The population of the United States is continually rising. The birth rate continues to rise, but more importantly, the number of foreign-born immigrants that relocated to the United States in 2003 was a staggering 33.5 million, and that number rises every year (Jarvis, 2008). With such a large immigrant population comes the need for medical professionals that are culturally competent. Being culturally competent means that the caregivers, “understand and attend to the total context of the individual’s situation, including awareness of immigration status, stress factors, other social factors, and cultural similarities and differences” (Jarvis, 2008, p.38). Because the United States is so diverse, it is a federal law that all caregivers must be culturally competent. It should be noted, however, that is not something that can be accomplished so easily. It is a process that can take a lifetime. To become culturally competent one must have knowledge in several areas. These include, but are not limited to, knowing one’s own personal heritage, the heritage of the nursing profession, the heritage of the health care system, and the heritage of the patient (Jarvis, 2008).
When performing a cultural assessment of an individual one must take into account five important aspects of the individual’s heritage. These aspects will give the nurse an idea of the patient’s heritage consistency. First, is the individual’s culture. Everyone has a culture. There are four basic characteristics of culture. First, it is learned; from birth one is learning the language and socialization of that culture. Second, it is shared. All the members of the same group share that culture. Third, it is adapted. Culture adapts to environmental and technical factors, as well as the groups availability to natural resources. Finally, it is dynamic. Meaning, it is always changing (Jarvis, 2008). The second aspect of one’s heritage is ethnicity. This is a group within the social system that have a common geographical origin, race, religion, values, traditions and food preferences. The term ethnic is tricky in the United States (US) because of how large the US is, and the large diversity of ethnic differences it has. Religion is the third aspect of one’s heritage. Religion is extremely important because an individual’s religious beliefs play a huge part in one’s health-related behaviors and how someone perceives illness and death. There are roughly 1500 different religions in the United States which is why this aspect is so important when performing an individual’s cultural assessment (Jarvis, 2008). The fourth aspect of one’s heritage is socialization. When someone is raised in a specific culture, the person naturally acquires the characteristics of that group. Many people in the United States are bicultural, acquiring certain customs and traditions of the United States while staying loyal to their traditional culture as best they can. Time orientation is the fifth and final aspect of one’s heritage. Every culture has a different understanding of each other’s perception of time. Depending on the individual’s heritage, that person may focus on the past, the present, the future, or a combination of the three. It is important for the nurse to recognize the individual’s perception of time to gain a better understanding of how to individualize a plan of care.
To gain a better understanding of cultural assessment and how it relates to health care and being culturally competent, a sit down interview was performed with an 84 year old female of German-American heritage, who believes that any belief or view differing greatly from hers are strange, and usually wrong (Riley, 2008). In order to preserve her right to privacy, she will be referred to as G.E.
G.E. is 84 years old and was born and raised in the United States. She considers herself an American who is extremely proud of her German heritage. She...