Connecting with others requires patience, kindness and understanding. At times our connection with others may be blocked by our personal “culture” that does not allow us to recognize and appreciate the differences in others. These differences may inhibit our approach with others particularly in the healthcare setting when connecting and communicating is vital to insuring understanding and compliance.
Many of us have witnessed changes in the last 40 years to improve cultural diversity and sensitivity in the workplace. In many organizations, training is provided to learn about other cultures, obtain a baseline of knowledge and gain a general acceptance of differences.
As we move from just accepting our differences to acknowledging and embracing our differences, we build our own cultural competency. Cultural competence emphasizes the idea of effectively operating in different cultural contexts and altering practices to reach different cultural groups. We learn new patterns of behavior and we apply them to the appropriate setting. Sometimes we are successful, sometimes we make mistakes. But rather than just accept, we continue to attempt to reach out and truly connect.
In the healthcare setting, healthcare providers, come from a position of power. Healthcare providers can have power over the healing process including medications, activities of daily living, meals, family, and pain. But how do we reduce the power imbalance to obtain the therapeutic alliance, the bond of trust that allows us to learn from the patient and family, improve communication, compliance and outcomes? How do we reduce or eliminate possible cultural power imbalances between each other that may inhibit the team delivery of compassionate, quality care?
As defined by Tervalon and Murray – Garcia, Cultural Humility is the lifelong commitment to self-evaluation and self-critique to develop beneficial and non-paternalistic relationships. Each of us is a unique intersection of various aspects of culture. There may be norms but there are variations of the norm, therefore a checklist of required elements identified with a culture will not create a culturally competent individual.
Through humility, we accept our humanity and relate to others free of pride, power and arrogance. Through humility, we accept that is impossible to learn all cultures, we cannot know everything but we become familiar, that knowledge of culture does not create mastery and standardization of practices and that perceived mastery can lead to miscommunication or mismanagement of care.
We do not live in a culture-free world. Every day we are exposed to variations of culture in our families, our friends, co-workers and patients. Our very humanity continually involves and is influenced by other cultures including our clothing, food, entertainment, and healthcare among other domains of life.
What can we do each day to approach life with love, an open heart to create connections built on a foundation of cultural humility, caring and respect?
Ask questions in a humble, safe manner
Express kindness and compassion
Support a safe and welcoming environment
Start where the patient is at