The culturally competent healthcare provider
Healthcare providers face multiple challenges when working with patients from different cultures. Unlike managers and employees who work with diverse coworkers and customers, healthcare providers interpretations and decisions impact the patient’s life and future.
I enjoy delivering culture training to healthcare workers. They usually “get it” and understand the importance the role culture plays in their interactions, as well as the idea that culture is more than just ethnicity.
Still, I often hear the frustration healthcare workers encounter when providing services to members of other cultures. Even though they have the best intentions, they often don’t know how to address these differences.
1. Only immediate family were allowed to visit a patient in the hospital. About 12 members of an extended Hispanic family showed up, wanting to see the patient. When the provider said, “only immediate family” the response was, “We are immediate family!” To them, the idea that a cousin or aunt is any less immediate was ridiculous.
2. A woman from Jordan was in consultation with a physician, her elder brother by her side. Before she would make any decisions or offer any responses, she would look at her brother, have a quick conversation in Arabic, and then the brother would provide the answer. The physician thought she could build a better relationship with the patient without the brother in the room. When she asked him to leave, the patient panicked and started to cry.
3. An Hispanic patient brought her 3 children with her for her MRI, even though the healthcare provider explained that the testing would take about 1 hour, and the children could not be left unattended in the waiting room.
4. During intake at a psychiatric hospital, an Asian woman refuses to make eye contact with the healthcare provider. The provider isn’t sure if it’s cultural or related to a mental illness.
One workshop participant told a story that showed the importance of active listening, clarifying, summarizing and probing for more information. She said she was offering bereavement counseling for a Haitian woman who had just lost her 3-year-old daughter. In discussion, it came up that the woman did not attend her child’s funeral with the rest of the family. At first, the counselor was shocked at what she initially saw as a horrible thing for a parent to do. Without judging the Haitian woman, she engaged her in further discussion, only to learn that she was pregnant, and didn’t want to risk the life of her new baby by going into a cemetery. She was, by her cultural standard, being a caring and protective mother. A fact that only came out because the provider took the time to learn more.
What cross cultural issues have you encountered in the healthcare system?