The United States is increasingly becoming a multiethnic, multicultural group of citizens. Life is no longer similar for all individuals. As people migrate they bring with them their cultural views, beliefs and language (Bhugra and Becker, 2005). In order to live together with respect, dignity and without prejudice for all, the country has had to educate itself on the beliefs and values of these vast cultures migrating to what they perceive as a land of opportunity whether this be for economic, education, or political reasons.
For the most part in today’s world, cultural groups are intertwined in where they live, work, and attend school. To maintain a civil society, awareness and respect of the various groups needs to be addressed, beginning in the home, schools, and workplace. As discussed by Leininger and McFarland (as cited in Barker, 2009), culture is a way of life that is learned throughout the generations. Although one would hope that cultural education and acceptance begins at home, it is an ongoing process that all individuals should embrace to avoid prejudice and promote harmony in these diverse groups.Cultural Awareness and Healthcare Healthcare is an area where cultural can play a major role in the overall health and wellness of an individual. Providers need to be sensitive to the patient’s traditional ways of medicine while combined with the traditional western method of medicine.
Healthcare professionals also need to be aware of the plethora of languages and dialects that are now part of the American population as well as religious beliefs. Barker (2009) identifies these factors to prevent bias or stereotyping of the patient.Nurses are patient advocates and to ensure that the patient needs are being met, this group will need to utilize their skills to bridge that gap between cultural competence and cultural conflict. For nurses to be able to effectively do this there needs to be ongoing education beginning in the undergraduate and graduate nursing programs as well as in the workplace. Nurses need to identify patients from a specific cultural background and engage the resources available to assist with communication and to accommodate the patient’s beliefs and traditions while providing care.
The Old Order AmishIn an article by Graham and Cates (2006), they address Old Order Amish population and their view of medical care. This group is Christian with an emphasis on family and community over one’s self. They believe in physical labor with a strong commitment to the church. The Amish believe that their life is in God’s hands and prayer is prominent in their lives. Education for this group is through the eighth grade as they do not believe in higher education.
The primary mode of transportation for this group is the horse and buggy while food provisions are from the land they farm.In understanding healthcare in this group, the Amish are not opposed to western medicine however the monetary aspect can influence care. They will seek alternative methods of treatment such as herbs, vitamins, and reflexology prior to seeking care traditional western medical care. If this group deems a particular procedure too costly they may decline related to the financial constraints it would put on the community as a whole. They do not believe in extraordinary life saving measures as this can be viewed as against God’s will.They are a very stoic group believing that complaining is complaining against God.
They do not believe in birth control as they view children as a gift from God. Healthcare professionals can provide accepted care for the Amish but all need to be aware of specific beliefs and traditions to provide cultural care to these patients. This awareness begins by communicating with the patient and family to learn what treatment is acceptable and what we as providers can do to follow their beliefs and wishes. The Amish and Healthcare PracticeBarker (2009) defines the aspects of cultural competence as cultural autonomy, acculturation, and imposition. Cultural autonomy is to uphold ones cultural values without invoking pressure to change their views. Cultural acculturation refers to adapting to traits from another culture and cultural imposition is when one attempts to impose their values upon another.
For nurses to provide culturally competent care to the Amish population they need to have a basic understanding of the beliefs and traditions.The patient and family will be the primary source of information although if internet access is available, this is an easy search that can provide the caregiver with some of the basic beliefs in order to develop a plan of care. During the interview process the nurse will need to educate the patient on the injury or illness, understand the extent of medical care the patient is willing to undergo and what the nurse can do to provide comfort during this time. Understanding the Amish strong belief in God, Amish women wear bonnets during prayer which can occur at anytime.
Nurses can respect this tradition by allowing the patient to wear the bonnet or at minimum place the bonnet on the patients head as to not impede care. If the patient believes in herbs as a form of medical treatment, and these will not interact with other medications, allowing the patient to continue to take the herbs signifies respect to their cultural beliefs. While caring for the Amish patient and a particular procedure is recommended and the patient refuses, the nurse needs to ensure that they have a full understanding of what the procedure is, why it has been recommended and to respect their right to refusal of treatment.There are simple measures that the nurse can do for this population to respect the patient’s cultural values and beliefs and it begins with communication among the patient, family and care providers. Summary The world today is filled with individuals from all walks of life and various backgrounds.
Beliefs and values will differ and mutual respect for these should be practiced by all. Cultural sensitivity begins with awareness of one’s own cultural values, beliefs and an open mind.With this as a basis, one can learn about other cultures traditions and ways of life. The article reviewed provided insight to the Amish culture, their way of life, and the views on medical treatment.
It also explained the importance of religion as a core value and allowed the reader to understand that simple measures can be taken to accommodate these values and beliefs into the patient’s plan of care. For the healthcare professional cultural sensitivity will enhance the overall care of the patient and family.
