Understanding nurses’ concerns when caring for patients from diverse cultural and ethnic backgrounds

Abstract

Aims and objectives: To explore the experiences of both student and qualified nurses of caring for patients from diverse cultural, ethnic and linguistic backgrounds, in one region of Ireland. Hearing the stories, experiences and attitudes of nurses has the potential to influence future clinical practice and has implication for nurses, nurse educators and nurse managers and leaders.Background: There is a wealth of international literature highlighting the importance of providing culturally sensitive care. However, global reports of culturally insensitive care continue. There is a paucity of in-depth research exploring the actual concerns and challenges nurses experience when caring for patients from diverse cultural and ethnic backgrounds, as well as what influences their actions and omissions of care in practice.Design: A qualitative exploratory descriptive design adopting the principles of a classic grounded theory approach was used.Methods: Focus groups (n À 10) and individual face-to-face interviews (n À 30) were conducted with student and qualified nurses studying and working in one region of Ireland. As data were collected, it was simultaneously analysed using the classic grounded theory methodological principles of coding, constant comparison and theoretical sampling.Findings: Uncertainty was the consistent main concern that emerged. Feelings of ambiguity of how to act were further influenced by a lack of knowledge, an awareness of ethnocentric beliefs and the culture of the organisation in which participants learn and work in. Instead of finding answers to uncertainties, participants demonstrated a lack of commitment to meeting patients' needs in a culturally appropriate way.Conclusions: This study adds new perspectives to our understanding of enablers and barriers to culturally sensitive care. It explains the poignant effect of uncertainty and describes how nurses were unable (or unwilling) to find answers when in doubt.It raises questions that remain unanswered in the existing literature, as to why nurses feel it is acceptable to choose to do nothing about their lack of cultural knowledge and the uncertainties which follow.Relevance to clinical practice: Identifying the nature and implications of the uncertainty experienced when providing care for patients from diverse cultural and ethnic backgrounds is an important contributing factor to improving cultural sensitivity and

Challenges of healthcare professionals in providing care to South Asian ethnic minority patients in Hong Kong: A qualitative study

“…Moreover, HPs may face challenges in establishing therapeutic relationships with culturally diverse patients, resulting in reduced sharing of health information and limited patient participation in the medical decision‐making process (Almutairi, Dahinten, & Rodney, ; Casillas et al, ; Degrie, Gastmans, Mahieu, Casterl, & Denier, ). Such high levels of uncertainty and doubt when crossing cultural boundaries have been found to result in stress and anxiety among HPs (Markey, Tilki, & Taylor, ).…”

Resigned indifference: An explanation of gaps in care for culturally and linguistically diverse patients'

“…This study aimed to generate a grounded theory explaining nurses' behaviours when caring for culturally and linguistically diverse patients', in Ireland. It was guided by the following research question, “What are the challenges experienced when caring for patients from diverse cultural and linguistic backgrounds and how are they dealt with?” While Markey et al (), reports how “uncertainty” is the main concern for participants in this study, this paper explains the patterns of behaviour used to deal with these uncertainties and the factors that influenced these behaviours.…”

“…Polish, French, Lithuanian and German are the top four non‐English languages spoken (Central Statistics Office, ). Consequently, nurses have experienced challenges in caring for the 199 different nationalities that constitute the social make‐up of the new unchartered multicultural Ireland (Markey, Tilki, & Taylor, ). Although not unique to Ireland, the growing reports of cultural insensitivity are concerning (Almutairi, Adlan, & Nasim, ; Hart & Mareno, ), but have received limited attention within the discourse on “missed care.” The importance of building capability and capacity to provide culturally responsive care is now paramount.…”

Identification and exploration of nursing competencies required for newly graduated nurses in Korea​​​​​​​

“…Several countries including Korea currently have been experiencing a cultural shift with the increase of migration and marriage for migration, which leads to the transition to multiculturalism (Chalmers et al, 1981;Markey et al, 2017). Therefore, providing multicultural educational support and training for the nursing workforce to be prepared for culturally competent practice may be required.…”

“…It is imperative to practise efficiently within the cultural context of patients and families for patient-centred care (Chae & Kang, 2013;Chenowethm et al, 2006). Several countries including Korea have been experiencing cultural shift with increasing migration and marriage for migration, which leads to a transition to multiculturalism (Chalmers et al, 1981;Markey et al, 2017). Particularly for Korean nurses, culturally safe care is a challenge due to the lack of educational opportunity in nursing education.…”