Healthcare and Cultural Considerations for Patients

As nursing professionals, we must practice cultural awareness with every single patient. Let me say that again… EVERY patient. I realize that many reading this may feel I’m simply stating the obvious and, to be honest, I would, too.

However, I have recently come across a string of scholarly articles and other online postings that were, in my opinion, based on cultural bias and ascribed characteristics of some, to all, in order to confirm the authors' assertions. This inspired me to post a video on my YouTube channel, Kim E. The Diabetes NP, regarding Cultural Considerations for Patients. 

Here, I want to elaborate on my thoughts in a written format.
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First Off, We Must Think Bigger When It Comes to Culture

Understand that culture is more than just race; there’s culture across genders and generations. Whether it is the dynamic between race, gender, or even generations, we must recognize that “culture” has many layers to it, and we cannot function in our biases as healthcare professionals. 

In fact, by definition, cultural awareness is the recognition of the nuances of one’s own and other cultures. With cultural awareness, I would offer that even within those individual groups, there needs to be an even deeper consideration. You see, even within races and cultures, every person in that group has not had, and will not have, the same experience.  

I’ll give you an example: 

I am an African American woman, born and raised in Tennessee. I married an African American man from Ohio. While race has resulted in cultural commonalities, region and socioeconomics alone have led us to react to shared experiences differently.  

Just because we are Black doesn’t mean that we are the same and when dealing with us in a clinical setting, a provider would need to understand that Black people across the diaspora are individuals that come with their own unique experiences. 

Now this is not to throw off that people of the same race, culture, and gender will not share similarities, but all this still needs to be considered when dealing with our patients. I cannot stress how each patient needs to be addressed as an individual and not lumped into a collective.
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Next, Patient-Centered Care

As a Family Nurse Practitioner, I see this heavily with diabetes education and management. It is no secret that there are demographic groups that are more at risk for diabetes; however, what often gets overlooked, or not even considered, is that many of those factors are not because of the genetics of the group but of the circumstance of the group.  

With that in mind, the circumstance could translate to any person regardless of race, culture, or gender. In a recent post from my blog, I wrote about the Food Guidelines for Diabetes, and I discussed that even with nutrition there are barriers that prevent those from access to healthy options.  

So, below, I would like to outline just a few cultural considerations to keep in mind when caring for patients, whether dealing with diabetes or another chronic illness. I ask that you keep an open mind and remember that our goal as providers is to deliver the best possible care: Care that is comprehensive and patient focused.
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The Patient Is an Individual

While considering the patient’s background, also keep in mind the person is an individual with their own unique experiences. Even within our own country, we all have unique experiences. Let’s examine gender briefly. What may work for one woman won’t necessarily work for every woman; and moreover, the woman should be able to evolve. 

People are allowed to change… change their way of life, their views and opinions, and yes, change even their minds. This could only be done by examining each person on a case by case basis. The same can be said for those part of other groups. 

Like I stated earlier, I am from the south, and my husband is from the Midwest. The way of life is totally different in the two regions.  The foods eaten, pace of life… complete opposites.  Even though we are of the same race, WE ARE DIFFERENT! 

Bottom line: One person doesn’t represent the group, and the group doesn’t represent the person.‍
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Tailor Your Care Plan and Education Accordingly

Patient-centered care is patient-driven care. Keeping the first point in mind, simply put, tailor your care and education to the individual. The plan of care should be as dynamic as our patients. Again, as people change so should our approach. 

Our approach is, and should always be, patient-centered. Not only will our patient outcomes improve, but a more collaborative environment will be created with our patients.  
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Set Your Patients Up for a Win!

Now, if we approach our patients as individuals and not part of a collective, then basing our care off their clinical and personal needs, we will ultimately have a better understanding of the person’s beliefs and practices. Knowing that there can be marked differences within a cultural group is pertinent in our care plan.  

Take this example: You have a Chinese diabetic patient that observes the Chinese New Year with their family. If our goal is better patient outcomes through means such as patient adherence, what good would it do to tell the patient to avoid all starchy foods when there is a strong possibility rice could be eaten at the celebration?  

That’s not setting that patient up for success but actually failure. A better approach would be educating moderation and portion control, and advising them to monitor their blood glucose more frequently during that acute period.  

Furthermore, being culturally aware is knowing that though this one individual has a certain set of customs and beliefs, those same beliefs cannot be necessarily ascribed to every member in that demographic (i.e. don’t make assumptions).
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We Can Change the Narrative

As nurses, we have a golden opportunity to change the narrative in cultural awareness and competency. We are the eyes and ears of our patients and, because of this, we are the most trusted profession. We are there with our patients on their best days and their worst days. By better understanding and applying cultural awareness, the rest of healthcare will follow suit.‍

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And for more from Kimberly, check out her blog, Ellis Diabetes.