Last Week’s Show with Beth Lincoln: Cultural Awareness and Cultural Curiosity

If you haven’t listened into last week’s show with Beth Lincoln, MSN, RN, author of “Reflections From Common Ground: Cultural Awareness in Healthcare,” here’s a snippet of our conversation with Beth:

Keith: Thanks it’s great to have you here, and you are obviously an expert in this area. I finished reading your book in the last week, and I posted a review on my blog Digital Doorway this morning. I do have to say it’s an excellent book. I think it is probably the best book on diversity in health care that I’ve read, and it’s far and away light years ahead of the books that I read when I was back in nursing school. Congratulations on a really excellent book.

Beth: Thank you. I think what makes it stand apart is it really does come from that clinical standpoint and true to life narratives and opportunities for reflection and can be used in a group situation or as an individual, so it’s really very user friendly.

Keith: It really is, and I’m wondering is it something adopted by nursing programs? I know you’re a nursing professor, so is your program using it?

Beth: Yes we are, and in fact faculty has been using it as well. It’s a great book that could be used as an adjunct to other transcultural nursing classes or actually used in the classroom setting. It lends itself to dialog and discussion. I think when we’re looking at nursing students, they’re inquisitive. They want information. They want answers, and what they find in the group process is that they learn so much from each other and get some ah ha moments…

Keith: Your book focuses on cultural awareness on the part of clinicians toward their patients, toward the people we’re actually serving. You’re also saying that in the educational world, educating nurses for instance, we also have to keep this in mind when we’re deciding how to teach our upcoming nurses or doctors or whomever and make sure that their needs are being met educationally.

Beth: Exactly and actually the last chapter in the book is Health Occupation Faculty It Begins Here, and it really was my experience at that time when I was doing the seminar for a local junior college and they wanted me to come and talk about how they could have their students become culturally competent. The research all said, really it has to be the faculty who becomes culturally competent first. Understand when you’re dealing with minority students that there might be some sense or feelings of isolation or loneliness or discrimination, and I would like to read this one little excerpt at the beginning of that chapter, because it was so moving.

It was from an Ethiopian nursing student who happened to be in this group, and she said, “I’ve lived in this country for over 11 years, and I’ve always felt invisible. Since the first time I came to this college, it’s like I’m not even in the classroom. I don’t even think my teachers realize they’re doing this.” And her faculty was in the room with her and it showed such courage to even speak up, but we need to be aware. It’s in the clinical setting, but it’s also in the academic setting…

Beth: Another good question that I think providers can ask nurses, social workers, and PA’s is what is your preferred mode of communication? For Nancy (One of our callers from the show), it might have been I really want face to face, or I really want a phone call. For a boomer it might be the face to face, but they’d probably take an email. You get down to the Millennials, the 1980’s to 2000, and what they want is a text message.

Don’t interrupt, so we need to ask that question. How would you like me to communicate information to you once you’ve left the office? It’s a real important part.

Kevin: I think that’s a great first step Beth. Essentially as Keith was talking about with the “Silver Tsunami”, and our care for our patients transitioning back into the home environment, we are now not necessarily on our turf anymore in the clinical setting but now invited into more of an intimate setting of someone’s home. Obviously these barriers to care whether it be language or some type of cultural belief is a step into more of an intimate involvement for the health care provider. Like I said, when we’re in the clinical setting, it’s a little more familiar, and we’re a little bit more comfortable in that environment. As we transition into the home, this can certainly create a very big obstacle at first.

Beth: Exactly and the other thing that’s really important is one’s approach for individualistic..collectivistic. If we look at the American culture, people thrive on competition and achievement, and I can do it myself. It’s the individual, but 80% of the world’s cultures are collectivistic which means the group, the family is more important than the individual. That if I ever do anything it’s going to be the group that does that.

That’s why we see in hospital settings large groups of people coming to the ICU or the ER or to the Labor and Delivery Area. Like you’re saying Kevin, if they’re in the home environment, who needs to be there? That’s one of our questions too. I’m going to your house, but who is the person who you rely on to help you with your healthcare. Would you like that person to be here? Especially in families where it is about the group. We need to make sure that everybody is hearing the information and that we are supporting them.

One thing I just need to mention briefly, and you’ll see it in the hospital, and you’ll see it in homecare as well. For example, the patient is in the hospital, and she is a Mexican American patient who’s in the hospital. Her job is to be taken care of by her family in the hospital. The nurse is thinking you need to get up, and you need to take care of yourself. You need to go take a shower, because how else are you going to get home and recover unless you start taking care of yourself. But from her cultural beliefs, she’s saying I will get better, because my family is here to take care of me.

To hear more, just listen in here.