Last Saturday, as part of a program called “Minority Nurse Leadership in the 21st Century,” about 100 minority nurses from all around California met at Saint Agnes Medical Center in Fresno to discuss the role of nurses in patient advocacy and leadership. According to statistics, 40 percent of the California population are Latino while only 7 percent of the nurses statewide are Latino, proving the need for more minority nurses in California.
A 2014 Board of Nursing report from the California State Board of Registered Nursing reported that Latinos will continue to be underrepresented and become even more underrepresented in the nursing workforce in the future. African American nurses are also expected to be underrepresented until 2030, while all other racial groups continue to be overrepresented compared to the general population.
The number of white nurses in the workforce has declined from 77.2 percent in 1990 to 51.6 percent in 2014. This decline leaves the most highly represented nonwhite group of nurses as Filipinos at 20.3 percent of the workforce, with non-Filipino Asian nurses at 8.5 percent, and black nurses at about 5 percent.
Pilar De La Cruz-Reyes, a member of the California State Board of Registered Nursing and director of the Central California Center for Excellence in Nursing at Fresno State, says the purpose of the minority nurse meeting in Fresno was to get more minority nurses into leadership positions so they can serve as role models and mentors to minority students who want to go into nursing but don’t see a realistic way to get there.
Kimberly Horton, chief executive officer at Vibra Hospital of Sacramento, says that nursing is an opportunity that many Latinos have never thought about so nursing programs need to be marketed to that population, and using minority nurses to educate their peers about the nursing profession is a great way to get started. Horton is an African American registered nurse and she was one of five speakers at the Fresno meeting.
Minority nurses can be wonderful advocates for patients, bringing a special understanding of health beliefs that are ethically, culturally, and religiously based and that can have a real effect on patient health. By including nurses who represent ethnic groups in the development of patient health care plans, health care teams can better develop logical plans for treatment that won’t negatively impact the health of minority patients due to common misunderstandings or misperceptions that patients have about their health and treatment.
Nurses in the United States can expect to encounter several unfamiliar cultural practices throughout their careers.
Depending on where you practice, you might find your cultural knowledge base challenged every day or it might only happen a few times a year. What you can plan on is wanting to make sure you don’t offend your patients because you don’t understand their practices or their beliefs.
Even if they seem unusual, complicated, or outdated to you, the most important attitude shift you can make is to remember they aren’t your practices to adapt. But it is your job to honor them for the sake of your patient’s comfort. Culturally competent nursing practice makes you a better nurse overall.
With so many different practices in the world, and even varying practices within a single culture or religion, you don’t have to spend hours studying to get it all right. Although it’s helpful to become familiar with the cultures you see most often, the best way to find out what is important to your patients and their families is to do one simple thing – ask.
Ask new patients about their preferences and if they have any religious or cultural guidelines they follow in their everyday lives. These could range from food preparation and serving to modesty issues. Some families have a strict order of hierarchy, so talking with a patient could involve the entire immediate family.
Talking with your patients and asking them questions, not only helps you take better care of them but it also helps you both establish mutual trust. And if your patients trust that you will honor something so important to them, they are much more likely to be open and honest with you about their own health care practices (especially when they are not following medical orders for a culturally influenced reason).
One of the biggest benefits of practicing culturally competent care is the honest relationship you’ll establish. If they are open with you, you will be able to develop a health plan that will include awareness of certain habits or practices and will find substitutions for others. If your diabetic patient has a period of fasting he or she strictly adheres to, mandating food during that time could easily be ignored. Trying to find a way to accommodate the practice within safe and healthy guidelines will help both of you.
Nurses also find some self reflection helpful when they are dealing with a culturally diverse population or even just one population they are not familiar with. If you are aware of any biases, any fears, and any prejudices you have, you can work hard to keep them from interfering with a patient’s requests.