'To be heard you have to listen'

Honing interpersonal skills can improve cultural competency


The breadth of understanding required to be a culturally competent caregiver has expanded greatly in just a few years. “It’s so much more than caring for patients from other countries and cultures,” said Karen Andrews, community outreach specialist for Hallmark Health System’s community services. “It now encompasses everything from poverty to gender politics, from behavioral health care to the epidemics of drug use and obesity.”

Caring for a baby who was born addicted to drugs and whose parents are still using. Understanding that applying an alcohol swab before drawing blood is anathema to some strict observant religions. Selecting a right-sized wheelchair to transport an obese patient. These are some examples of the expanding interpretation of cultural competency.

No health care worker can possibly know all the rituals, beliefs and routines of patients, particularly in the center of the area’s cultural melting pot. “Malden is the second most diverse city in the Commonwealth, with more than 65 languages spoken here,” said Eileen Dern, RN, CES, director of community services. “And other communities we serve are increasingly diverse as well.”

Yet Dern and Andrews, long-time members of the system’s diversity steering committee, believe there are several keys to practicing cultural competency:

Corral bias.We need to recognize our biases and put them aside.
Listen. If we want patients to hear us, we need to engage in sincere, open-minded listening.
Be respectful. This applies not only to what you say but your body language and how you interact with others.
Be flexible. If it doesn’t impact the patient’s care or safety, why not let patients’ families bring items from home so the patient is more comfortable?
Be inclusive. Include family members when appropriate and encourage patients to be active participants in their own care, giving them choices and options whenever possible.

How does cultural competency impact patient safety? “Patients who are not comfortable with the way they are being treated will be less likely to heed instructions or disclose potentially important information that could impact their care or could hinder their recovery,” said Dern. “They may be embarrassed about asking questions or sharing information if they believe they’ll be judged.”


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