Cultural Bridges to Care

The culture of western medicine is both powerful and iconic. While most of the patients in our care will have been exposed to it on some level and many will feel comfortable enough within its bounds to function effectively as patients, still others will find the system difficult to comprehend or navigate.

Cultural issues, in the broadest sense (including issues of race, ethnicity, class, gender, sexual orientation, spirituality), play a large role in how each patient interprets the medical setting, communicates about their illness, and makes sense of the care and recommendations they are receiving.

The experience of disease -- “illness” -- is an experience that holds meaning shaped in profound ways by one’s world view and personal perspective, in short by one’s “cultural background.” The biological aspect of disease (or treatment processes) is just one of many factors affecting how a patient will respond to medical recommendations.

Nurses have a unique and critical role in their work with patients and families, because they do so much of the hands-on medical care, while simultaneously nurturing a psychologically and emotionally supportive connection. Very often, it falls to nurses to create cultural bridges between a medical team and its patients. Nurses become the active interpreters, the living links between a patient’s cultural world and the culture of the hospital or clinic. Because we rely on nurses for this intense combination of clinical care, patient education, and support, it is critically important that nurses develop a personal awareness of the myriad issues that affect their daily interactions with patients, of their own cultural perspectives, thoughts, ideas, values...

The nursing experience of treating patients is shaped as much by a nurse’s personal cultural background as it is by the culture of the western medical setting in which we all work. Practitioner-patient relationships of all kinds are bound by the interplay of these cultural underpinnings. Learning how to interpret patient and family understandings and expectations of illness and treatment, as well as how to work effectively within the bounds of one’s own cultural experiences, makes it possible to provide effective, compassionate and clinically sound care to diverse patients and families.

Issues of cultural competency run far deeper than a simple cataloging of the “norms” of any given ethnic group. If we are to provide culturally competent care, care that seeks to meet the needs of every patient, we must first understand our own worldview and the culture of western medicine, which sets the tone for all of our interactions with our patients. We must also learn to quickly and effectively interpret our patients’ cultures and worldviews and to gauge how closely (or not!) their cultural understandings fit with our own expectations of patient behavior and with those of the setting. In so doing, communication is strengthened, practitioner-patient trust is fostered, and acceptance of (and adherence to) treatment recommendations is enhanced.