Introduction
The increased cultural is an issue that is not only affecting the healthcare sector but also almost all industries across the globe. Globalization has enhanced international exchanges and interaction of people from different cultures. Consequently, nurses are now required to take care of patients from diverse cultures. However, transcultural care is now one of the major issues affecting nursing, a significant number of nurses do not have relevant knowledge and skills that are needed to treat patients from various cultures ( McFadyen et al., 2018) . Therefore, the proposed policy change is the introduction of the transcultural curriculum in the nursing education system.
Current Nursing Issue
Culture is one of the factors that affect almost all aspects of human life. Thus, culture has much influence on an individual's health behaviors. To provide quality care, health professionals need to understand cultural factors influencing health behaviors of patients ( Değer, 2018) . However, the ability of nurses to provide quality care for patients across the cultural divide has been one of the major challenges facing nursing roles. According to the findings of a study that was conducted by Amiri and Heydari (2017), patients from minorities and smaller cultures have been neglected by nurses because of cultural conflicts. Besides, a substantial number of nurses are not able to understand foreign cultures due to a lack of cultural competence or relevant knowledge of cultural diversity.
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Nurses often react negatively to cultural diversity, especially when they encounter cultural conflict. First, nurses always apply ethnocentrism when they face cultural conflict. Specifically, they interpret the culture of patients based on their own culture or dominant culture. Secondly, nurses always resort to stereotyping in cases of a cultural conflict without factoring in individual differences. Also, cultural blindness is common in nursing, as many nurses do not pay attention to the cultural diversity of patients (Murcia & Lopez, 2016). Therefore, cultural conflict is a major problem in the nursing practice, and it always occurs when patient and nurses exhibit different cultural values.
The Proposed Policy Change
To address the problem of cultural conflict in nursing, the government should collaborate with nursing schools or colleges to integrate transcultural curriculum in the education system. Transcultural nursing is not a new concept, as its origin can be traced back to the 1950s when scholars realized that culture plays a critical role in the health behaviors of individuals (Değer, 2018). The main objective of transcultural nursing, therefore, is to provide nurses with the necessary knowledge and skills to enable them to address and effectively respond to various cultural issues in the field. The primary objective of transcultural nursing is to improve the cultural competency of nurses.
However, even though the concept of transcultural nursing is not new, it has not been integrated into the nursing curriculum. As a result, it is essential to introduce transcultural nursing in the education system with the primary intention of enhancing the cultural competence of nurses. Although various hospitals have been teaching their employees about cultural diversity, the academic setting has the most significant impact in promoting cultural competence (Prosen, 2015). Introducing the transcultural concept in the nursing practice will improve the cultural competence of nurse significantly.
Agenda Setting Strategies
A policy is not likely to succeed if it fails to get the attention of relevant stakeholders or the public. Hence, agenda-setting is one of the most critical parts of policymaking. The first agenda-setting strategy that is relevant to the proposed policy is mobilizing supporters. It is essential to mobilize supporters to gain the attention of the public (Princen, 2011). The main supporters for the proposed policy include nurses, nursing schools or colleges, health agencies, and health advocacy organization. The second strategy is to arouse the interests of major stakeholders by framing the proposed policy as a critical issue that should not be ignored (Princen, 2011). The policy should be framed as a top-priority policy in the healthcare sector, especially concerning improving the quality of care.
The third strategy is using policy influencers who can easily influence both private and public organizations to embrace the policy, leading to its success (McGetrick et al., 2019). Besides, social media platform such as LinkedIn, Facebook, and Twitter can be used to set an agenda or the proposed policy. Social media should mainly be used to target young people who are techno-savvy and rely on the internet to get information (McGetrick et al., 2019). The proposed policy should get the attention of all relevant stakeholders and the public.
A Model to Bring About the Change
The Leininger Sunrise Model (LSM) is the most appropriate model that can be used to bring about change. The model is appropriate because it factors in various cultural aspects such as religion, social, and philosophical dimension ( Albougami, Pounds & Alotaibi, 2016) . Besides, the model can effectively be used to factor in language, which is one of the significant cultural barriers in many healthcare settings. Also, one of the major benefits of the LSM model is its ability to reduce or stop the stereotyping of patients ( de Melo, 2013) . The model can also bring out change as it factors in need to provide patient-centered care ( Albougami, Pounds & Alotaibi, 2016) . Therefore, the implementation of the proposed policy should be based on the Leininger Sunrise Model (LSM).
Designing Strategies
The designing of strategies will involve all relevant stakeholders. Importantly, the strategies will be designed collectively by nurses, the government, and nursing college administrators ( McFadyen et al., 2018) . Also, designing policies will be based on experience. The strategies will be designed in such a way that they factor in the need and interests of all stakeholders. Also, the strategies should be evidence-based.
Implementation Strategies
The first step in the implementation process is the need to understand the cultural factors that affect the role of nurses. A study will be conducted to assess the cultural knowledge and skills of nurses. The second step will be the integration of the transcultural concept in the nursing education curriculum. The integration process will be designed to address major cultural concerns and issues ( Prosen, 2015) . The teaching and learning techniques will be designed to achieve major objectives, including enhancing cultural awareness, knowledge, skills, and encounters. Importantly, students should be involved in the implementation process to improve the effectiveness of the policy.
Evaluation Strategies
The major evaluation strategy will be a written exam to assess the level of students' cultural competence. Also, students will be required to engage in work assignment, which will include role-play and case scenario. At the same time, the ability of nurses to address cultural issues in the workplace will be assessed, especially among intern nurses. The policy is expected to improve the cultural competence of nurses.
Conclusion
Cultural diversity remains to be a significant issue in the healthcare sector, primarily in nursing practice. Nurses now provide care services to patients across cultures. Unfortunately, many nurses have low cultural competence, which can be improved through the integration of transcultural nursing in the curriculum. Transcultural nursing should be given priority to improve the quality of health care services, especially in a culturally diverse setting.
References
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Amiri, R., & Heydari, A. (2017). Nurses' experiences of caring for patients with different cultures in Mashhad, Iran. Iranian journal of nursing and midwifery research , 22 (3), 232-238.
De Melo, L. P. (2013). The sunrise model: A contribution to the teaching of nursing consultation in collective health. American Journal of Nursing Research , 1 (1), 20-23.
Değer, V. B. (2018). Transcultural Nursing. Nursing , 39(1).
McFadyen, T., Chai, L. K., Wyse, R., Kingsland, M., Yoong, S. L., Clinton-McHarg, T., ... & Wolfenden, L. (2018). Strategies to improve the implementation of policies, practices, or programs in sporting organizations targeting poor diet, physical inactivity, obesity, risky alcohol use, or tobacco use: a systematic review. BMJ Open , 8 (9).
McGetrick, J. A., Raine, K. D., Wild, T. C., & Nykiforuk, C. I. (2019). Advancing strategies for agenda-setting by health policy coalitions: A network analysis of the Canadian chronic disease prevention survey. Health communication , 34 (11), 1303-1312.
Murcia, S. E. A., & Lopez, L. (2016). The experience of nurses in care for culturally diverse families: A qualitative meta-synthesis. Latin American Nursing Magazine, 24(1) .
Princen, S. (2011). Agenda-setting strategies in EU policy processes. Journal of European Public Policy , 18 (7), 927-943.
Prosen, M. (2015). Introducing transcultural nursing education: Implementation of transcultural nursing in the postgraduate nursing curriculum. Procedia-Social and Behavioral Sciences , 174 , 149-155.
