Emerging Standards of Care Paper
An increase in health disparities among minorities is a growing problem in the United States and is due to the poor quality and accessibility of health care services provided to these individuals. In the intensive care unit, care is focused on life saving treatment with little attention to cultural care. With the rising population of minorities seen in the intensive care unit, it is imperative for critical care nurses to become culturally competent to provide to best care possible to their patients and create a plan of care that they will have the resources to maintain compliance. According the Department of Health and Human Services' Office of Minority Health (2011), “The increasing population growth of racial and ethnic communities and linguistic groups, each with its own cultural traits and health profiles, presents a challenge to the health care delivery service industry in this country. The provider and the patient each bring their individual learned patterns of language and culture to the health care experience which must be transcended to achieve equal access and quality health care”. Cultural Competence. To be a culturally competent nurse means “having specific cognitive and affective skills that are essential for building culturally relevant relationships between providers and patients. Obtaining cultural competency is an ongoing, lifetime process, not an endpoint” (Kersey-Matusiak, 2012). Cultural competence in the intensive care unit also involves the nurse recognizing the education level and language barriers of patients and families and their familiarity with the hospital environment. The intensive care unit can be a frightening place for those with limited experience to invasive procedures and use of complex equipment. Leininger’s Theory of Transcultural Nursing defines this as Culture Shock: “The state of being disoriented or unable to respond to a different cultural environment because of its sudden strangeness, unfamiliarity, and incompatibility to the stranger's perceptions and expectations at is differentiated from others by symbolic markers (cultures, biology, territory, religion)”(Nursing Theories, 2012). Many patients and family members in the intensive care unit refrain from asking questions involving care because they are frightened or embarrassed; creating a barrier to care. The critical care nurse should be sensitive to the cultural needs of the patient and family by explaining procedures and equipment. The nurse can use patient feedback to continue education by assessing what he or she already knows about the care they are receiving. Resources for non-English speaking persons should be utilized when explaining procedures and filling out forms to ensure understanding of these items and for the safety of the patient. Populations Served. The average population seen in the intensive care unit is a mix of African Americans, Mexican Americans, Hispanics and underprivileged white Americans. Although the United States collects statistical evidence on health disparities among minorities, it is still unclear what exactly predisposes these individuals to illness. This data is continually collected and may even be skewed as a result of cultural incompetence. Commonly, the influx of minorities to the intensive care unit is due to acute and chronic illnesses related to heart disease, diabetes, obesity, stroke, and chronic liver disease; all common health disparities involving minorities with poor access to health care (Unites States Department of Health and Human Services, 2011). Heart disease is the leading cause of death for most minorities in the United States and accounted for 25% of minority deaths in 2008 and is the result of other major health disparities including obesity and diabetes (Unites States Department of Health and Human Services, 2011). According to the Office of Minority Health (2012), African American women were 80% more likely to be obese that...
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