As I listened to the Riverbend scenario I thought of my own cultural competence and how at one time I knew very little of the Hmong culture. Working in a city where Asians make up only 3% of the population, this is a population I knew little about. I have learned that most Hmong are from the mountainous region of Laos, and are granted preferred refugee status by the U.S. (Cobb, 2010). From 2000 to 2010 the number of Hmong grew 40%, there are currently 260,073 Hmong people living primarily in California, Minnesota, and Wisconsin. Even though the Hmong people seem to be prospering after thirty years in the U.S., there are still challenges with communication, understanding of cultural beliefs, and use of traditional medical practices (United States Census Bureau, 2013) In the Riverbend scenario, the novice nurse Jessica Jameson makes a quick assessment based on her level of understand on the Hmong culture and assumed that the young boy has been abused. At no time does the more senior ED staff members mention the possibility of the use of coining for young Lue Vang. Coining is common practice by Hmong, oil is placed on the back, and then a coin is run down the middle of …show more content…
If nurses lack of understanding regarding community demographics and cultural differences, they can have unintentional bias, and stereotype patients due to a lack of awareness of the cultural demographics of the community they serve (Camphinha-Bacote, 2011). Cultural competence is the understanding of different cultures and how that impacts the provision of patient care. Cultural competence in nursing is defined as one willingness or the desire to understand a patient’s culture, the ability to learn about a defined cultures belief system, and to work effectively as a healthcare provider understanding the dynamics of the patient’s culture as it relates to their relationships and care (Kardong-Edgren et Al.,
The only dilemma I might face if I were to be involved in a Hmong
‘The spirit catches you and you fall down’ was published in 2012 by essayist and reporter Anne Fadiman. This introductory book review analyzes the way in which different cultures perceive illnesses and diseases. It focuses on the story of the Lees a Hmong family, who moved to the United States and experiences difficulties with language, culture and biomedicine method of healing, which contradict to Hmong’s way of healing. The chapters describe the differences between the ways childbirth is conducted in Hmong society compared to the western society. As well as the struggle the Lees family has with the cultural differences in diagnoses and treatment of their ill daughter.
It was a federal grant used to establish “an integrated mental health delivery service utilizing Hmong healers and western mental health providers” (Fadiman 2012). The program was successful and treated 250 patients. In one case, the traditional healer, the txiv neeb, was able to heal a man with a swollen penis. Another case, the txiv neeb was unable to heal his patient with gall bladder problems, but was able to help assist the patient in consenting to surgery. During the mid-1990’s, cross-cultural training emerged slowly in medicine.
The book represents the Hmong and western medicine as being static. Throughout the book the Hmong are depicted as being very hard headed and not willing to adapt. It however also shows mainstream western medicine being just as stubborn to change. Historically the Hmong have faced many challenges, from being used by the American Army as cheap labour and soldiers to becoming refugees but they never gave up their cultural beliefs (Fadiman 1997). A specific example of this can be seen she talks about the tensions the Hmong faced in China, and how the Chinese government tried to change the Hmong community, and make them wear Chinese clothing, cut their hair short etc, however the Hmong responded to this by first fighting and eventually migrating(Fadiman 1997:16).
In The Spirit Catches You and You Fall Down, Anne Fadiman uses careful comparisons and contrasts to appeal to the emotions of readers. Throughout the novel, Fadiman explores different scenarios that are encountered by the Hmong that would make anyone feel frightened. Through these scenarios, we discover what the Hmong have had to endure in order to make a small amount of progress. Some of the individuals in the novel we encounter, including Dr. Robert Small, see the Hmong as “ignorant” and “almost a Stone Age people”. However, some individuals such as the social worker to Lia Lee, Jeanine Hilt, and the author of the novel understand why the Hmong reacted the way they did to the doctors.
3. Give specific examples of how health care professionals did not value or respond effectively to any of the Hmong values/beliefs you have listed in the questions above. What was the outcome of that cultural insensitivity. The Hmong traditions, beliefs and ways of life were often compromised at the hands of American society.
Before fully getting into the details of this major problem, it’s important to quickly summarize the Hmong culture. The Hmong originated in China and fought the Chinese to maintain their culture. During the Vietnam War, they fought against the Communist forces but were forced to leave their homes to escape persecution when the US withdrew their support. Most of the Hmong people then immigrated to the United States and tried to rebuild their lives as best they can. Their tenacity and unwillingness to surrender, both during the war and in every-day life, helped them survive, but also made their visits to the doctor extremely difficult, to say the
The Spirit Catches you and you Fall Down” is an astonishing book that reveals the need for improvement of cultural competency in the American healthcare system. This book teaches me the importance of the role of healthcare administrator as a cultural advocate between the patients and the providers. This book also influences me in realizing the differences between patients’ culture and providers’ culture. Moreover, I can relate to Jeanine Hilt, a social worker who truly cares for the Hmong culture and the Lees Family. Healthcare administrators must be aware of the cultures of the population that reside in the region that your facility is located.
Walt Kowalski was a widower living in his home that he has owned for many years in Michigan. Over the years, the demographic has shifted in the neighborhood, from the white, working class to poor immigrant Asian families. Walt did not hide his displeasure for his neighbours, the Vang Lor family. The Vang Lor’s were from the Hmong culture. The Hmong people were people from the mountainous regions of China, Laos, and Thailand.
In the documentary, “The Split Horn: Life of a Hmong Shaman in America,” portrays the journey of an immigrant Hmong family battling to maintain their cultural traditions alive in the United States. In the Hmong culture, it is believed that every individual has seven souls and if they have an illness, for example sickness, it means that their soul has departed or taken by evil spirits. Hmong people believe in Shamans, who are gifted and respected people who can make contact with their ancestors and return the lost souls of people. In this documentary, the main character Paja Thao is a shaman who is challenged by American customs to keep his cultural Hmong traditions alive and pass it down to his children. Paja becomes sick because he feels like his children don’t care about the Hmong tradition anymore because they don’t participate in his rituals and realizes his children have assimilated to the American culture.
Over the progression of the book the view points and relationships between the Lees and the doctors develops slightly. The medical staff was not prepared with a translator or a cultural understanding of the Hmong and how their beliefs would not match up with their medical practices. “Not only do the Hmong fail resoundingly to improve the payer mix- more than eighty percent are on Medi-Cal- but they have proved even more costly than other indigent patients, because they generally require more time and attention, and because there are so many of them that MCMC has to hire bilingual staff members to mediate between patients and providers” (Fadiman 25). This theme in the story was immensely eye opening for all of the cultural gaps that exist throughout the United States. The solution to this problem is for both sides standing on opposite sides of the gap to take the time to bridge the gap together.
The way a person thinks about health, “whether that is our ‘philosophy’, our ‘worldview’, our ‘framework’ influences what we do as individuals in practice,” as well as how we deliver the health service. These elements allow us to think about healthcare in our own culturally acceptable way, this isn’t always an acceptable way of delivering the service to people with views different to our own. Cultural competence is an approach that aids in influencing the service and the education of healthcare professionals. (Taylor, K., & Guerin, P., 2010). Cultural competence is defined as a knowledge and understanding of cultures, histories and contemporary realities and awareness of protocols, combined with the proficiency to engage and work effectively in a cultural context congruent to the expectations of the people of that culture.
Cultural competency: Indians Culture competency is defined as one has the knowledge, the abilities and the skill to deliver care congruent with the patient’s cultural beliefs and practices (Purnell, 2013). As a nurse or a health care provider, increasing ones consciousness of culture diversity improves the possibilities for health care practitioners to provide competent care (Purnell, 2013). Nurses and all health care providers should be aware of other cultures to provide the best care that they can for that individual. Developing a relationship with diverse cultural groups involves good interpersonal skills and the application of knowledge and techniques learned from the physical, biological, and social sciences as well as the humanities (Purnell, 2013). I am choosing to select the Indian culture for my first assignment.
Retracing back to my ethnic history, Hmong people was a minority group that originally originated in China and slowly spread to Laos, Thailand, Vietnam, United States, Australia, and France. It was never identified if the Hmong people had their own country or if they were part of the Chinese lineage whom had become a minority group of their own with its own language and culture. It is found that, the Hmong cultural last names consist of 18 different last names and were very similar to the Chinese last names. As to that there are still Hmong people who live in China mainland. For this reason, it had been a belief that the Hmong cultural did exist from China and had ancestors who were monarchs.
The United States is a culture diversity country, and it is sometimes described as a melting pot in which different cultures have contributed their own distinct "flavors" to American culture. The valuable aspect of a nurse is to be a cultural awareness which means to have an understanding of people’s culture is needed in health care is important in order to provide an adequate care to the patients. Diversity awareness also applies to healthcare professionals and other co-workers. Everyone belongs to one or more cultural groups. Additionally, it is important to acknowledge that culture can be ever changing, not static.