Communicating with culturally and linguistically diverse patients in an acute care setting: nurses’ experiences

doi:10.1016/S0020-7489(02)00089-5

International Journal of Nursing Studies

Volume 40, Issue 3, March 2003, Pages 299-306

https://doi.org/10.1016/S0020-7489(02)00089-5 Get rights and content

Abstract

Communication with culturally and linguistically diverse (CLD) patients has been shown to be difficult. This study describes nurses’ experiences of communicating with CLD patients in an acute care setting. A purposive sample of registered nurses and certified midwives (n=23) were interviewed. Main findings were: interpreters, bilingual health workers and combinations of different strategies were used to communicate with CLD patients; some nurses showed empathy, respect and a willingness to make an effort in the communication process with others showing an ethno-centric orientation. Main recommendations were: prioritising access to appropriate linguistic services, providing nurses with support from health care workers, e.g., bilingual health care workers who are able to provide more in-depth information, increasing nurses’ understanding of legal issues within patient encounters, supporting nurses to translate their awareness of cultural diversity into acceptance of, appreciation for and commitment to CLD patients and their families.

Section snippets

Background

Australia is a multicultural society whose cultural pluralism is recognised and addressed in government papers (Roach, 1997). Within Greater Western Sydney Region 30% of the population is composed of ethnic minority groups with some quite substantial culturally diverse consumer groups in some area health services. This cultural variation has marked implications for health professionals particularly nurses as they could be considered to have the most direct and continuous contact with patients

Cross-cultural nursing practice

As multiculturalism and acceptance of a pluralist society with different values and traditions is current policy in Australia (Garrett and Lin, 1990; Roach, 1997) nurses need to be culturally competent to providing culturally congruent care (Giger and Davidhizar, 1999; Leininger, 1995). In today's borderless societies cultural competence is a necessity (Purnell, 2000). A four-phase process outlined in Howell's (1982) model of competence describes the development of this accomplishment. The

Research approach

This study explored and described nurses’ experiences of communicating with CLD patient population and their families in an acute care hospital with a high non-English speaking background patient population. An interpretive-descriptive design in the qualitative tradition (Thorne et al., 1997) has been selected to address the question as it can capture the multiplicity of nurses’ experiences in an acute care hospital and focus on the elements of communicating with CLD patients.

Sample

Twenty-three

Findings

The nurses interviewed in this study came from two distinct clinical areas, general and midwifery. Twelve were certified midwives and 11 were registered nurses. Their experiences ranged from 5 to 25 years with the median being 10 years. Thirteen of the nurses were from Anglo-centric backgrounds and ten were from a variety of ethnic backgrounds. These backgrounds were Asia, South America, the Philippines, Sri Lanka, Europe and indigenous Australia. Five of the nurses not from Anglo-centric

Discussion

Nurses indicated that accessing interpreters was most usually successful for main CLD patient groups. However, for the minor CLD patient groups it was more difficult as were weekends and night shifts. This highlights the administrative difficulty of delivering linguistic services to a CLD patient population who speaks many different languages. Nurses found that cultural and linguistic diverse groups who had recently arrived in Australia; for example, Somali and Bosnian groups, lacked the

Acknowledgements

To the nurses and midwives who so willingly agreed to share their experiences of caring for CLD patient groups. To the Acting Director of Nursing, Ms Jan Tweedie, who supported the study. To the bilingual health workers, Ms Nawal Amahesh and Ms May Chung for their support of the study. To the University of Western Sydney for study funding by a Research Seed Grant 2001 of $4107.

References (34)

M.M. Andrews et al.
Transcultural nursing care
P. Benner
H. Bernal
A model for delivering culture-relevant care to the community
Public Health Nursing
(1993)
J. Blackford et al.
Nurses of nesb working in a multicultural community
Contemporary Nurse
(2000)
J. Blackford et al.
Breaking down language barriers in clinical practice
Contemporary Nurse
(1997)
P.L. Donnelly
Ethics and cross-cultural nursing
Journal of Transcultural Nursing
(1997)
P. Ebdin et al.
Bilingual consultation
Lancet
(1988)
P. Garrett et al.
Ethnic health policy and service development
Giger, J.N., Davidhizar, R.E., 1999. Transcultural Nursing. Assessment and Intervention. 3rd Edition. Mosby, St Louis,...
D. Gorman
Multiculturalism and Transcultural Nursing in Australia
Journal of Transcultural Nursing
(1995)

W. Howell

P. Josipovic

Recommendations for culturally sensitive nursing care

International Journal of Nursing Practice

(2000)

A. Kinebanian et al.

Cross cultural occupational therapya critical reflection

The American Journal of Occupational Therapy

(1992)

S.R. Kirkham

Nurses’ descriptions of caring for culturally diverse clients

Clinical Nursing Research

(1998)

A.J. Kuzel

Sampling in qualitative inquiry

M. Leininger

Transcultural nursing educationa worldwide imperative

Nursing and Health Care

(1994)

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^☆: Ethics approvals for this study were obtained from The University of Western Sydney Human Research Ethics Committee and The Western Sydney Area Health Service Human Research Ethics Committee. The University of Western Sydney funded the study with a Research Seed Grant 2001 of $4107.

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Communicating with culturally and linguistically diverse patients in an acute care setting: nurses’ experiences☆

Abstract

Section snippets

Background

Cross-cultural nursing practice

Research approach

Sample

Findings

Discussion

Acknowledgements

Transcultural nursing care

A model for delivering culture-relevant care to the community

Public Health Nursing

Nurses of nesb working in a multicultural community

Contemporary Nurse

Breaking down language barriers in clinical practice

Contemporary Nurse

Ethics and cross-cultural nursing

Journal of Transcultural Nursing

Bilingual consultation

Lancet

Ethnic health policy and service development

Multiculturalism and Transcultural Nursing in Australia