Cultural negotiation

Once assessment is done, cultural negotiation can take place in terms of agreeing on a treatment regimen that is acceptable to both patient and provider. The goal of cultural negotiation is to join Western and non-Western beliefs in a way that helps the patient achieve a healthy outcome. For example, a dietitian can use Chinese beliefs about cold (yin) and hot (yang) foods to plan a diabetic diet that is both acceptable to the patient and that helps the patient maintain an appropriate blood sugar level.

In participating in cultural negotiation, nurses can use other health care providers who are from the patient’s own cultural group. However, it is important to remember that, if there is a large gap between the beliefs of providers and patients, and if providers are westernized, they may distance themselves or look down on those who hold traditional beliefs. When this happens, the care providers cease to be therapeutic, even though they share a common cultural heritage. It is important to remember that language alone does not ensure cultural understanding. Patients and care providers from the same country may come from different class and social structures and may not always communicate effectively.

The nurse must know when and how to present material so that it respects cultural values. At times, patients are encouraged to learn new ways of approaching care, or when necessary, are helped to accept mandated changes, such as altering parenting skills to change more abusive child rearing practices to those legally acceptable in this culture. Native Americans may value nonverbal and more passive approaches to communication than Anglo-Americans. Responses to questions may be short and long periods of silence may mark the exchange. Knowing this aspect of culture, the nurse can become more comfortable with periods of silence without pressuring the patient to formulate an answer or assuming that he or she is uninterested. In Hispanic cultures, establishing a personal relationship with the patient that supports the norms of dignity, politeness, and respect is important in the counseling exchange. Latino patients often describe a successful interaction with a health care provider as „she was like a cousin or a good friend „.

Using interpreters in health care