Cross-cultural nursing asserts that optimal healthcare is achieved when it is congruent with the client’s culture. Transcultural nursing proposes that true healthcare should be provided within the context of the patient’s culture. Madeleine Leininger is recognized worldwide as the founder of transcultural nursing. In the modern world, cross-cultural nursing is more relevant than ever.
Cross-cultural nursing is a mid-level theory of nursing science that asserts that optimal health care is achieved only when it is congruent with the client’s culture. A patient’s illness, treatment and health are defined as much by his culture as by physiology and medicine. Not only holistically, but fundamentally, an oath-bound nurse can only be certain that she is “doing no harm” if care is administered with the understanding that such care is not inappropriate for the specific culture of the patient.
The definition of “culture” is a particular set of people’s norms and practices that are learned and shared and that guide an individual’s thinking, decisions and actions. A culture might have unique values in common with no other culture: idealized principles that have isolated its very existence over time. A common practice in one culture might be morally good, but it might be rare and unethical in a different culture. While race and ethnicity have historically been standard demarcations of culture, modern ethnography, or the study of cultures, generally rejects classification theories and methodologies.
Although culture is a social construct, its foundation lies squarely in the mind, body and spirit of the individual. The culinary tradition is a striking example where the social guidelines of food consumption of a group of people are deeply rooted in the spiritual, mental and physical well-being of the individual. To the extent that nursing practice involves caring for an individual and not for oneself, providing care as oneself or ethnocentrically may be a Hippocratic violation. Despite the best of intentions, out of sheer lack of knowledge, if a nurse inflicts a cultural taboo on a patient, the nurse has fundamentally harmed that patient.
Transcultural nursing proposes that true health care should be provided within the context of the patient’s culture. The cause of an illness is often related to where the patient comes from, and the success of recovery from the illness often depends on where he returns to. Knowledge of the patient’s culture gives the practicing nurse greater awareness and sensitivity to the effectiveness of treatment. Broader cultural perspectives allow the nurse to apply basic care through multiple and flexible methods.
One of the prominent theorists, recognized worldwide as the founder of transcultural nursing, is the anthropologist Madeleine Leininger. After a research assignment in New Guinea and her appointment as dean of the University of Washington School of Nursing for five years, she outlined the main tenets of the theory and created the Transcultural Nursing Society in 1974. Dr. Leininger believed that the universality of the human condition comes through innumerable cultural pathways, and that the goals of nursing must therefore necessarily chart that pathway for any given patient. A further principle of cross-cultural nursing is the recognition that the nursing discipline is a culture of its own, with its own medical language and common practices. Recognizing this may be a nurse’s first step, to be able to step through their own learned bubble and into an empathic understanding of the other.
More than ever, in the modern world, cross-cultural nursing is relevant. Countries and societies are increasingly multicultural, and with this diversity, each discrete group has different cultural understandings, including the very definition of who qualifies as a nurse and what constitutes care. Globalization has made group boundaries more porous, and managing a society’s health may even require in-depth knowledge of a culture half a world away, as is the case with treating a pandemic. Healthcare with ignorance of a client’s culture can not only make the individual worse, but can potentially cause unintended harm in a larger dimension.
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