by Marion Karpinski, RN
In January 2002 I decided to create a DVD/Video program on cultural competence for health care providers. I wanted to highlight how culture affects health care and offer tools for providers to improve the quality of health care for people of all cultural backgrounds.
In the process of my research and consultation with diversity experts, I found that I had to revise a basic assumption. As a Caucasian native-born American, I had never I thought of myself as an ethnic person, but I learned to reframe that belief. We are all ethnic people. Cultural diversity includes each of us in ways that go beyond nationality and race. We embody the culture we grew up in, the culture of being male or female, our sexual orientation and the culture of our education and work. Cultural factors affect almost everything we believe and do. They especially come into play with respect to the decisions we make about health care.
If we disregard the role that cultural beliefs and values play in regard to health, the quality of health care suffers and we can even do harm. The health care system in the United States has its own cultural framework and adheres to a very specific set of beliefs. Culturally competent care is designed to fit an individual's cultural beliefs, values and customs rather than imposing one standard of behavior and beliefs on everyone. Using this approach, the patient is provided with meaningful and beneficial care.
We had many gratifying experiences while filming in the San Francisco Bay area. I was constantly amazed at the generosity and trust of those who participated. No matter where we went, whether it was to a Vietnamese classroom, native American health clinic, or Hindu festival, people thanked us for allowing them to participate in our project.
Our most moving experience was at the Allen Baptist Temple in downtown Oakland. We anticipated filming there for just a short time, but we were in for a surprise. When we arrived, we were brought into a prayer circle. There, people expressed gratitude for our presence. During the service the pastor, Dr. Alfred Smith, asked us to stand in front of the congregation. He eloquently described our effort to help all people receive the best quality health care and asked the congregation to help us with our project. Then he thanked us for choosing Allen Baptist Temple. "Out of all the churches they could have picked," he said, "they chose ours."
We were welcomed, cherished and honored by Pastor Smith and by those who attended the service that day. The temple was our first filming location, and what happened there set the tone for the rest of our journey.
Health care providers who view the finished video will learn how to work in an atmosphere of respect, cooperation and cultural sensitivity. When this happens, the quality of health care improves and, as I learned, we reach the essence of our connection with one another. Developing Cultural Competence is full of heart and people who gave from the heart.