Culture is one of the most critical factors that determine healthcare practices and beliefs. Cultural competence is a necessary skill for nurses. Nurses should make themselves aware of the patient’s cultural values, beliefs, and behaviors as they come together in a nurse-client relationship. This essay summarizes a cultural assessment exercise involving Sam, an African from Kenya who is in the US for studies.
Sam recently moved to our neighborhood. He is a graduate student at the local university. He is from Kenya, a country in East Africa. Sam describes Kenya as a multi-ethnic society with many unique cultures, beliefs, religions, and traditions. Sam comes from the Kalenjin community; a group known for its athletic prowess. Sam was born in Rift Valley province in Kenya. He has been in the US for almost two years, and he is yet to adjust to life in America.
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Sam has the flu; he is blaming it on the flu virus that has been making rounds in school and in the neighborhood. His fever has lasted for two days, and he is fatigued. Sam complains that he has not been keeping warm or eating the right food to strengthen his immune system. Back in Kenya, his mother would pack for him healthy traditional vegetables, fermented milk and other traditional meals that boosted his immune system. Sam complains that he does not have access to that food. After the onset of the flu, Sam has been relying on the typical home remedies such as lemon, ginger, and honey to address his symptoms.
Sam recalls that when he was unwell, his mother will make him millet porridge. Sam claims it is nutrient rich and it gives him the energy to fight the disease. When he was young, his parents would pray for him when he was unwell or apply specific oil which was meant to protect him from evil spirits. Sam is not sure if the oil made a difference in his health. However, his mother placed a lot of value on the practice.
Sam notes that Africans rely on modern medicine and supplement with herbal/traditional medicine. They extract traditional medicine from tree stems, whole plants, leaves, roots, and barks. Traditional medicine is cheaper and readily available for those who are knowledgeable about them. There are known traditional healers in the community who are experts in traditional medicine. However, most Kenyans still go to hospitals or pharmacies to buy medication. Sam gave an interesting experience with an herbalist who gave his family bitter herbs to cleanse their systems. Sam says within minutes of ingesting the bitter herbs, all the family members began vomiting for the rest of the day. By the end of the day, they were so weak and dehydrated, and this is what they consider detox. Sam adds that some herbalists had helped him, for example, when he had recurrent tonsillitis he was given some herbs which addressed the issue. He is open to both modern and traditional medicine.
Sam is the last born in a family of six, and he has a tight bond with his parents and siblings. He is also close with the extended family, including his grandparents, aunts, and uncles. Women and men have distinct roles, where women take care of the children or engage in domestic chores while the men provide for the family. The roles have changed as women like his sisters are educated and have jobs. Back at home, he has a lot of support unlike here where he relies on his girlfriend when he is unwell. Sam does not tell his parents back at home that he is unwell because his mother will worry so much about him. Sam needs help for his flu. He says there is no potential conflict between his home-based remedies and the hospital regimen. He is using lemon, ginger, and honey, but they have not helped. Back home, Sam would combine certain herbs with modern medicine, and others he was warned not to combine because they do not go well together.
After the interview, I realized Sam’s culture is unique from American culture. Sam is having a hard time adjusting to the American culture, including the health sector. Back in Kenya, health professionals enjoy close relationships with their patients such that the patients are not afraid to open up about anything that could be affecting their health. Nurses must take time to get to know the patient if they want to deliver patient-centered care. By getting to know the patient’s culture, nurses will be able to determine the best course of action and how to support the patient ( Blais & Hayes, 2015) . Some patients tend to leave their medication for traditional options when they feel that they are not getting well. Other patients like Sam have no problem finishing their drugs even though they still supplement them with natural or home remedies.
The cultural assessment was enlightening. I learned about the dominant beliefs, practices, and traditions rather than making assumptions about the person (Campinha-Bacote, 2011). Sam spoke fluent English and made me realize that Kenya has all the aspects of modern society as there are McDonald’s, Subway and other American enterprises over there. The medical sector is also advanced, even though they still value the traditional healers. The biggest lesson from the cultural assessment is that health professionals should not make assumptions as they can only deliver culturally competent care when they take time to know patients.
References
Blais, K & Hayes, J. (2015). Professional nursing practice: Concepts and perspectives . Pearson.
Campinha-Bacote, J. (2011). Delivering patient-centered care in the midst of a cultural conflict: The role of cultural competence. The Online Journal of Issues in Nursing , 16 (2).
Questions
Can you tell me about your cultural group, where you were born, and how long you have lived in this country?
What do you call your problem? What name do you give it? What do you think has caused it?
What kinds of things do you do to maintain health? For example, what types of food do you eat to maintain health?
What foods do you eat during illness, and how is food prepared? What other activities do you or your family do to keep people healthy (e.g., wearing amulets, religious or spiritual practices)?
What kinds of things do you do to treat illnesses? Do you use traditional healers (shaman, curandero , sabador , priest/priestess, espiritualista , herbalist, acupuncturist)?
How would you describe your past experiences with cultural healers and Western health professionals?
I would like to learn about your family. Who are the members of your family? What family duties do women and men usually perform in your culture
Who will be able to help you during and after treatment? Do you need help to contact these people?
What assistance will be needed from the healthcare institution or staff to accommodate a combined approach to a problem?
Are there potential conflicts between the client’s traditional remedies and the regimen prescribed by the physician?
