversity requires more than knowledge of my ethnicity. A review of my past, present, and future will be required if I am to have an impact on the provision of culturally competent nursing care. Once an assessment of the past, present, and future is completed, a plan of care for the individuals diagnosed with multiple sclerosis can be implemented.
To begin my autoethnography, I must explain that I was born in Frankfurt, Germany November 12th, 1972. My father was serving in the U.S. Army and my parents were living in Aschaffenburg, Germany. However, my father would complete his enlistment obligations to the Army when I was two years old. Our family of three, at this time, would return to my father’s hometown of Quasqueton, Iowa which was also near my maternal grandparents’ farm.
My parents would have three more children and our home remained in Quasqueton, Iowa, near the Wapsipinicon River, surrounded by corn fields, and close to grandparents, aunts, uncles, and cousins.

Although my mother did not work outside the home, she worked diligently, relentlessly, and efficiently in our home. I can recall her baking and selling cakes, babysitting for other mothers, and preparing balanced meals as we enjoyed the luxuries of an organized, clean, well-maintained ranch style home that my father had built. Her day started before her kids woke up in the morning and didn’t end until late in the evening, long after we were in

bed.
Although Quasqueton, called “Quasky” by the natives, was a town of less than six hundred people, my three siblings and I had plenty to keep us busy, most of which was for our own entertainment. I was very active in my church, a Union Protestant church, attending Sunday school, youth group, church, choir, and playing the organ. I also had a lot of friends with similar interests.
Despite the fact only thirty-six students were at East Buchanan, a public high school class that encompassed three small towns in this rural community, I was very involved in school, enjoyed learning, and various extracurricular activities. A highlight was the band director selecting me to tour Europe with the Iowa Ambassadors of Music. Although, I was not able to visit the city where I was born or the town where I lived in my first two years of life, I experienced Europe’s sights, sounds, and attractions with other musicians.
In spite of the fact I was busy with all these activities, the summer of 1986 my mom learned of the nearby hospital’s request for the orientation of candy stripers, now known as hospital volunteers, about twenty miles from our home. In summary, caring for people seemed to be my calling as volunteering as a candy striper in 1986 led to completion of a certified nursing assistant, CNA, class in 1987. However, a paid CNA position quickly followed, and I graduated from Luther College in Decorah, Iowa with a bachelor’s degree in nursing in 1995.
Potential Personal Conflicts of Interest
As I recall, it was 1992 and I was enrolled in a pathophysiology class learning about neurological disorders. However, it was multiple sclerosis that peaked my interest as I studied that patients were often diagnosed in their twenty’s and I was about to turn twenty. As I studied further in my maternity nursing class, family planning decisions are even more complicated when multiple sclerosis is present.
Although I wanted to be much like my hard-working, caring mother, I dreamed of finding the right husband and having children, but two would be plenty as I wanted a nursing career after graduation. Unbeknownst to me, I would be introduced to my future husband in April of 1993. He was living in a small town near Quasky while I returned to Luther College to finish my bachelor’s degree.
However, my plans were disrupted as a neurologist explained to me and my boyfriend, the results of the magnetic resonance imaging (MRI) scan of my brain. Dr. Worrell, MD, now retired from the University of Iowa Hospitals and Clinics pointed to areas of the brain where the myelin sheath of the nerve cells were damaged. He further explained the damage was disrupting the ability of the nervous system to communicate which would explain the facial dropping, numbness, and stroke-like symptoms I was experiencing after the annual influenza vaccine I received at my workplace, Lutheran Homes.
The day was exhausting as I shared my medical history, an episode of blurry vision about a year earlier that had resolved within two days. Of course, I sought an eye exam from an ophthalmologist at the time, but he described most likely I had a virus as the blurry vision resolved so quickly but multiple sclerosis was a possibility. More than a year had passed since I had thought of that blurry vision episode and Dr. Worrell did his best to describe treatment options and their attempts to improve function after an attack and prevent new attacks.
Plan of Care
Fortunately, my boyfriend would decide he would propose marriage despite my multiple sclerosis diagnosis. However, my plan of care may have been different had I received culturally competent care. In November of 1997, although I complied with Dr. Worrell’s 500 mg prescription of oral methylprednisolone for five days, I decided not to begin an interferon injection he recommended, Avonex.
I was conflicted and needed time alone to process my thoughts. With this illness came an awareness of loss, a question of possible causes, and a lot of uncertainty regarding how or if the disease with manifest and my future. My first thought was that I was not deficient in a medication named Avonex, a drug that is a treatment but not a cure. My second thought was if the injectable interferon medication is not a cure and I can’t change my European ancestry, what can I change? Was the disease caused by the environmental toxins from the fields near my home or the Luther College campus, a virus, foods I’ve eaten or haven’t eaten, stress?
Weeks would go by and my mind was still processing whether I should start a treatment regimen of interferon injections. Thinking further to my past healthcare, a primary care physician had directed me to limit my sun exposure since my 6th grade softball season when I developed a rash on my skin when exposed to sunlight. Was my multiple sclerosis due to a vitamin D deficiency? I would make a list of questions to ask Dr. Worrell upon a return appointment to see if I could have my vitamin D level tested.
I want to know why, why God, why? The why me, God, questioning would eventually transform to a why not me question and finally to what now, God? As a result, I read the Avonex pamphlet and saw in writing what the physician had said, the drug should not be taken if you are pregnant. The family planning question was presenting itself before I was married.
Today, I am case managing members in need of transplants. Some of these transplants are autologous stem cell transplants for members with a multiple sclerosis diagnosis. However, the members with multiple sclerosis questioning autologous stem cell transplant and other treatment options that I care for have similarities and dissimilarities from me in their personal knowledge, background, traditions, perceptions, disease course, beliefs, culture, and diversity.
Culture and tradition is important if nurses are to provide culturally competent care as these best practices reduce health disparities using patient empowerment while integrating cultural beliefs into patient care while expanding health care access to vulnerable groups (Douglas et al., 2014). The understanding of my own heritage, a female of European descent, culture, and traditions provide me with a greater cultural understanding of how to provide a bridge in the healthcare setting between the institution, the member, and the people who are from a different cultural background (Spector, 2017). Specific to the multiple sclerosis population and my heritage, religion, personal knowledge, treatment options, family planning perceptions, and belief in an incessant need to accomplish as much as I can in less time could potentially conflict with culturally competent care.
Conclusion
Sir William Osler, a Canadian physician and founding professor of John Hopkins hospital stated, “It is more important to know what person has the disease than which disease the person has” (Galland, 2006). Cultivating the virtue of culturally competent care requires presence, awareness, and sensitivity (Brannigan, 2012). Moreover, understanding the heritage, culture, traditions, and epidemiological principles of multiple sclerosis will provide a greater understanding of how to bridge the gap between institutions and organizations, patients and members, all those who are from a different cultural background (Spector, 2017). “Presence is ultimately a matter of practicing and fostering the art of using the little time we have, which may be all the time we really need, in the best way we can” (Brannigan, 2012, p. 75).