Cultural Competency- For Providers

Summary

The 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

• 😔 The script discusses the struggles of refugee children who, despite appearing normal, carry invisible scars from their experiences.
• 🌟 It highlights the importance of understanding and addressing the emotional and psychological needs of these children.
• 🏠 The transition to a new country like the United States comes with its own set of challenges, including the pressure to assimilate quickly.
• 🤰 The story of Njma, a Somali woman, illustrates the cultural barriers faced by refugees in accessing healthcare.
• 🕰️ Njma's initial experience with the healthcare system was marked by confusion and misunderstanding due to differences in cultural practices.
• 📝 The script emphasizes the significance of cultural competency in healthcare, where understanding and respecting patients' cultural backgrounds is crucial.
• 👩‍⚕️ The healthcare team's participation in cultural competency seminars led to improved communication and care for patients like Njma.
• 📆 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.
• 🩺 The script underscores the value of community involvement in healthcare, as seen when the local Somali community helped tailor care to Njma's needs.
• 🌐 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

00:00

🌍 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.

05:00

🏥 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.

10:02

🌐 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.

Keywords

💡Assimilation

Assimilation refers to the process by which immigrants or minority groups are absorbed into the dominant culture of a country. In the video, the concept is highlighted when discussing the challenges faced by refugees who are expected to adapt quickly to the United States' way of life. The script mentions the pressure to 'just be yourself' in a short period of time, which underscores the difficulty of assimilation.

💡Cultural Competency

Cultural competency is the ability to understand and effectively interact with people from different cultural backgrounds. The video emphasizes the importance of cultural competency in healthcare, where the clinic staff attends seminars to better treat patients like Njma from Somalia. It illustrates how increasing cultural understanding can lead to better patient care and avoid misunderstandings.

💡Anemia

Anemia is a medical condition characterized by a lack of healthy red blood cells to carry adequate oxygen to body tissues. In the script, Njma is diagnosed with anemia, which is a significant health issue, even though she does not feel sick. This diagnosis is used to discuss the importance of preventative care and understanding cultural perceptions of health and illness.

💡Refugee

A refugee is someone who has been forced to flee their country to escape war, persecution, or natural disaster. The video script tells the story of Njma, a Somali refugee, and her experiences in a new country. Her narrative exemplifies the struggles refugees face, such as cultural adaptation and accessing healthcare.

💡Mental Health

Mental health refers to a person's emotional, psychological, and social well-being. The script mentions depression and the emotional toll of war on children, indicating the importance of addressing mental health issues, especially among refugees who have experienced trauma.

💡Prenatal Care

Prenatal care is the medical care a pregnant woman receives to ensure the health of both her and her baby. The script describes Njma's prenatal appointment, which includes a blood test and advice on diet. This highlights the importance of prenatal care in detecting and preventing potential health issues for both mother and child.

💡Iron-Rich Foods

Iron-rich foods are those containing high levels of iron, which is essential for the production of hemoglobin and the prevention of anemia. The video script discusses the provision of a list of iron-rich foods to Njma, which is later tailored to include foods familiar to her culture. This shows the importance of culturally appropriate care in dietary recommendations.

💡Medical Misunderstandings

Medical misunderstandings occur when there is a lack of shared understanding between healthcare providers and patients, often due to cultural differences. The script illustrates this when Njma is confused by the need for punctuality, paperwork, and the roles of different healthcare professionals, which are unfamiliar to her.

💡Cultural Bridging

Cultural bridging is the process of building connections and understanding between different cultures. The video shows how the healthcare team learns about Somali culture and applies cultural bridging techniques to communicate more effectively with Njma, demonstrating the value of such approaches in healthcare.

💡Interpreter

An interpreter is someone who translates spoken language from one language to another, often used in situations where language barriers exist. The script mentions Njma's role as an interpreter, emphasizing the importance of language support in helping individuals navigate new cultural environments.

💡Healthcare Team

A healthcare team consists of various medical professionals who work together to provide comprehensive care to patients. The video script describes the different roles within the healthcare team that Njma encounters, such as the nurse and the doctor, and how understanding these roles is crucial for effective patient care.

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]