Howard_Melissa_MC538_CulturalSelfAssessment

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1 Cultural Self-Assessment Melissa M Howard University of South Alabama MCN 538-801: Intro to Women’s Health NP Dr. Daphne Hutto September 7, 2023

2 Cultural Self-Assessment Self-Awareness and Health Professionals Having respect towards the client is an attitude I feel is the easiest to achieve. Having an open conversation with the client about what their expectations are and acknowledging what can be honored and what cannot and having those discussions. Avoid making assumptions, this falls into that of having open discussion. Example would be that you cannot assume that since someone is a Jehovah Witness that they will not accept any blood form of blood transfusion, when there are people who will accept certain parts of blood products. A way that I might increase my knowledge about diversity in my community is by visiting a local church for that culture. In the church setting you can see the different age range of people in a smaller setting. Several of the churches will have small festivals to help bring awareness to their culture while raising money. Culture and Essential Terminology I did not grow up around extended family due to my parents moving from New Jersey to Florida after they got married. I do not feel that my parents provided a lot of values and practice for me to learn, I learned many through growing up and people I have encounter along the way. I did learn from my parents about how to treat people the way that you expect to be treated, this is something that I still value and practice today. My household was not a religious one. When rating myself on a scale for how ethnocentric I think I am I would give myself a 4. I am most of time a go with the flow person, and I enjoy learning from others. My friends would probably rate me about the same because I am an easy-going person. I take advice and suggestions from others, and I do not feel that my way of thinking is set in stone. My co-workers in the hospital would rate me around a 7. At work I am someone who feels that policies and procedures are in place for a reason, and that they need to be followed. Even though the policies and procedures may not be my way, I work for the organization and chose to represent them by applying and accepting the job, therefore as an employee I should be following their way unless proven to cause harm.

3 I define race as the genetic make-up that an individual received from both parents. Even though some one may have pale white skin with light eyes, one of their parents could have dark skin and be of African descent. I find myself using the term background instead of race, I would ask about ethnicity and what cultural they identify with. On the last census I identified as White. For race and ethnicity on the census I do think that Hispanic should be added especially since I live in Florida, and we have a large Hispanic population. Hispanic origin is a question however it is not included in the results for race and ethnicity. When thinking of a nurse I visualize a female in her late 20’s dressed in white scrubs (pants and shirt) with no hat on. I work in maternal child, and we currently only have female nurses with the majority being in their late 20’s. When I started working in the emergency department as a new nurse, I would only hear the negative judgements on patients who had addiction problems and that these were the worst patients to take care of because all they wanted were drugs. The first time that I took care of a known drug addict, I was short with them, spent very little time in the room. The doctor did the same thing, so I didn’t think much of the way I was treating the patient we both thought that all they wanted was pain medication. After a while I started to feel horrible for the way that I was treating this patient, that I went into the room and apologized and was honest. In the end they patient became honest with me and was there only for pain medications. I still felt bad for stereotyping and passing judgement on this patient. Now I do not let other people opinions of patient’s sway how I am going to care for the patient. I do still find myself passing judgement in my mind when I take care of patients who have drug addictions while pregnant, and I try my best not to let that affect the care I give. In the area of maternal child, a generalization on a group of people that I have made was that teen parents are not going to be attentive parents and that it will be the grandparents who raise the child. I am glad that much of this generalization has not been true and that teen parents step up to the responsibility of being parents. Primary and Secondary Characteristics of Culture My primary characteristics of culture are a 35-year-old White female from Florida who has no religious affiliation. For the primary characteristics that I have the only one that has changed is my age. As I

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4 have gotten old my worldviews have changed. I was limited as a child of what I was exposed too, in my house we did not watch the news, we did not have discussions about race, religion or politics. Growing up a white female I would find that my voice would get lost in the crowd and that when I did speak up and have an opinion I would be labeled in a negative way. As time has gone, there are more strong female voices out there that I look up to and find to be a role model. My primary characteristic of having no religious affiliation when I was younger made me feel that I would have no purpose when I were to pass or that I was not a good person. Over time I realized that I had parents who taught me value and morals and ways to be a good person. As an adult I feel that my morals now are not that different from those who were raised with a religious affiliation and people should not be looked down upon for what their religion is or is not. My secondary characteristics of culture are a middle class single heterosexual urban nurse with a master’s degree. I grew up lower middle class and have been able to maintain that socioeconomic status as an adult with my career. Growing up in lower middle class some resources like a car, college were not out of the question for me, but I needed to work a little to have those things. Example would be for college I wanted to go to a university and my scholarship only covered 50% of the cost, my parents would only be able to help me for the 1 st year then after that I would have to take out student loans. Instead, I felt that financially it was better for me to stay home and go to a community college that was covered 100%. I still know that I am lucky to be able to maintain the same social class that I was raised in. I used to think that others would just waste their money on “junk” but as I got older, I now know that someone could have financial strains that others are now aware of. Living in an urban area I did not know of criminal activity that went on. I thought that it only happened in the “bad areas.” Now there is criminal activity that happens in every part of the world, and it does not matter your socioeconomic status or the area you live. When I was younger, I had this worldview that you had to be married in your early 20s and then you had a family. Now as a 35-year-old, being single and childless at this age it is slowing become accepted. I do feel that I am being judged by people for not having a significant other. Getting older I know that not everyone is going to follow the same mold and plan and that is okay.

5 Ethics Across Cultures I perceive truth telling as something that should all ways be done; I was taught at a young age that it is not right to tell a lie. I am someone who does not always tell the truth. I feel that there are situations in life where is it okay to lie to someone. I am also someone who will not state the whole truth. In the example given if there is a patient that is asking if she is going to get better, and the truth is that she is not. I would tell her that “as of right now it does not look like she will be improving, but that does not mean it can not improve.” Even though what I told her that she was not improving I did not tell her the whole truth. I gave that patient a little hope that her situation would improve and sometimes that can improve the quality of time that do have left. I feel that withholding information is a form of not telling the truth, that in the moment may feel like the right thing to do, but in the end, it is still a lie. A form cultural imperialism I have witnessed when I was a nurse at a big city hospital. There was a concierge service for VIP clients. I had a patient who was being prepped for an emergent imagine scan due to being a stroke alert. My patient was moved off the imaging table prior to the scan for the VIP client to have a scan done. I realize that we do live in a world where there are VIP clients, but when someone is getting taken care of at a public hospital their needs to have a hierarchy of patient condition over a client VIP status. I did speak up afterwards about how we have a time we had to meet for this patient who was being treated for a possible stroke, I was then told that the VIP client time is what gets the hospital money. I have also witnessed cultural imposition by a few of my coworkers that believed a fetal demised needed to be blessed by the chaplain despite the families wishes for it not to be. In one situation when the nurses were taking the demise to the morgue, they did their own ritual of blessing the baby. I approached the nurses about it, and they said it was what they do in their religion. There was no concern over the family’s beliefs that could have their own way of blessing the demise. I know that I cannot change others outlook on cultures, but I can help to educate myself and make my own decisions. Individual Cultural Competence

6 I think that the values and the beliefs of the client’s should come first. If a client is coming to you for care and assistance, they are already placing their trust in you. Most likely they are in a vulnerable state when they are seeking care, and helping to maintain their cultural values and beliefs can assist them. As healthcare providers we took on our roles to help those in need. If we have a patient that we do not agree with their beliefs, we should assist in finding an appropriate provider that will. An example that I witnessed in previous years was a patient who wanted to terminate a pregnancy due to medical reasons. The provider did not believe in abortion with a heartbeat under any circumstance. Instead of just ignoring the patient’s wants the provider assisted the patient with finding a provider that will assist. This is an example of being able to uphold your values and beliefs while still assisting someone who goes against them. The Purnell Model for Cultural Competence Global Society : I see the world and cultures all connected. I take opportunities to learn about someone cultures when I can. I enjoy travelling and try to adapt to the area I am in. Family: My parents divorced, and I have an estranged relationship with my father. With my mother we see each other on holiday and special occasions but are not physically or verbally affectionate towards one another. Person : As a healthcare provider I try to provide the type of care I would like to receive. Overview/Heritage: My heritage is that of an American culture. Even though my ethnicity is English and Irish I did not grow up knowing these cultures. We celebrate traditional Christian holidays and birthdays. Communication : I am someone who only speak American English with no known dialect. I am not someone who is considered a “hugger” I enjoy personal space and can get overwhelmed with a lot of sound. Family Roles and Organization : I do not feel that there is a head of the household, both parents are equal in it despite who makes the most money, who spends more time with the family, who cleans more. As someone who is currently childless and single, I am looking towards possible being a single mom by choice. I do not feel that you have any less of an upbringing if it was done by one parent or two.

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7 Workforce Issues : There are language barriers I come across at work, and I am trying to learn a new language to help. Biocultural Ecology : I come across disparities in my line of work. I try to take interest so I can learn more. High-Risk Behaviors : My high-risk behavior is that I consume alcohol. I am a social drinker, therefore the amount of alcohol I consume is dependent on the event setting I am in. I average about 3 drinks a week. Besides alcohol, I do not participate in other high-risk behaviors, I wear my seat belt, I eat a well-balanced meal and I am someone who stays active. Nutrition: I eat a well-balanced diet. I have my healthy food as well as the non-healthy food in moderation. I am dairy-free due to intolerance. I also limit my caffeine consumption to less than 250 mg a day. Pregnancy: Pregnancy is something I have not experience yet. Pregnancy is something I want to experience in the future. I do think oral contraceptives should be more readily available to the population. Death Rituals : When it comes to death, I am not someone that knows how to process it. I accept that death occurs, but it is hard for me to accept that there is nothing after life. This stems from the lack of religion I was exposed to as a child. Spirituality : I am not someone who will lead a prayer, however I will join in. Even though I do not identify as a certain religion I do believe that there is power in prayer. Health care practices: I try to give culturally competent care, if I do not, I try to learn from it. Health care practitioners: I have cared for those whose practices I do not agree with. I either do my best to educate them or if I need to hand them off to someone else.

8 References Purnell, L. (2005). The Purnell Model for Cultural Competence. The Journal of Multicultural Nursing & Health, 11(2).

Howard_Melissa_MC538_CulturalSelfAssessment

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