Importance of Cross-cultural Communication in nursing, and its influence on Nurse-Patient Interaction
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Importance of Cross-cultural Communication in nursing, and its influence on Nurse-Patient Interaction
Introduction.
This paper will discuss the importance of cross-cultural communication in nursing, and its influence on nurse-patient interaction of diverse backgrounds in achieving proper care within their context of diversity. Cross-cultural communication is essential for the improvement of nurse-patient relationships and health care practices. In the nursing profession, nurses are responsible for using their voices to represent the voices of the ill that people they are caring for, whom may be unable to speak or advocate for themselves (Vertino, 2014). Cross-cultural communication can be defined as a field of study that looks at how people from differing cultural backgrounds communicate, in similar and different ways among themselves, and how they endeavour to communicate across cultures. Culture consists of shared beliefs, values and assumptions of a group of people who learn from one another and teach to others that their behaviours, attitudes and perspectives are the correct ways to think, act, and feel. Culture is learned, shared, dynamic, systemic and symbolic. It influences how each individual perceives and responds to the world, solves life’s problems and interacts with others. Cross-cultural Communication has an inter-disciplinary orientation, for it is an attempt to bring together the fields of cultural anthropology and communication. It is interested in the study of communication strategies used in co-cultural populations. Multicultural, cross-cultural and intercultural communication are often used interchangeably in some studies. These terms are, however, slightly different in meaning. Multicultural refers to a society that has several cultures or ethnic groups which may not necessarily have interactions with each other. On the other hand, cross-cultural compares different cultures where one is considered the dominant and the rest compared and contrasted to it. Intercultural Communication is the ideal and describes communities in which there are deep understanding and respect for all cultures, where no one is left unchanged because everyone learns from the other and grows together.
Cross-Cultural Communication in Nursing
When two societies come together, they provoke the mutual antagonisms and adjustments termed cultural change. For the last four hundred years, the expanding world capitalist economy has brought large numbers of people together, primarily through political centralization and migration. These people have to learn to live together for a harmonious society. Patients get to the healthcare sector with a variety of cultural backgrounds, beliefs, practices and languages that require culturally competent communication to maximize the quality of care they receive.
The goal of cross-cultural communication is to enable nurses and caregivers to be diplomatic and sensitive. The first step towards achieving this is first to be conscious of one’s own culture and if it can impede cross-cultural communication. The gradual increase in cultural diversification that currently takes place – as it also has been in the past and the fact that people from different groups have to live together has given birth to the notion of “intercultural communication” (Cakir 2010). Intercultural Communication is the process of interaction between patients and healthcare professionals from different cultural backgrounds that are based on an understanding of their respective cultures.
Cross-cultural communication empowers the nurse to learn to value cultural and ethnic diversity. The current world is a global village, and there is a diversity of cultures in the place of work among colleagues and patients. There will be marked differences between races, genders and ethnic cultures. In some cultures, for example, men are not expected to display emotions in public. Therefore, a nurse who has no cross-cultural communication will not understand the lack of expressions. Self-disclosure is also uncommon in men compared to women. Patients and nurses may have different understandings of the relationships among illnesses, symptoms and appropriate treatment, and these expectations may not always depend on scientific evidence but may revolve around their cultures.
Cross-cultural communication is essential to eradicate prejudices and ethnocentrism. Ethnocentrism is the belief that one’s own culture is superior to others. A nurse who has such biases will try and impose their culture on others. The nurse should be objective and accommodative of others even as they seek to accept their cultural orientation. This objectivity will lead to respect between them and the patients. Socio-cultural Communication will provide knowledge on racial and ethnic universality through exposure to cultures, geographies and histories in the process of interaction leading to understanding. A nurse who will interact with people from all cultural orientation as equals will learn about different cultures and will eradicate stereotypes when they discover that all people have similar dreams, challenges, vices, virtues and capability. This interaction will change their perception and the perception of the patients whom they interact.
Cross-cultural communication boosts confidence since the nurse can understand nonverbal communication and variety in paralinguistic cues. Experts have labelled the term kinesics to mean communicating through body movement. Huseman (1991) explains that eye contact, facial expressions and the use of space are effective forms of communication. Other cues include sitting posture, gestures, shaking hands and nodding. Eye contact sets the tone between two individuals and significantly differs in meanings between cultures. In the Americas and Western Europe, eye contact is interpreted as conveying interest and honesty. One can misconstrue staring as arrogance in some cultures in Africa, the Middle East and Asia and patient from these cultures might avoid eye contact since they perceive direct eye contact to be disrespectful and challenging to authority. This clash can be confusing to health care workers who consider looking away can be seen as a sign of disinterest. The socialization will be better understood through conscious effort to achieve cross-cultural communication.
Nurses will find it easier to understand the use of conflicting gestures once they become exposed to cross-cultural communication. Huseman (1991) explains that gestures can be in the form of emblems; sign language, illustrators, regulators, affect displays and adaptors. Nodding of the head in many cultures symbolizes agreement and shaking shows disagreement. However, it might not always be so, and cross-cultural communication will enable the nurse not to make assumptions. Gestures are also not universal. A thumbs-up sign can have varied meaning to different cultures. Another example that means other according to the culture is the regulator of making a circle with the hand which indicates agreement in America, is symbolic for money in Japan and conveys the notion of worthlessness in Japan.
The nurse should also be sensitive and an intelligent observer of affect displays that reveal emotions through the change of facial expressions. The patients will portray emotions and general malaise by changing facial expression. For example, smiling to show happiness or frowning when in pain, tears and lack of tears among others that differ according to the cultural dispensations. Asking questions of healthcare providers is not allowed in some cultures. Patients from these cultures may speak less even when they understand the dominant language. They may not ask clarifying questions to enable them to understand their condition and to follow the proper treatment plan. Cross-cultural communication will allow the nurse to identify such limitation and put in measures to volunteer adequate information even without being asked.
Cross-cultural communication will enable the nurse to understand cultural barriers stemming from superstitions, customs or traditions. Cultural barriers may be evident in the way members of a culture perceive health and illness. An example is a patient who views sickness as a curse or punishment and may not be cooperative in the interventions. Some other patients may prefer traditional remedies which may not augur well with the prescribed medication. To understand such patients, the nurse will require cross-cultural communication proficiency. Nurses with intercultural communication competence are aware of an individual’s similarities and differences relative to other cultures Tand can understand how the individual’s own culture and cultures of other individuals involved in the communication will influence the thoughts and behaviours. They exhibit sensitivity towards cultural differences and perspectives of people from different cultures and build effective Communication (Chen & Starosta 1996).
With cross-cultural communication competence, the quality of care steps up, and patient safety is ensured. Effective communication is established between the patient and healthcare professionals, work stress of caregivers decreases and their knowledge and skills improve, while satisfaction perceived by recipients of care increases. Incidents of cultural differences between the recipients and givers of care are inevitable thanks to globalization tendencies. These aspects are crucial as nurses will provide service to populations with ever-increasing heterogeneity. Language is another barrier that can be solved by providing translation services. All patients should provide data on their primary language and their language competency to prepare the health care workers to know how to communicate with them.
Cross-cultural communication will eradicate stereotypes and will lead to an acceptance that there is a variety of culture apart from one’s own and that what has been thought of others perceived to be inferior or superior cultures is not necessarily so. Interaction and even cross-cultural friendships will enable empathy among the participants. In this manner, there will be an appreciation of others brought about by understanding the universality of human existence. Nurses interact with people of different religious, ethnic and social background daily within and outside their work setting. To be effective, efficient nurses need to have good communication skills. By acquiring cross-cultural communication skills, a nurse will be able to express themself with confidence and understand how to be patient with other people who aren’t from a similar background. It will also provide an excellent opportunity to meet and understand people from other cultures and appreciate their differences and similarities. Ultimately, cross-cultural communication creates equal opportunities and calls for fair judgement. Some institutions aim to make people from different cultures comfortable seeking care from them; others send subtle messages that others are unwelcome. The attitude will be conveyed through the workforce, and nurses are at the forefront because they have direct interaction with the patients.
The socio-cultural tradition looks at the way our understandings, meanings, norms and rules are worked out interactively in communication. The practice focuses on the creation and enactment of social reality from which we can understand the world, relate to and create the truth in the process of interaction. A nurse should always be aware that they are an extension of the groups they belong to. This awareness will enable them to exploit the strengths fully and to be conscious of any intervening stereotypes developed through their group socialization. Good patient-provider communication is associated with better patient satisfaction, better adherence to treatment recommendations and improved health outcomes. Thus, socio-cultural and intercultural communication is essential for nurses and all healthcare workers to create rapport with their patients.
In this section, I have discussed that enhanced cross-cultural communication is essential and cannot be ignored because it empowers the nurse to learn to value cultural and ethnic diversity and to eradicate prejudices and ethnocentrism. Moreover, they will learn nonverbal communication and variety in paralinguistic cues, understand cultural barriers and accommodate superstitions, customs or traditions; and to enhance proficiency at the workplace generally. You cannot serve clients whom you do not relate with, and therefore cross-cultural communication must be achieved by all means. In the next section, I will discuss the influence of cross-cultural communication on nurse-patient interaction of diverse backgrounds to attain proper care within their context of diversity.
Influence of Cross-Cultural Communication on Nurse-Patient Interaction
Betancourt et al. (2014) aver that clinicians have the skills and knowledge of communicating in culturally sensitive manners. When they portray communication mannerisms that are culturally sensitive, then it implies that they understand and respect All persons, and this culminates into satisfaction for both family and patients within their care (Claramita, 2016). Douglas et al., (2011) posit that when nurses or any other clinician portray cross-cultural communication skills and by the collaboration of both nonverbal and verbal skills in these communications, then they can single out patient’s needs. Moreover, nurses can establish a reflection on personal values, preferences, values and culture. Besides, they portray respect and understanding for traditions, practices and perspectives the patients who have culturally diverse communities, families, and individuals. Cross-cultural communication thus is very paramount for nurses, and the giver and the receiver felt its presence. The giver as the one receiving the care and is, therefore, able to sense when the nurses use holistic and individualize communication skills that incorporate cultural considerations and preferences that are identifiable by those in the surrounding. (CATSINaM, 2016)
Cross-Cultural Communication influences the enhancement of cultural sensitivity among nurses and patients. It reduces risks of miscommunication and any cultural disparities that many arise hence enhancing the adherence to adequate treatment. This, in the long run, promotes good health among patients and reduces adverse effects prevalence (CDNM, 2017) it is good to understand that the world has become global. In places like Europe, Oceania and Northern America, immigrants account to close to 10% of all people (United Nations, 2017) this has increased the high chances of culturally diverse populations being eminent. (World Health Organization, 2016). It is likely that in hospitals, one encounters culturally diverse persons on the grounds of ancestry, spoken languages, ideas, customs, social norms, aboriginal descent, and not limited to parent’s origin. It is upon the nurse’s responsibilities to ensure that the cultural diversities of all these patients does not affect the process of providing health care services to them. This is only possible when nurses are skilled in cross-cultural communication techniques.
From reports in the United Nations, (2017) article, it is clear that since the 1990s hospitals have received patients from diverse origins due to socioeconomic changes of globalization. Cross-cultural communication thus allows nurses a room to be conscious of the fact that patients can have preferences that are culturally inclined. They, therefore, end up utilizing these communication skills in ensuring equity and safety when taking care of the patients. Besides, cross-cultural communication influences the sensitive and open communication that is strategic and endeavours to collaborate with the family and the patients for achieving optimal cared for the patient. Cross-cultural communicative nurses positively influence patients and their families, and this informs their perception of oh the hospital and the care provided in that hospital.
Cross-Cultural Communication, when done to perfection, it influences the perception that patients and their families have on health facility. There increased international focus towards the improvement of quality of services provided in health cares and hospitalized patients safety. However, culturally sensitive communication, according to Esposito (2013), is minimally understood. This paper presents that this a nursing element that is paramount and should be given prominence. It should be understood that in any business sector clients view of q1uality if services offered is essential. The hospital is not an exception either. The patients as well can feel; when communication is culturally sensitive and insensitive which implies that the nurses and the hospital have a role in educating their nurses and any other medical practitioner on how influential across cultural communication can be in a hospital. Nurses should acknowledge that the features that make communication culturally sensitive will vary amongst patients (CATSINaM, 2016). Nurses will only be able to do this if they start by understanding their own cultures and the role they play in their lives. Beyond, they can try fitting in the patient’s shoes and questioning on the impact it would create if someone violated their rights by disrespecting their cultures. Only then would they be able to understand that every patient’s cultures and backgrounds matter and their way of life should be respected at all levels. Cross-cultural communication enhances the patient’s engagement and how they perceive the hospital health care quality.
Cross-cultural communications influence the approach that a whole medical facility gives to services it offers to its patients. It remains aware that it is not the nurses who should observe these cross-cultural skills while handling patients, instead of all the stakeholders. It is thus likely that medical facilities establish training programs that train medical personnel and all hospital staff on the importance of cross-cultural communications skills. Actually, according to Riley (2008, p. 20), it is observable however that this solely does not depend on the nurses but on nurse-patient’s relationship as the due brings on the table its attitudes, knowledge, experiences and patterns of behaviour to their relationship. The behavioural patterns that are rather individualistic demand that cross-cultural communication styles are employed in the meeting of any expectation set by the health care on the patients and the caregivers as well. McDaniel (2020) conclude that the collective and individual perceptions contain some embedded notions of culture and all contribute to the communication outcomes in this hospital setting.
Just like Wardhaugh (2010, p. 233), argues, communication can influence a mirage of issues in a healthcare and language can act like an “a screen or filter to reality and determines how speakers of a language perceive and organize both the natural and social worlds around them.” The nursing environment is an environment that is paramount to healing for patients. Nurses should understand that they are commissioned to take care of the world. A world that is diverse and complex at the same time. Thus, being sensitive to people and their cultures and for this matter, patients are very critical if they must get well. Nursing practices include the taking care of All sorts of patients and being considerate of their cultural needs. Thus, the ability to utilize cross-communication skills can be very crucial for the delivery of care that is optimal. Nurses must underpin intercultural care among patients by incorporating their understanding of culture, their feelings, experiences, and attitudes in taking care of patients.
When it comes to the influences that cross-cultural communication has on nurse-patient interaction of diverse backgrounds in achieving appropriate care within their contexts of diversity, (Alizadeh, 2016) presents the evidence of advantages brought by culturally oriented healthcare provides. The acceptance that competent cross-cultural communication is essential influences the decisions to incorporate culturally sensitive interventions on several healthcare services provided by medical facilities (Beach et al., 2004). Besides nurses are likely to watch out on their level of knowledge as it pertains to culture, their attitudes and behaviours as far as cross-cultural health care is concerned. The acceptance that cross-cultural communication is paramount as argued by Shen (2015) calls for an examination of nursing education and how feasible out is for various cultural setups. Calls for educational model determines to incorporate cultural knowledge on the syllabuses so that nurses are prepared to address all patients from their varied backgrounds. Nurses, as well from their experiences with these culturally diverse patients, should be receptive of any form of training that prepare them for encounters with different people from different cultures. They learn to handle all forms of patients, and this becomes an added advantage for them in this global world.
The influence cross-cultural communication on patients with diverse backgrounds is that health systems have begun to adopt strategies that help respond to the needs of patients from various ethnic and racial minorities. Besides, states have also increased state regulations that encourage incredible responsiveness of health care facilities to the ethnic growth realities in the patients who currently visit hospitals. This is done to minimize disparities found in health facilities related to race or ethnic diversities. Also, hospitals have realized that when they develop and implement cultural strategies and competencies within their nurses, then they provide a fantastic business strategy that boosts the interest of patients and [providers to participate in any health plans offered by the facility. Besides, based on the increase of cultural competence for health care providers, the hospital organization is likely to adopt policies that are concerned with linguistic and administrative barriers during health care. This is because any policies that are set by the hospital related to cultural sensitiveness must be all around. This is to mean they must touch on all hospitals stakeholders and at the end, it is not only the patients who are happy but all hospitals stakeholders.
Cross-cultural communication influence how patients and nurses view their beliefs, individual values, beliefs, and health behaviours and also how they view the actions of those of neighbours like other patients. When a nurse is culture-sensitive, then they are likely to impart culture sensitivity on other patients and create a harmonious coexistence within the hospital. When a nurse is culturally competent, they are possible to integrate all sensitive practices in taking care of patients as well as incorporating the same skills in dealing with all medical staff. This influences other hospital personnel to practice the same and promote peace and a conducive working environment.at the end the hospital will find itself providing the ultimate care for patients regardless of their race or ethnicity. It is a way of letting it known that, beyond our cultural differences, we are all humans and all guided by similar principles. That when we get sick, it is the human body that gets sick and all need ultimate care to get fully recovered. There is no point when culture or ethnicity is paramount for health care services to be provided.
Summarily there is an increased need to be attentive to the competence of nurses and other health care providers on matters culture. This is because as presented in this discussion when there is increased awareness of pones and others cultural and traditional features then it prepares a nurse for any hospital’s cross-cultural encounters besides improving the competence of nurses in matters culture. Crosio cultural communication, when handled correctly, it gives ultimate satisfaction to patients, and this influences their perception on a particular medical facility which translates to more clients and more profits. Biased the maximum satisfaction of nurses and other medical providers are seeing their patients satisfied. Presentation of good cross-cultural Communication gives an excellent impression about medical personnel and so hospitals should be very vigilant on how nurses who work with them handle patients from diverse backgrounds. If lacking, then knowledge should be provided to them to ensure they address all patients legally hence printing a good picture for the healthcare facility.
Conclusion
Vertino (2014) recognizes the importance of communication for nurses during their practice. It is this fair voice use that will transcend the communication of their own needs and communicate the needs of their patients. They thus become a voice for the ill; those who cannot speak for themselves. Beyond recognizing this fact, this paper is majorly centred on the importance and influence of cross-cultural communication for nurses during their practice. Besides acknowledging the importance of cross-cultural communication in the provision of optimal health care, the paper presents its impact on the hospital health care providers, and the whole hospital should not be underestimated. A hospital thus should always endeavour to provide health care services that are culturally responsive, equitable and mindful of ethnic backgrounds of all patients admitted or receiving services from it. Nurses have a role that encompasses the elimination and reduction of any health disparity and also minds personal and cultural differences that include communication differences. A culturally competent nurse should learn to incorporate the culture of the patient values, spiritualities and beliefs in any form of communication with them and when providing care. It should be understood that in one culture, there are words that can be termed obscene while in another should be not. To understand all these nurses should be responsive to patients verbal and nonverbal cues to understand that which offends them. Use of cross-cultural communication skills is a big way through which health care disparities are minimized. Thus, the practice nurses can provide to their patients, culturally; competent, diverse, and appropriate care to persons of diverse cultures and linguistic capabilities. In a nutshell, outcomes of useful cross-cultural communication techniques include and not limited to improvement in health care access, coordination of health services and also good utilization of quality in health care and outcomes and patient, caregivers and family’s satisfaction.
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