WELCOME TO MY
WORLD
BOSS,T.
Clinical Nurse
Consultant, Paediatric Outreach Service,
Fairfield, Sydney,
Australia.
When nurses come to the
clinical interface, there is a meeting of the cultures, beliefs and social
morěs of both the nurse and the patient. In paediatric nursing, the care
domain is expanded to include the whole family. Between families, how a
family is defined may vary widely. There will be some similarities in
culture, beliefs and social morěs and most likely there will be differences.
The paediatric nurse’s ability to acknowledge the similarities and at the
same time accommodate the differences will have a direct influence on the
health outcome for the child, related to that particular health issue, and
possibly multiple other issues.
The inclusion of the elements of a family’s cultural identity in
planning the child’s care demonstrates the provision of “culturally
sensitive care”.
Many beliefs about
health, illness, child-rearing, death and life have cultural foundations.
This means that such beliefs and practices lie embedded within a framework
of spiritual, political and social dictates. When planning, implementing
and evaluating nursing care provided to children, paediatric nurses must
take in to consideration “the expectations shared by the cultural group
members [as these] affect the manner in which health, care and illness are
perceived” (Wenger,1993)
Families are usually the
major stake-holder in the provision of care to children, in both wellness
and illness. It is therefore imperative that the family are involved in the
care planning process and agreeable to the implementation of that care
plan. If a plan of care is proposed and/or imposed upon a family that does
not meet their needs, with regard to their beliefs about, and approach to ,
issues on health, illness, and child-rearing it is unlikely that they will
adhere to that treatment plan. This is not about resistance or
non-compliance but perhaps related to
a misunderstanding about or disagreement with a plan of care for
their child that is incongruent with their own beliefs and cultural needs.
If paediatric nurses want to promote and facilitate best
outcomes for the children in their care, then they must not be afraid to
come to the clinical interface, learn about the needs of the family and
work in partnership to develop plans of care that are congruent with the
family’s needs, whilst at the same time, acknowledging their own cultural
needs and biases. This is not an easy task.
This paper will explore concepts related to culture
and its relationship to health, with particular emphasis on the application
of culturally sensitive care in the domain of paediatric nursing.