Culture, Generational Differences and Spirituality

Nursing Leadership &

Management

Chapter 16

Objectives:

Upon completion of this presentation, the ADN nursing student will be able to:

• Define culture

• Understand race and ethnicity and health care disparities.

• Discuss cultural competence

• Identify key cultural nursing theories and theorists

Objectives:

• Discuss organizational culture

• Review strategies with working within a multicultural team

• Review generational differences and perceptions

• Integrate spiritual beliefs into culturally competent nursing care.

What is Culture?

Integrated lifestyle that includes:

• Learned and shared beliefs

• Values, world views, knowledge

• Artifacts, rules, and symbols

• Passed from generation to generation

Culture

• Guides the behavior of a particular group of people

• Incorporates the experiences of the past and influences the present

• Explains patterns of thoughts and actions

• Contributes to the group’s physical and social activities

The Development of Culture

• Culture is learned and shared from parents, teachers, religious and political leaders and respected persons.

• Normally, children learn as they are growing up.

Families

What is a Subculture?

Smaller groups within a culture that may be based on:

• Professional and occupational affiliation

• Nationality or race

• Age group

• Gender

• Socioeconomic factors

• Political views

• Sexual orientation

What is Cultural Shock?

What is Cultural Shock?

Develops when values and beliefs upheld by new culture differ radically from person’s native culture.

Ways to alleviate cultural shock?

Newcomers can assimilate into the new culture by learning the new culture’s important values.

What is Race and Ethnicity?

• Race-geographical or global human population distinguished by human traits and physical characteristics.

• Ethnicity-identification of person or group based on racial, tribal, linguistic, religious, national or cultural group.

Population of the United States by Race and Hispanic/Latino Origin, Census 2000 and 2010

• White 63.7% [2010] and 75.1% [2000].

• Black/African American 12.2% [2010] and 12.3% [2000].

• American Indian/Alaska Native 0.7% [2010] and 0.9% [2000].

• Asian 4.7% [2010] and 3.6% [2000].

• Native Hawaiian/Pacific Islander 0.15% [2010] and 0.1% [2000].

• Hispanic/Latino 16.3% [2010] and 12.% [2000].

U.S. Census Bureau: National Population Estimates: Decennial Census.

What are Health Care Disparities?

• Cultural beliefs that can cause marginalization or separation from mainstream health care.

• Marginalization groups often suffer high rates of morbidity, mortality and disease due to: lack of health care access, inadequate financial resources, immigrant status and lack of knowledge of available resources.

Differences in Health Risks and Health Status

According to, the Office of Minority Health and Health Disparities (OHMD, 2010), death rates for the black population of the U. S. surpassed the white population by:

• 48% for cerebrovascular disease

• 31% for heart disease

• 21% for malignant neoplasms

• 113% for diabetes

Differences in Health Risks and Health Status

According to the U.S. Census Bureau (2011), the following groups of people live below the poverty line:

• 30% of Native American Indians

• 29.5% of Hispanics

• 14.1% of Asian/Pacific Islanders

Compared to:

• 9.8% of the White population

Diversity in Nursing

• Most nurses are Caucasian women

• 6.2% male nurses

• 10.9% Blacks are highest minority

American Association of Colleges of Nursing

(AACN, 2010).

Language

In the United States:

• 80% of the population speaks English

• Of the remaining 20%, 62% speak Spanish

*Provide an interpreter, it is a guaranteed right under Title IV of the Civil Rights Act of 1964

What is Culturally Competent Care?

A complex integration of knowledge, attitudes and skills that extend across cultural lines, according to the American Academy of Nursing (AAN, 1992)

http://youtu.be/Dx4Ia-jatNQ

Care that is:

• Designed for the specific patient.

• Based on the unique culture of that patient

• Provides cultural sensitivity.

• Provides the patient empowerement to make decisions (AAN, 1992)

Nursing Education in Cultural Diversity

• Since the 1960s, nursing education has included cultural diversity and sensitivity concepts in it’s curriculum.

• The National League of Nursing Accrediting Commission, Inc. (NLNAC, 2008) has made cultural diversity training mandatory for accreditation.

• Cultural nursing theories and theorists help to guide nurses to manage, understand and lead culturally sensitive workplaces.

Organizational Cultural

Culture

• A system of shared values and beliefs that influence the behaviors of its members.

• Values, existence, resources, degrees of change and strength set the culture.

Socalization

• Workplace culture.

• Strong and shared mission, vision and goals.

• Sensitive to culturally unique staff.

• Perceptions of responsibilites and roles is important.

Generations

• Generations are groups that share birth years, age, locations and significant life events.

• Approximately, 15 to 20 years in length.

• Value systems differ.

Generational Perceptions

Traditionalists

• Born before 1940s

• Born after the Great Depression

• Raised with discipline to obey orders

• Obligated to conform

• Work is a duty

Steady

Generational Perceptions

Baby Boomers

• Born between 19440 and 1960

• Grew up in educational and economic expansion

• Work for challenge and career advancement

• Largest generation with financial impact

Careers

Generational Perceptions

Generation X

• Born between 1960 and 1980

• Self Reliant and independent

• Look for career security not job security

• Willing to change jobs, loyalty to oneself not employers

• Want technologically current work environment

Independent

Generational Perceptions

Generation Y

• Born after 1980

• Children of Baby Boomers

• Grew up at the end of the Cold War

• Speak your mind philosophy

• Focus on early retirement

• Mantra is change

• Expect countless options

Speak your mind

Generational Perceptions

Generation Z

• Born in late 1990s

• Born during technology

• Have a multi-cultural and multi-racial friends

• Do not believe in the “American Dream”

Technology

Spirituality

• Component of healing in most every culture

• Important assessment during hospitalization

• Nurses can use resources for spiritual support

Spiritual Distress

• Recognized as a North American Nursing Diagnosis (NANDA)

• Identifies when a person has impaired ability to integrate meaning and purpose in life with self, others, art, music, literature, nature or power greater than oneself.

• Help to connect patients spirituality with method such as meditation, prayer, participation in religious services or rituals.

Champion Spirituality

• Provide holistic care to patients and fellow staff.

• Develop understanding and empathy for others spirituality.

References American Academy of Colleges of Nursing (AACN). (2010). Race/Ethnicity of students enrolled in generic (entry-

level) baccalaureate, master’s and doctoral (research-focused) programs in nursing, 2001-2010. Retrieved from http://www.aacn.nche.edu/research-data/EthnicityTbl.pdf Kelly, P. & Tazbir, J. (2014). Essentials of nursing leadership & Management (3rd ed.). Clifton Park, NY: Delmar NLNAC accreditation manual. (2008). National League of Nursing Accrediting Commission,, Inc. Retrieved from http://www.nlnac.org/manuals/NLNACManual2008.pdf Office of Minority Health & Health Disparities [OMHD]. (2010). About minority health. Retrieved from http://www.cdc.gov/omhd/AMH/SMH.htm U.S. Census Bureau. (2007). American community survey. Retrieved from http://www.census.gov/acs/www U.S. Census Bureau. (2011). 2010 census data.gov/2010census/data/

Association