Culturally competent care: Curandero Case

Course Description

This course focuses on the fundamentals of an evidence-based approach to examining a range of cultural norms, religions, and alternative health care practices of varied racial and ethnic groups, and how these practices affect the definition, design and implementation of culturally competent, individualized health care. Variations in race, ethnic, age and gender groups, family structure and patient support will be explored. Emphasis will be placed on summarizing intercultural aspects and how the multicultural professional nursing workforce can collaborate to assess, plan, and manage care according to the cultural and spiritual needs of individual patients and populations.

Course Learning Outcomes

By the end of this course, students should be able to:

1. Identify and contextualize the factors that constitute their personal culture, beliefs, and upbringing to understand how those factors influence interactions with patients and the environment. (PLO 2)
2. Discuss variations in cultural, and religious backgrounds and practices of patients and families, and their effect on compliance with treatment. (PLO 3, 7, 9)
3. Analyze alternative healthcare practices and the effect they have on the provision of patient centered care. (PLO 3, 7, 9)
4. Synthesize aspects of knowledge and communication principles pertinent to the intercultural aspects of patient care, and manage care according to the cultural and spiritual needs of individual patients. (PLO 2, 4, 5, 6)
5. Evaluation of knowledge of the impact between morals and ethics and how they direct patient and provider choices for treatment across the lifespan. (PLO 2, 8, 9)

WEEK ONE MODULE OVERVIEW (required reading)

Cultural competence has been discussed in nursing for many years, but what is cultural competence? Is it just that someone is from a different country or that they do not speak English? Is it that they may practice a different religion?

By the end of this course you will be able to define what cultural competency is and how it is embedded into your practice. You will come to know and learn the importance of cultural competence and the richness it brings to the care you give.

A story:

A number of years ago in a community clinic, a mother brought her young daughter in (around 8 years old). She said her daughter just did not seem to be herself. This was the first time the mother and daughter had been to the clinic.

The Mother spoke Spanish and was asked if she would like to have a translator available, (as the clinic was located in an area where most families spoke Mexican/Spanish there were translators on staff everyday at the facility) Mom stated that she understood English fine and declined. A full history was obtained. While the mom was giving the history the child was given paper and crayons to draw a few pictures. After the history the attention was turned to the child. The drawings were of the girls family, but there was another person in the drawing, when asked who that person was, the mother quickly answered and said “a friend”. The exam was explained to the child first so that she knew what was going to happen, her feet would be touched, her legs and arms, her head and that her ears would be looked at and so on. The exam itself was unremarkable.

Labs were also drawn. Mom was told that we would interpret the labs first and then give mom a call as to what we thought the diagnoses might be. Within 48 hours the lab results showed  a high lead level.

Mom was called and asked if there was anything that she might have forgotten to mention in the history such as medications or vitamins that her daughter might be taking. The mom told stated that she was certain that she had told everything.

The mom was asked to bring her daughter in again in three days.

Mom actually came in the next day without the child and stated that she had been going to a Curandero (Mexican natural healer). The healer had given her a solution to give to her daughter to drink, 1 tsp two times a day. She had been doing this for a year. Mom was asked if she had the solution with her, she said yes, we asked if we could have a sample of the solution. Mom was a bit reluctant but did give a sample. The sample was sent to a lab for testing of what it contained. The lab result came back + for  lead. The mom was called and notified to take the child to the hospital for chelation therapy. Remembering the picture that the little girl had drawn, the mom was asked about who that other person was, (knowing that the area that the clinic was in had a healer in the community). The Mom said she did not want to get the Curandero in trouble thus, she did not tell us that her daughter was taking the solution. We told mom that we understood her concern, and the most important thing now was to have her child get healthy. She was then asked if any other child in her home was taking the solution and she assured me they were not.

After a few weeks, the mother was called to see how things were going, and to ask the mom if she might get in touch with the Curandero. We wanted to set up a meeting with her and partner with her so that we could all work toward the best outcomes of those in the community. Mom thought that was a good idea, but she did not think that the Curandero would be open to it.

About six weeks later the Curandero came to the clinic, she wanted to look around and just see what we had in mind. It took many meetings but in the end the Curandero decided we could be trusted and became apart of our support. We learned many things from her and she in turned learned from us. It has been a benefit to all.

The story is about being open, being trusting and knowing your environment. How you approach the topic and ones attitude plays a role in the success of being culturally competent and providing culturally sensitive care.

ASSIGNMENT

Discuss what your understanding of culturally competent care is and what it means to you.

Expectations

• Length:  250 Words min
• A minimum of 3 references (not older than 5 years) with corresponding in text citations using APA format 7^th ed