Exam #2 Study Guide
Chapter 9 (Culture and Diversity)
Know definitions of ethnocentric, acculturation and stereotyping and what examples.
Ethnocentric: evaluation of other cultures according to preconceptions originating in the
standards and customs of one's own culture
o Characteristic where we put our own ethnicity at the center of everything we believe
o Circular to own culture
o Ex. Think of everything through lens of Western medicine/culture
Acculturation: assimilation to dominant culture, esp a dominant one
o Assimilation: process in which individual adapts to host’s cultural values and no longer
prefers the components of the origin culture
o Individual or group transitions from one culture and develops traits of another
o Can lead to stress when values of new transitioning culture differ from accepted traits of
another
Stereotyping: associating a characteristic with a specific group
o Occurs in two cognitive processes…
Activation of a stereotype when individual categorized into social group beliefs
and prejudices come to mind about what members of that particular group are like
People use activated beliefs and feelings when they interact with individuals
o Ex. All Canadians are polite
Know what social determinants of health are: external factors that affect a person’s health.
"The conditions in which people are born, grow, live, work, and age” (external factors)
o Economic stability
o Social and community context
o Neighborhood and environment
o Health care
o Education
How can nurses develop culturally-competent practices? What is the first step toward developing these
skills (hint: begins with awareness of your own cultural beliefs and practices.
How did you become culturally competent? I ASKED (cultural Awareness, Skill, Knowledge, Encounter,
Desire)
Five constructs = framework for practicing cultural competence
o Cultural awareness: process of conducting self-examination of one’s own biases toward
other cultures and in-depth exploration of one’s cultural and professional background
Involves being aware of existence of documented racism and other “isms” in
health care delivery
o Cultural knowledge: process which health care professional seeks and obtains sound
educational base about culturally diverse groups
in acquiring this knowledge, healthcare professionals must focus on integration
of 3 specific issues: health-related beliefs and cultural values, care practices,
disease incidence and prevalence
, o Cultural skill: ability to conduct cultural assessment of patient to collect relevant cultural
data about patient’s presenting problem, as well as accurately conducting culturally
based physical assessment
o Cultural encounter: process that encourages health care professionals to directly engage
in face-to-face cultural interactions and other types of encounters with patients from
culturally diverse backgrounds
Aims to modify health care provider’s existing belief about a cultural group and
to prevent possible stereotyping
o Cultural desire: motivation of health care professional to “want to” (and not “have to”)
engage in the process of becoming culturally aware, culturally knowledgeable, and
culturally skillful in seeking cultural encounters
Chapter 22 (Ethics & Values)
Know definitions of: autonomy, beneficence, nonmaleficence, justice, and fidelity
Autonomy: freedom from external control
o Respect for the autonomy of patients commitment to include patients in decisions
about all aspects of care
Individuals have right to determine own actions and freedom to make own
decisions
o Key feature of patient-centered care
o Acknowledge and protect patient’s independence
o Based on:
Individual values
Adequate info
Freedom from coercion
Reason and deliberation
o i.e. informed consent process team’s role is to inform patients about risks and
benefits of treatment options and then, with patient, determine plan of care that
matches their goals and values
o i.e. explaining nursing procedures, such as taking BP or administering meds
Beneficence: taking positive actions to help others
o best interests of patient remain more important than self interest
o promoting good for others
, Nonmaleficence: duty to do no harm
o Foundation of medicines Hippocratic Oath
o Principal of the double effect: one may produce a distressful or undesirable effect if the
intent is to produce an overall good result
Justice: fairness and distribution of resources
o Health insurance, hospital locations and services, organ transplants
o Ex. Should those with greater need for resources receive more than others? Should
health care resources be available to those who earned them or should they be
distributed equally?
Fidelity: faithfulness or agreement to keep promises
o Duty of nurse to be faithful to patient, institution you work for, and yourself
o Honoring commitments and promises
o Ex. Saying you will get patient pain medicine – get the patient their pain med, follow
through
o Key foundation for nurse-patient relationship
Veracity: telling the truth, not lying
o Fundamental to continued trust between people
o Exceptions – patient asks not to be told the truth or patient is mentally incompetent
Chapter 23 (Legal Implications)
What is negligence? What has to be proved? What are major causes of negligence in nursing?
Negligence: “failure to act as a reasonably prudent person would act in the same circumstance”
o Conduct that falls below the generally accepted standard of care of a reasonably
prudent person
o Make a decision that hurts someone
o Nurse is negligent when he or she had a duty of care that is breached and a patient is
physically harmed
Ex. Hanging wrong IV solution for a patient
o Most lawsuits are negligence
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