Multicultural Competency in Nursing: Alan’s Case Study Case Study

Introduction

Multicultural competency in nursing is a core concept when providing healthcare to patients with diverse cultures and ethnicity. It aids in the development and expansion of nurses’ roles by incorporating relevant social norms and values, particularly for a client. Because the nursing profession is versatile, caring for the sick entails not only the provision of treatment plans and care but also ensuring the ability to give the best medical competencies.

This can be facilitated by demonstrating the cultural awareness of a patient using various clinical observations. In essence, it encompasses the knowledge of a client’s cultural diversity while offering treatments. Having someone in the care team who can closely relate to Alan is essential in underpinning the language and ethnic barriers, thus leading to the provision of appropriate strategies that address his needs.

Role of Multicultural Competencies in Assessing and Treating Allan

Multicultural competencies are necessary for a caring nurse to deliver the best health services to patients, resulting in high gratification for Alan. Notably, without cultural competencies, most healthcare systems run into losses and subsequently limit the services that they can offer to the patients. Therefore, multicultural competencies play such key roles as providing a strong background and knowledge of the culture to which a patient belongs. Without the nursing cultural competencies, there is the probability of nurses developing stereotypes toward patients who are not of their race. According to Farber et al. (2017), cultural stereotypes reduce the provision of patient-centered care. Therefore, through such competencies, the nurse can emphasize, associate more with Alan, and attend to his needs.

Allan’s Needs as Related to Diversity

Inpatient Rehabilitation

One of the needs related to Alan in terms of diversity is providing inpatient rehabilitation with a culturally sensitive background. For instance, Alan’s substance abuse, the pain of the family financial issues, unemployment status, and delayed veteran benefits affect his health situation. The inpatient rehabilitation should be one that essentially belongs to the same culture as Alan, thus allowing him to feel a sense of belonging. Since Alan is hesitant to show his feeling to others, putting him in the same facility with other cultural groups may increase the chances of treatment relapse. Because African-Americans face the greatest burden of social injustices and prejudice, staying in the same rehabilitation might cause falls in treatment plans.

Family Counseling

Alan requires family counseling especially after indicating that his wife does not understand the pain he is undergoing. According to research, ethnic minority families face a lot of domestic-related conflicts and home-based violence because of family structure (Assari et al., 2018). Counseling Alan together through the help of a nurse from the same ethnicity is an important aspect of ensuring holistic nursing intervention, which is culturally sensitive. Counseling Allan and his partner are essential in making sure that both understand the importance of maintenance of sobriety.

Strategies to Support Allan’s Advocacy Related to his Needs

One of the strategies needed for Alan’s advocacy is to connect him to the required resources. The nurse should help Alan to access the recourse both inside and outside the hospital which will further support his treatment and well-being. The nurse should be able to identify the resources in the community that can be shared with the patient such as financial assistance, transportation, patient or caregiver support networks, and other needs.

The nurse can also help Alan in advocating for the claims based on his special circumstances with the relevant authorities. For instance, veterans are often eligible for other types of disability compensation upon determination of if the disability was service-related. Therefore the nurse should provide the patient with the right information with regards to such compensation claims as individual unemployability, automobile allowance, destabilization, and hospitalization. Upon satisfying such claims, the patient’s benefits may be hastened and delivered to Alan on time.

How the Identified Needs Influence Strategies and Processes

Alan has a strained family relationship that might cause the treatment and prevention of future relapse to occur. Therefore, because one of the objectives is to reduce the risk of falls, a lack of better family relations influences the strategies necessary for the treatment of post-traumatic stress disorder (PTSD) and substance abuse (Wakhid & Hamid, 2020). Instead of delegating certain duties to the wife, the nurse must change the modalities of the treatment options which limit the wife from offering more to the client than the healthcare providers. The intervention involves meeting with Mr. Allan twice a week or as often as possible and supporting him with what elicits his alcohol abuse through one-on-one meetings, journaling, the transmission of feelings, and a free relationship.

Moreover, the involvement of the local community in the planning of care is an essential care option. Andersen et al. (2020) describe the importance of the Community Reinforcement Approach (CRA), a strategy that validates the implication of direction of a patient’s problems to its community members. The use of a local business organization to employ Mr. Alan can be advocated by the nurse. In addition, the local school should be used to provide free education to Mr. Alan’s son until he secures employment.

Description of Possible Legal and Ethical Issues while Counseling Allan

Treating Alan without involving the family proxy might constitute legal implications. For instance, since the patient is undergoing antidepressant medication due to his PTSD and pain medication for substance abuse disorder, he might not be in the right mental capacity to give consent to his treatment options. According to Evans et al. (2020), family proxy consent is necessary for a situation where a patient cannot give consent to treatment because of the mental incapacity to provide such consensus. Therefore, the participation of his wife will help them develop ways to handle situations that may arise due to potential relapses for Allan.

Involving Alan and the wife during counseling may also constitute certain ethical considerations. The wife might want to comprehend the information given to the nurse to comply with the preceding treatments. Deciding how to share this information, especially if it goes against the family’s beliefs, can be a complex situation. However, disclosing such information as Alan quotes, “my wife doesn’t understand the pain I am in physically or psychologically”, may result in family conflicts.

In this regard, the nurse will be in the dilemma between being honest versus withholding the information. According to nursing codes of ethics, nurses should advocates for truth-telling and honesty (Devine & Chin, 2018). Therefore, as a nurse, identification of the best strategy to convey the information is essential in ensuring that the greatest benefit is achieved and Alan’s safety is accorded.

Conclusion

In conclusion, due to the cultural diversity of Alan, nursing care should ensure the provision of a multicultural framework and competencies for quality nursing care. As illustrated above, multicultural competencies ensure that all aspects of patient care are addressed, thus providing patient-centered care. Moreover, the addition of a multidisciplinary team ascertains that such challenges as legal and ethical implications, social injustices advocacy, and family issues are addressed. Therefore, the nurse’s role is to provide appropriate education to Alan to ascertain that his substance abuse and PTSD are treated without chances of relapse.

References

Andersen, K., Behrendt, S., Bilberg, R., Bogenschutz, M. P., Braun, B., Buehringer, G., Ekstrøm, C. T., Mejldal, A., Petersen, A. H., & Nielsen, A. S. (2020). Evaluation of adding the community reinforcement approach to motivational enhancement therapy for adults aged 60 years and older with DSM‐5 alcohol use disorder: A randomized controlled trial. Addiction, 115(1), 69−81. Web.

Assari, S., Caldwell, C. H., & Zimmerman, M. A. (2018). Family structure and subsequent anxiety symptoms; minorities’ diminished return. Brain Sciences, 8(6), 1-11. Web.

Devine, C. A., & Chin, E. D. (2018). Integrity in nursing students: A concept analysis. Nurse Education Today, 60, 133-138. Web.

Evans, C. J., Yorganci, E., Lewis, P., Koffman, J., Stone, K., Tunnard, I., Wee, B., Bernal, W., Hotopf, M., & Higginson, I. J. (2020). Processes of consent in research for adults with impaired mental capacity nearing the end of life: Systematic review and transparent expert consultation (MORECare_Capacity statement). BMC Medicine, 18, 1−55. Web.

Farber, E. W., Ali, M. K., Van Sickle, K. S., & Kaslow, N. J. (2017). Psychology in patient-centered medical homes: Reducing health disparities and promoting health equity. American Psychologist, 72(1), 28-41. Web.

Wakhid, A., & Hamid, A. Y. S. (2020). Family resilience minimizes post-traumatic stress disorder: A systematic review. Enfermeria Clinica, 30 (1), 1-5. Web.