Nurses and healthcare workers have skills that they can easily carry with them when they cross borders and practice in new countries, but are they culturally competent and do they deliver appropriate care in an increasingly diverse society? Do they meet the needs of each and every patient – regardless of creed, colour, ethnic or cultural background – with compassion and care?
A world leader in the issue of cultural competence in healthcare, Middlesex's Professor Irena Papadopoulos has developed a training model that enables nurses and other healthcare professionals in the UK and Europe to understand the needs of diverse patients and populations, to treat them with respect and to recognize inequalities and discrimination. Papadopoulos and two other colleagues (Tilki and Taylor) developed the Papadopoulos, Tilki &Taylor (PTT) model for transcultural health and nursing. Using this as a template, she then set up the EU -funded 'Intercultural Education of Nurses in Europe' (IENE 1) project at Middlesex to develop new methodological approaches with others in the UK, Belgium, Bulgaria, Germany and Romania.
"There are more and more nurses coming in to the UK to work but many are also going from here to work in other countries too. I recognised that we needed something that would be helpful to nurses and other health professionals who wanted to move within the EU countries, that would help them respect the rights and dignity of all patients," explains Papadopoulos.
The PTT model of cultural competence comprises four components: (a) awareness of one's own and that of others' cultural worldviews, (b) knowledge of different cultural practices and worldviews, and understanding of both the causes of and the remedies for health inequalities, (c) cultural sensitivity including the importance of trust, dignity and compassion and the establishment of therapeutic relations through intercultural communication, and (d) applying the previous three components to the assessment, diagnosis and planning of care.
"We took the four main constructs of the PTT model and asked nurses who were participating in the countries in IENE1 to tell us what they needed to know in order to be culturally aware, knowledgeable and sensitive and competent. As a result of that survey we were able to modify the model to meet the needs of the people in those countries," says Papadopoulos. "We created a number of resources including learning modules for people's self-directed learning and a good practice manual. We compiled a common glossary because in every country the terminology is different and hopefully nurses look at the glossary and familiarise themselves with the shared meanings that we have developed.
"An important element in achieving cultural competence is how professionals view people in their care. Unless clients are considered as true partners, culturally competent care is not being achieved and we (nurses and other health care professionals) risk using our power in an oppressive way. Equal partnerships involves trust, acceptance and respect as well as facilitation and negotiation. We hope that IENE1 has helped in some way to recognise and achieve that."