Nursing students' experience of learning cultural competence.

INTRODUCTION: European societies are rapidly becoming multicultural. Cultural diversity presents new challenges and opportunities to communities that receive immigrants and migrants, and highlights the need for culturally safe healthcare. Universities share a responsibility to build a fair and equitable society by integrating cultural content in the nursing curricula. This paper aims to analyze European student nurses´ experience of learning cultural competence and of working with patients from diverse cultural backgrounds. MATERIALS AND METHODS: A phenomenological approach was selected through a qualitative research method. 7 semi-structured focus groups with 5-7 students took place at the participants' respective universities in Spain, Belgium, Turkey and Portugal. RESULTS: 5 themes and 16 subthemes emerged from thematic analysis. Theme 1, concept of culture/cultural diversity, describes the participants' concept of culture; ethnocentricity emerged as a frequent element in the students' discourse. Theme 2, personal awareness, integrates the students' self-perception of cultural competence and their learning needs. Theme 3, impact of culture, delves on the participants' perceived impact of cultural on both nursing care and patient outcomes. Theme 4, learning cultural competence, integrates the participants' learning experiences as part of their nursing curricula, as part of other academic learning opportunities and as part of extra-academic activities. Theme 5, learning cultural competence during practice placements, addresses some important issues including witnessing unequal care, racism, prejudice and conflict, communication and language barriers, tools and resources and positive attitudes and behaviors witnesses or displayed during clinical practice. CONCLUSION: The participants' perceived level of cultural competence was variable. All the participants agreed that transcultural nursing content should be integrated in the nursing curricula, and suggested different strategies to improve their knowledge, skills and attitudes. It is important to listen to the students and take their opinion into account when designing cultural teaching and learning activities.

[Community health and interculturality]. / Santé communautaire et interculturalité.

An interventional research study in public health was carried out with populations originating from sub-Saharan Africa living in France. With the aim of acting on health inequalities through health education, the researchers focused notably on the links between intercultural relationships and the improvement of health promotion actions.

REVISITING "THE INVISIBLE CULTURE OF THE MULTIRACIAL, MULTIETHNIC INDIVIDUAL: A TRANSCULTURAL IMPERATIVE".

Past and present policies, politics, myths, stereotypes, and societal attitudes influence the lived experience of multiple heritage individuals, often resulting in marginalization, disparities, invisibility, cultural pain, and/or unmet needs. This article offers commentary about the past and present with thought-provoking questions for future direction regarding "The Invisible Culture of the Multiracial, Multiethnic Individual: A Transcultural Imperative." The commentary revisits and reminds readers about the 2001 article on the same topic, quickly brings them to the reality of the present, and challenges nurses and other professionals to dismantle disparities through cultural congruent care that focuses on making the invisible culture visible.

THE INVISIBLE CULTURE OF THE MULTIRACIAL, MULTIETHNIC INDIVIDUAL: A TRANSCULTURAL IMPERATIVE (REPRINT FROM 2001).

The main purpose of this introauctory article is to evoKe professional awareness, spark interest, stimulate thought, and disseminate information concerning multiracial, multiethnic (multiple heritage) individuals within the United States. General background information, terms, definitions, ethno-historical influences, practice implications, and current issues will be highlighted. Areasforfurther exploration will be proposed. Transcultural imperatives urge all nurses and other health care professionals to become active participants in the new cultural evolution of a different, broader worldview that uncovers the "invisible" culture of multiple heritage individuals. The new vision challenges nurse and other health care professionals to embark upon a new journey in the quest for cultural congruent care for all individuals.

Recruitment of nurses from India and their experiences of an Overseas Nurses Program.

BACKGROUND: Overseas recruitment has been vital to the contribution of staff growth in the National Health Service (NHS). In 2011, high nursing vacancy rates within critical care required that overseas nurses were recruited. The recruited nurses were placed in an Overseas Nurses Program (ONP), a course designed to assist overseas nurses in adapting to the NHS. AIM: To describe the experiences of nurses recruited from India who participated in an ONP. DESIGN: A qualitative, research approach was chosen to gather descriptions of the lived experiences of nurses from India transitioning to London, to work in critical care settings. METHOD: A descriptive qualitative approach was taken using in-depth, semi-structured and audio-taped interviews. They were conducted over a 69-day period (30 November 2012 to 6 February 2013) with 16 nurses from India. The nurses were questioned about challenges, experiences and differences; they were also asked to make suggestions for other nurses undertaking an ONP in the future. Interviews were transcribed verbatim into a formal written style with NVivo10. RESULTS: Eleven females and five males aged 25-33 years who had completed up to four years of university training participated in this study. The themes extracted were autonomy and responsibility, language, culture (food and climate), loneliness and work challenges (ONP and essay writing). Participants identified that they would have benefited if pre-allocated mentors from non-English speaking countries who had previously been through the transition process were available to assist them with their personal and professional integration into a new country. CONCLUSION: Autonomy disparity, language barriers and cultural differences need to be recognised and acknowledged by multi-disciplinary teams, by allowing sufficient time and additional support for non-English nurses undergoing ONPs. RELEVANCE TO CLINICAL PRACTICE: Overseas nurses would benefit from being mentored by another nurse from a similar culture, with a non-English background. It may be feasible for overseas nurses to receive training in cultural competencies to improve disparities.

Walking in two worlds.

It has been nearly quarter of a century since nursing educator Irihapeti Ramsden wrote the guidelines on cultural safety (Kawa Whakaruruhau), ratified in 1992 and subsequently much revised (most recently in 2011) by the Nursing Council. The Te Puna Hauora Kaupapa Nursing Service at Tauranga Hospital has been in existence for more than 18 years. Despite this, the experiences of Maori nurses described here, and the lack of adoption of truly bicultural nursing services in other parts of the country, indicate far more investment is needed in Maori nursing. What all those working in the health-care system need is the capacity to deliver whanaungatanga models of care, through cultural awareness education, and through the development of cultural competencies.

Cultural safety in New Zealand midwifery practice. Part 1.

Midwives in New Zealand work within a unique cultural context. This calls for an understanding and appreciation of biculturalism and the equal status of Mãori and Europeans as the nation's founding peoples. This paper is the first of two papers that explore the notions of cultural safety and competence. Exploration and discussion take place in the New Zealand context, yet have transferable implications for midwives everywhere. This first paper provides a background to practice in a bicultural country where cultural safety strategies were introduced over 20 years ago to help reduce health disparities. The implications of these strategies are examined. The second paper will focus on midwifery education and practice.

Motivation and international clinical placements: shifting nursing students to a global citizenship perspective.

Nursing programs are increasingly offering international clinical experiences as part of nursing curricula. The purpose of this study was to understand what motivates student nurses to take part in these experiences. Related to motivation, student awareness of emerging nursing discourses on global citizenship was also examined. As part of a qualitative study, nine undergraduate nursing students were interviewed about their motivations for choosing a clinical placement to a low-income country. While students appeared to have a sincere desire to make a difference, closer examination of the data revealed that the majority approached their international clinical placement in ways that could be construed as paternalistic to some degree, rather than reflective of broader professional imperatives such as social justice. This finding suggests that additional education preparation may be needed prior to these experiences; global citizenship frameworks may be helpful in shifting perspectives towards a more critical enquiry of global issues.

Nurses Christian Fellowship International: Partners in Care.

The Nurses Christian Fellowship International Quadrennial Conference was held November 5-10, 2012, in Santiago, Chile. The theme, "Partners in Care: Unity in diversity through Christ" brought together nurses from all over the world for Bible teaching, education, networking, and fellowship. Plenary and session abstracts are available as supplemental digital content through the HTML and PDF versions of this article at journalofchristiannursing.com.

Engaging with communities to foster health: the experience of inner-city children and families with learning circles.

The authors briefly introduce a clinical outreach initiative that is innovative because of the types of partnerships that have been formed within an inner-city community context. The initiative was designed to foster access to primary health care and specialized services for children and families who are vulnerable because of their social and material circumstances.Through ongoing engagement and dialogue, the clinicians and the community have developed a number of points of engagement with the children and families.The authors use the case of Learning Circles to describe ways in which Indigenous knowledge and ways of being influenced the approaches taken to working with children and families. They reflect upon the ways in which this approach influenced community engagement and consider its potential for achieving health equity.

Addressing health inequities through indigenous involvement in health-policy discourses.

Although the health of Indigenous peoples is affected by structural inequities, interventions to address health inequities are often focused locally rather than at a structural level where they could play a transformative role. Addressing structural health inequities by involving Indigenous peoples in health-policy discourses can serve to address power imbalances that are implicit in policymaking processes. Using an analytical framework based on interdisciplinary perspectives rooted in critical and decolonizing approaches, the author presents a discussion of theoretical considerations for including Indigenous peoples in policy discourses as a means of addressing health inequities. She argues that the involvement of Indigenous peoples in health-policy discourses has the potential to mitigate epistemological colonialism, push forward an agenda of decolonization, and address health inequities caused by inequitable systems of power. The article concludes with suggestions for future research and implications for nursing and health professionals of addressing structural inequities through attention to policy discourses.

Global health for nursing...and nursing for global health.

This article draws on the literature to present a conceptualization of global health (GH) that corresponds with the discipline of nursing and defines the contributions of nursing to GH. The author's perspective is that "health" should be defined and considered holistically to reflect the fact that GH involves more than the eradication of disease and that health as a fundamental right of every human being must be made explicit. "Global" refers to the supraterritorial links among the social determinants of health located at points anywhere on earth within a whole-world context. The focus of GH is the supraterritorial determinants and its ultimate objective is health equity for all nations and all people. The contributions of nurses are advocacy, healing and alleviating suffering through caring, and increasing nursing capacity globally. To truly advance the GH agenda, a new world order is needed, one in which political decision-making is guided by our shared humanity.