Response to Diversity

Responseto Diversity

Responseto Diversity

Forthe health care providers, the cultural diversity is a priority and achallenge, because of the changing demographics and growingmulticultural world. Knowledge of the cultural diversity is extremelyimportant in nursing practice. This can positively affect the healthcare delivery system. The cultural competence in nursing careimproves patient outcome and the quality of care provided. Aculturally competent nurse identifies that every patient and familymember is unique and deserves to be treated with respect. It isessential for the nurse to recognize patient/family’s values,beliefs, preferences, and personal needs. I could provide aculturally competent care for the following situation in NeonatalIntensive Care Unit (NICU).


Athirty-nine week by gestational age baby was admitted to NICU withrespiratory distress. On admission, the baby was placed on bubbleCPAP, PEEP 6 and 23% FIO2. A blood sample was sent for CBC, glucoseand blood culture. Peripheral IV was done for IV fluid andantibiotics. Feeding was given via orogastric tube. On the second dayof life IV fluid was discontinued and the baby weaned off CPAP toroom air. The mother of the baby visited Neonatal Intensive CareUnit (NICU). I introduced myself, arranged a private place, andoffered her a recliner. I explained the infant’s condition brieflyand called the doctor to explain in detail about the medicalcondition of the baby. As the baby was sleeping the mother did notwant to hold the baby. The mother was very sad to see the baby, andher anxiety was clear on her face. I could see her eyes filled withtears, and sometime she sobbed. It is important to increase medicalcare outcomes by providing tailored or individualized health servicesto the young patient.

ElicitingCultural Information

Myprimary responsibility is to elicit essential cultural information. So, I asked her whether she has any religious, spiritual, cultural,social or other preferences or practices that I need to know, forproviding a comprehensive, individualized care for her baby.According to Schub, Leininger’s theory of Sunrise Model can be usedas an assessment tool for individualized cultural assessment. “Themodel presents seven social structure domains. “Technologicalfactors religious and philosophical factors kinship and socialfactors cultural values, beliefs, and lifeways political and legalfactors economic factors and educational factors, must beconsidered when assessing patient’s needs within a culturalcontext” (Smith, 2016). The mother said that she was a Muslim andused to recite the Qur’an at home, and wanted to recite the Qur’an,for her baby too. I offered the spiritual care service from Harrishealth system. But she declined the chaplain’s service. I shouldincorporate Muslim cultural beliefs, attitudes, and traditions forMuslim patients. Our caring involves knowing the different values,beliefs, and behaviors of other cultures, which may be different orsimilar from our own. This values and beliefs influence how we relateto others to integrate them into the plan of care. I told themother, she can bring her religious leader for the prayer andrecital. The cause of her sorrow was that she wanted to recite a partof Quran to the baby. As transportation was very difficult, she wasnot able to arrive at Neonatal ICU for that purpose. She was veryhappy when I told her that there were employees who knew the Quran.Unfortunately, those employees were off on that day. I arranged aprivate place for her prayer and recital. I offered a clean blanketto keep her Qur’an, another big blanket for her prayer. But themother refused the blanket for her prayer she said she would praywhile standing. “Prayer consists of reciting religious textpassages while standing, bowing, prostrating and kneeling” (Smith,2016). I showed her the restroom, to perform her rituals before theprayer. “According to religious law, a Muslim person must cleansehis or her face hands, mouth, nose, forearms, and feet prior toperforming ritual prayers” (Smith, 2016).

Healthprofessionals are competent enough to generate cultural informationabout a patient. The most effective approaches to getting culturaldata and information from the patients are interviews andobservations. The health care worker is expected to ask culturalquestions and encourage the patient to provide an appropriateresponse. Culture is just a transmitted system of shared values,beliefs, artifacts, and practices. It differs from one community toanother, and this describes the diversity of patients and healthstaff (Margaret et al., 2016). I made oral inquiries to identify thecultural background of the mother. She is a Muslim and thus prefersto pray several times in the hospital. She requested for a cleaningroom because Muslims wash their face, hands, and feet before prayers.

CulturalDifferences and Effects on Care

Asa nurse, to provide a culturally competent care, I should respect thepatient beliefs, values and learn to integrate them into the plan ofcare. So, I gave a suggestion that if she could write the part of theQuran in English, I might recite it to the baby. She was extremelyhappy to hear these words and she agreed. She wrote that part of theQuran in English, and she read it to me. She corrected thepronunciation of some words and I, in turn, read it to her. Accordingto Smith, “the most effective spiritual interventions for Muslimsinvolve reading and discussing a passage from the Qur’an” (Smith,2016). I asked her whether somebody might be assigned for therecital in my absence. She was not very happy to do so. As I was onduty for consecutive two days, I did the recital myself for the baby.The mother was very happy.

Healthcare is provided differently to patients from different culturalenvironments. The Muslims believe that health care should beintegrated with spirituality. The mother highly approved the healthcare given to her baby. This is because the care incorporatedtreatment with cultural and spiritual practices. I agreed to recitethe Quran to her and her baby during the treatment process. Shebelieves that the prayers are critical in improving the healthoutcomes of her baby.

UnderstandingHealth System Culture

Itis important for the family to understand the culture of the healthcare system. I explained the visitation policy (24 hours unrestrictedvisiting time), the importance of hand washing to prevent infection,safe and quiet NICU environment, and availability of health supportservices. I encouraged her to contact a social worker, through thetelephone, to discuss her transportation problems. With theapplication of the principles of patient-centered care, for caringthis baby and its family, I coordinated communication between theneonatal team and the mother. “A patient- centered approachinvolves being aware of the role of cultural health beliefs andpractices in a person’s health-seeking behavior and being able tocollaborate with patients and negotiate treatment optionsappropriately and in a culturally sensitive was” (Smith, 2016). Thebaby was discharged after two days. Having arrived home, the mothertelephoned me and expressed her boundless love and gratitude. After afew days, I rang up to the mother and inquired about the baby. Themother stated that she was satisfied with the care received for herbaby in the NICU, incorporated with her spiritual and culturalbelief.

Thepatients and their family members are required to understand theculture of the health system. Good health culture improves patientsatisfaction (Margaret et al., 2016). Teamwork is an importantculture in health systems. This is because the health professionalswork together to offer high-quality and affordable care to thepatient. Teamwork improves information exchange and, therefore,health challenges are easily addressed. The mother was allowed tovisit and care for her baby at any time. The health institution has aculture that encourages unrestricted visitation. The health systemculture shows effective communication between the health staff andthe patients or family members. I engaged in continuous communicationwith the mother of the sick baby. The information exchange enabled meto understand how to offer individualized care to the baby and themother. The health system culture monitors the progress of thepatients after treatment or discharge (Hanlon, 2014). I telephonedthe mother to enquire about the recovery of the baby. The motherexplained that the recovery progress of the baby is satisfactory.

InterpretingDiversity Effects on Care Needs

Diversityaffects the care needs of patients. The plan enables health careworkers to provide care services to patients based on their interestsand expectations (Josepha, 2016). The care plan improves the patientrecovery and satisfaction level. This is because the patients arediagnosed and treated based on their interests. The baby in NICU wasgiven appropriate care that involved usage of 23% FIO2, CPAP, andPEEP 6 medication after medication. The mother was allowed to monitorall the diagnosis and treatment processes that the baby received. Themother was given the opportunity to take care of her baby duringtreatment.

CulturalDifferences and Effects on Care

Healthcare is provided differently to patients from different culturalenvironments. The Muslims believe that health care should beintegrated with spirituality. The mother highly approved the healthcare given to her baby. This is because the care incorporatedtreatment with cultural and spiritual practices. The health staffagreed to recite the Quran to her and her baby during the treatmentprocess. She believes that the prayers are critical in improving thehealth outcomes of her baby.

AdaptingCare to Meet Specific Patient Needs

Healthcare is planned to adhere to the diversity needs of the patient. Thecultural interest of the patient is achieved through the provision ofmedical care that is culturally sensitive. The health staff shouldenquire from the patient the care that adheres to his or her culture(Hanlon, 2014).The case shows that the Muslim mother was given room to wash herface, feet, and hands before prayers. I also volunteered to recitethe Quran to her and her baby during the treatment process. Sheappreciated the effort of the health worker to provide sufficientemotional, spiritual, and culturally sensitive support during thecare process.

AccommodatingDifferences that are Personal and Professional

Itis important to consider the personal interest of the patient duringthe treatment process. The opinion of the patient or family membersshould be sought by the health professionals if there are alternativetreatment options (Margaret et al., 2016). In case specialized careis required, the perspective of the patient and family members isimportant in selecting the health institution that will manage his orher health condition. The personal interests of the Muslim patientand her baby were considered by the health team. The nurse wrote someQuran verses in English. The mother was happy the nurse agreed torecite the Quran to her baby. The professional level of the Muslimmother is not indicated in the case study. The nurse, however,explained all the health care stages to the mother. She understoodthe care system and even requested for the integration of Muslimcultural beliefs and practices. The young patient and her motherexperienced high satisfaction level because of the individualizedcare that they received from the care team.


Hanlon,P. (2014). Bubble CPAP: cost-effective, efficient, and safe.Retrieved from

Josepha,C. (2016). Many Faces: Addressing Diversity in Health Care. Retrievedfrom

Margaret,C. et al. (2016). Patient Education: Addressing Cultural Diversityand Health Literacy Issues. Retrieved from

Smith,N. (2016). Culturally Competent Nursing Care: A cornerstone ofcaring. Retrieved from http//