Cultural Competency- For Providers
Summary
TLDRThe transcript details the experiences of Njma, a Somali refugee, as she navigates the US healthcare system while pregnant. Initially overwhelmed by cultural differences, she struggles with appointment timings, medical terminology, and the unfamiliar healthcare process. After healthcare providers attend cultural competency seminars, they better understand Njma's background, leading to improved communication and care. Njma eventually becomes a community partner, helping bridge the gap for others like her.
Takeaways
- π The script discusses the struggles of refugee children who, despite appearing normal, carry invisible scars from their experiences.
- π It highlights the importance of understanding and addressing the emotional and psychological needs of these children.
- π The transition to a new country like the United States comes with its own set of challenges, including the pressure to assimilate quickly.
- π€° The story of Njma, a Somali woman, illustrates the cultural barriers faced by refugees in accessing healthcare.
- π°οΈ Njma's initial experience with the healthcare system was marked by confusion and misunderstanding due to differences in cultural practices.
- π The script emphasizes the significance of cultural competency in healthcare, where understanding and respecting patients' cultural backgrounds is crucial.
- π©ββοΈ The healthcare team's participation in cultural competency seminars led to improved communication and care for patients like Njma.
- π The importance of punctuality and the structure of appointments in Western healthcare systems is a stark contrast to the more flexible approach in some cultures.
- π©Ί The script underscores the value of community involvement in healthcare, as seen when the local Somali community helped tailor care to Njma's needs.
- π It concludes by advocating for increased cultural competency in healthcare to ensure equitable and effective treatment for all patients.
Q & A
What challenges did the children in the script face after arriving in the United States?
-The children faced the challenge of assimilating into a new culture while dealing with the emotional trauma of their past experiences. They were expected to function normally but struggled with invisible scars from war and displacement.
Why did some of the children not make it through their struggles?
-Some children did not make it due to joining gangs or succumbing to depression, as they lacked the support and understanding needed to cope with their past traumas.
What was the cultural expectation for children in the script's home country?
-In their home country, the cultural expectation was for children to be seen but not heard, with no one attending to their emotional needs after experiencing war and displacement.
How did the healthcare system in the United States differ from what Njma was used to in Somalia?
-In Somalia, patients wait to be seen by a doctor without set appointment times, and there are no forms to sign. In the United States, Njma encountered strict appointment schedules, forms for record-keeping, and a team of healthcare professionals including nurses and lab technicians.
Why was Njma confused about her first healthcare appointment in the United States?
-Njma was confused because she was used to a different healthcare system where there were no set appointment times, no forms to fill out, and a more personalized approach with doctors. The American system's structure and paperwork were unfamiliar to her.
What was the misunderstanding regarding the purpose of the forms Njma had to fill out at the clinic?
-Njma was unsure about the forms, thinking they might be used against her by the police. She later learned they were for medical records to ensure continuity of care and were confidential.
Why did Njma throw away the list of iron-rich foods provided by the clinic?
-Njma threw away the list because it contained foods she was unfamiliar with and did not know how to cook. It did not align with her cultural dietary practices.
How did the healthcare team improve their approach to treating patients like Njma?
-The healthcare team attended cultural competency seminars to better understand and treat patients from different cultural backgrounds. They learned about Somali culture and how to use cultural bridging techniques for effective communication.
What role did Njma's neighbor play in helping her navigate the healthcare system?
-Njma's neighbor recognized the difficulties Njma faced during her first appointment and took the initiative to schedule another appointment for her, ensuring she received the necessary care.
How did the healthcare team adapt their communication to better serve Njma during her second appointment?
-The team provided a reminder call, explained the importance of punctuality, and the purpose of the forms and medical procedures in a way that was culturally sensitive and understandable to Njma.
What was the significance of the second list of iron-rich foods provided to Njma?
-The second list was significant because it included foods that were familiar to Njma and could be easily obtained in her local community, making it more relevant and useful for her dietary needs during pregnancy.
Outlines
π Cultural Struggles of Refugees
The first paragraph narrates the story of a refugee from Somalia who, despite not having any visible physical deformities, carries invisible scars from war and displacement. The individual talks about the lack of support and understanding upon arriving in the United States, where the expectation is to assimilate quickly despite the trauma they've experienced. The refugee discusses the responsibilities they had in their home country and the stark contrast to their new life where they are expected to be independent and self-sufficient almost immediately.
π₯ Navigating a New Healthcare System
The second paragraph details the experiences of a Somali woman named Njma as she navigates the healthcare system in the United States. Njma, who recently lost her husband and is now pregnant, struggles with understanding the importance of timely appointments and the concept of preventative care. She encounters challenges with language barriers, cultural differences in healthcare practices, and the unfamiliarity of the American medical system. The narrative highlights her confusion and fear, as well as the eventual cultural competency training that the healthcare providers undergo to better serve patients like Njma.
π Enhancing Cultural Competency in Healthcare
The third paragraph discusses the importance of cultural competency in healthcare. It explains how the healthcare team at Njma's clinic attended seminars to better understand and treat patients from different cultural backgrounds. The paragraph emphasizes the use of cultural bridging techniques to communicate more effectively with patients and the benefits of understanding one's own culture as well as those of others. It concludes with the idea that increasing cultural competency can turn misunderstandings into opportunities for learning and building authentic connections.
Mindmap
Keywords
π‘Assimilation
π‘Cultural Competency
π‘Anemia
π‘Refugee
π‘Mental Health
π‘Prenatal Care
π‘Iron-Rich Foods
π‘Medical Misunderstandings
π‘Cultural Bridging
π‘Interpreter
π‘Healthcare Team
Highlights
Children of war experience invisible scars that affect their ability to assimilate into new cultures.
Some children succumb to the trauma of war, leading to depression or joining gangs.
Upon arrival in the United States, these children face pressure to assimilate quickly, exacerbating their trauma.
The expectation to be self-sufficient immediately in a new country can lead to a crisis of identity.
The importance of acknowledging the emotional trauma experienced by war-affected children.
The complexity of Somali culture and the diversity within it, contrary to being a monolithic entity.
The story of Njma, a Somali woman, whose husband died and who later discovers she is pregnant after resettlement.
Cultural differences in healthcare practices between Somalia and the United States, leading to misunderstandings.
Njma's confusion with the American healthcare system's appointment structure and paperwork.
The role of nurses in the American healthcare system, which differs from Njma's expectations.
The concept of anemia and its potential dangers, unfamiliar to Njma, is explained by her doctor.
Cultural competency training for healthcare providers to better serve patients from diverse backgrounds.
The importance of clear communication and understanding cultural nuances in healthcare settings.
Njma's realization of the importance of following medical advice for her and her baby's health.
The adaptation of medical advice to fit within the cultural context of the patient, increasing compliance.
Njma's desire to become a community partner, highlighting the empowerment of patients in their healthcare.
The transformative impact of cultural competency on healthcare practices, leading to more equitable care.
Transcripts
[Music]
we were kids who placing the system and
we expecting to function like every
other normal kid in United States but in
in reality we were normal kids we didn't
have any physical deformity or anything
visible but we were we had scarf that
were invisible A lot of them did not
make it some of them die because of they
Jo the gang some didn't make it through
depression I think you know overcome it
all you know like when I look I see you
know like a kid we had the war kids are
you know to be seen but not to be heard
from so nobody was comforting us or you
know there to attend your emotion and
say you know you went through War you
watch people blow into parts we lost our
belonging our home our whole identity
but this is why nobody ever said that so
we just left us along and then we came
here and here in United States people
are like here's your physiology needs in
your home and everything but you forced
so much to just be your own self in a
short period of time and all you hear is
why are you not assimilating why are you
not becoming but that time is when I
felt like when we it's when we were our
worst self you know like you it's when
you for the first time we were no longer
as a kid I was no longer watching after
my sibling I was no longer worry about
water or food or if my mother would
would get to a medical you know facility
every time she had a miscarriage so
after all that you know responsibility
was no longer on my shoulders it was I
was time to force to face
[Music]
me my highest point will be who I am
today
I
yeah now that I am an interpreter myself
working in main I find that a lot of
people would put put me under the
category of an exp
and I used say that what qualifies me to
be an expert I'm just somal person I
learn what Somalia is on how the
government what's working whatever like
any other American person I Google a
lot even though we have one culture one
language whatever we also have different
cultures individually you know every
household have their own little of
culture that they the way they raise
their kids the way they go about the
Islamic religion is different than the
next store so not to assume that we all
dress alike eat alike talk alike it's
not the case you
[Music]
know this is njma a 20-year-old woman
from Somalia last year njma and her
husband were set to be resettled by the
United Nations to Leon Maine two weeks
before their departure najma's husband
died of a respiratory infection he
contracted in the refugee camp a month
later now in Lewiston njma discovered
she was pregnant najma's neighbor urged
her to make an appointment to see a
doctor she said it was very important
for the health of njma and her baby in
Somalia people only see a doctor if they
feel sick but trusting her new friend
njma made an appointment the
receptionist told her to come at 2:00 on
Tuesday she had errands to run till 5:
but in Somalia patients wait to be seen
sometimes in the order they arrive
sometimes at the discretion of the
doctor sometimes for hours so coming
later would just mean someone else would
get the chance to see the doctor first
the errands took a little longer than
expected so najma arrived at 5:30 and
was flustered to find the clinic had
closed when njma called the next day the
receptionist said that they closed at 4:
as always and that njma needed to show
up the next day at 10:00 a.m. or else
there'd be no time for her for a month
this wasn't anything like the system she
was used to najma felt terrible being
spoken to like this she hadn't meant to
convey any disrespect to the
receptionist
and she was frustrated because she had
no idea why she a healthy woman was
going to the hospital
anyway the next morning najma took a
little longer than normal getting out of
bed she'd been sleepy in the mornings
lately but she was only 15 minutes late
so she figured she was close enough the
receptionist did not agree she rebuked
njma for her selfishness and lack of
respect for others she then handed njma
a clipboard of fors to fill out and sign
none of this made any sense in s IA
there are no set appointment times
doctors take as long as they need with
each patient and then call the next in
line there aren't any forms to sign
because records are seldom kept njma
wondered if the forms meant she was in
trouble she could speak and read simple
English and the forms had many questions
about her family and her past some
questions were very personal were these
questions for the police would they be
used against her she wished her husband
were here to handle these things she
felt like there was no one to help her
she did as she was told and filled out
the forms hoping not to get into any
more
trouble najma's name was called by a
cheerful woman who introduced herself as
a nurse she didn't know that word the
nurse did things najma expected the
doctor to do taking her blood pressure
and pulse she asked more personal
questions then she left saying the
doctor would be along najma waited 10
minutes for the doctor why had the
receptionist been so angry about njma
not arriving on time if she was just
going to be kept waiting why not just
come get her when they were ready in
Somalia the powerful often kept
subordinates waiting she guessed that's
what was happening here the doctor
finally came najma was
relieved the doctor looked at the
computer and then examined her a little
she said njma showed signs of anemia she
told her she was ordering a blood draw
for a full CBC and a prenatal panel njma
didn't understand any of that except
bloodletting which was a treatment in
Somalia sometimes she didn't feel feel
sick but the doctor said she had
something wrong with her she was
embarrassed and scared to ask the wrong
questions so she didn't ask what it was
the doctor left and a labtech came and
took some of her
blood after the appointment njma was
confused about who her doctor was in
Somalia you only saw the doctor but
there were so many people here and the
one she spent the most time with was the
nurse was the nurse the doctor here njma
got a call 2 days later from the nurse
saying they wanted to test her
hemoglobin and fertin levels the nurse
also said they would send her a card
telling her what foods to eat njma got
the card titled iron rich foods it was
full of strange foods she didn't eat and
didn't know how to cook she knew some
foods were used as medicine but she
didn't feel sick and she ate good food
anyway so she threw it
away Somali doctors typically call
patients to schedule follow-ups so when
the doctor never called she decided to
take it as a blessing and be done with
it nothing helpful had come from her
visit it and it had been very
unpleasant a few weeks later najma's
neighbor got to asking how the
appointment had gone she was dismayed to
hear what a catastrophe it had been she
took it upon herself to phone the office
and schedule another appointment for
njma in the interum the entire
Healthcare team at najma's Clinic had
attended cultural competency seminars
conducted by main Intercultural
communication consultants and they'd
learn how to better treat patients like
njma by examining their own culture
learning about somal culture and
discovering the many unexpected ways
culture shapes us all they also learned
cultural bridging techniques to
communicate their messages more
effectively as you'll see in a moment
this time the receptionist gave najma a
reminder call for her appointment and
she explained that the doctor only had a
short time with each patient before the
next one each patient had to be there on
time or they'd miss their spot like
you'll miss the sunset if you weren't
there to see it this was different for
najma but it made sense she was always
on time to appointments after that when
she got to the clinic the receptionist
told najmo why she had to fill out those
forms they were for records so the
office could remember every patient over
time sometimes doctors could look back
and solve illnesses that a doctor
without records couldn't solve and if
njma got a new doctor he or she would
know all about her she told njma the
information was confidential which meant
it could never be shared without her
permission or used against her the nurse
explained her role to njma she was part
of a big team that worked to keep lots
of patients healthy she explained why
patients sometimes have to wait for the
doctor she told her that some patients
need extra care or sometimes emergencies
happen but by being ready in the room
najma could see the doctor as soon as
possible the doctor came in and this
time she explained anemia and how even
though njma didn't feel sick now it
could make her very sick later it was
hard for najma to understand being sick
without feeling sick sick or the idea of
curing an illness in the future but the
doctor explained how they could see the
causes of sickness before they were felt
and before they were dangerous the
doctor said she'd like to do more blood
tests and explained what could be
learned from those tests she asked njma
if that was okay najma's Doctor provided
her with another list of iron-rich foods
but this list was developed in
partnership with members of the local
Somali Community it featured foods that
Somali ate and could buy locally and
some recipes too njma recognized some of
the foods as being fed to pregnant women
in Somalia and now she understood why
they were good for her njma asked the
doctor if she could be a community
partner too so she could help patients
like herself understand how to get the
care they needed the doctor said that
would be
wonderful remember no one knows
everything about every culture let alone
every individual within every culture
but by increasing your cultural
competency mistakes can become opport
unities for Learning and authentic human
connection working cultural competency
into all levels of your practice gaining
insight into your own culture as well as
others and using the cultural bridging
techniques like the ones discussed here
will allow you to serve all patients
with the best most Equitable healthare
possible
[Music]
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