Culture Case

Cultural diversity enriches New Zealand, but it also causes many challenges for health care providers in term of assessing and managing patients. This assignment will explain why nurses need to be aware of cultural issues when working in a New Zealand setting. The second part of this essay aims to briefly describe one of the Pacific model of health called Fonofale model discuss how this model can enhance nursing practice.

In 2006, it was estimated that there were approximately 67.5 percent of European, 14.6 percent of Maori, 6.9 percent of Pacific Islanders, 9.2 percent of Asian, 0.9 percent of The Middle Eastern or Latin American or African (MELAA) and 11.2 percent of other ethnicities in New Zealand (Statistics New Zealand, 2007). As New Zealand population is made up of diverse cultures and ethnicities, nurses working in a New Zealand setting need to have extensive knowledge of different cultures when dealing with patients. It is essential to understand one's own cultural health care beliefs and values and origins of patients' prejudiced views.

"Culture is the central to the manner in which all people develop and grow and how they view themselves and others" (Wepa, 2005). Culture has a profound effect on people' perceptions of health and illness, reporting of symptoms, expectation for health care providers. Culture also influences how patients manage and cope with an illness, accept a diagnosis or medication and emotionally express their pain. Different cultures have different ways of making decisions about the care of the patient, so nurses need to be knowledgeable about the cultural needs of patients' family. The extended family, gender and family roles significantly affect the course of treatment. For example, in Pacific culture, the family is central to Pacific people, they should be supported to be involved during treatment. The oldest male in the family is often the decision maker or spokesperson. If family members wish to be present during a procedure, doctors and nurses should give serious consideration. Cultural sensitivity and cultural competence play a decisive role in the nursing practice. To be able to provide an effective safe care, nurses need to recognise the differences that exist among patients' cultural background and understand how historical, political, social and economic structures affect multicultural patients' health. Being culturally competent allows nurses to see the entire picture and improve the quality of health care. Moreover, having a wide cultural understanding also helps nurse to adjust the nursing care, decide what needs to be considered to provide appropriate health care to the sensitivities of people from diverse ethnic background. Cultural awareness enables nurses build trust between nurses and patients, working together for the effective health outcomes.

In 1996, Nursing Council of New Zealand mentioned learning outcomes of cultural safety. The practice of respecting a person's cultural situation and heritage of nurses help them to successfully demonstrate flexibility in the relationship with people who are different from themselves. A culturally sensitive provider has an ability to evaluate the impact that historical and social problems have on the health of all people, and adjust approach to coincide with the need of specific patient.

Lack of cultural awareness and failure to provide culturally competent care can result in inadequate care provided by health care professionals. The patients' level of stress can critically increase if the health care provider is unaware of cultural belief and incorporate it into professional care. If nurses, doctors and related professionals are unaware of the kinds of cultural difference or careless about them, then the practice is going to be unsafe (Evans, 2005, p. 75). Nurses are often the first health care professionals people meet in the health system. As Papps (2002) states, if a nurse has attitudes of racism, criticism, discrimination or assumption, it can make patients feel demeaned and engender feelings of reluctant to seek health care or to return to a particular health service. Therefore, in terms of attitudes, nurses are expected to be nonjudgemental towards others. In addition, lack of cultural competence can lead to misunderstanding, negatively influence clinical situations and affect patient health outcomes.

People from the Pacific Islands have been in New Zealand for over a hundred years. New Zealand's Pacific people are a diverse and dynamic group. New Zealand Pacific population consists of a number of distinct ethnic groups such as Samoan, Cook Islanders, Tongan, Niuean, Fijian. The Samoan community is the largest (nearly