Culturally Competent Nursing: Respecting Diversity in Care - Essay Sample

Introduction

Cultural diversity may be defined as the existence of a combination of cultures within a particular social space. A culturally competent nurse, therefore, is a nurse that has developed knowledge about their existence, opinions, feelings, and environment and recognized the potential impact of these on their ability to render care but has risen beyond such influences. Such a nurse respects their clients' divergent views, behaviors, and values. American soldiers who engaged in the Vietnam War from 1964 to 1975 are today known as Vietnam veterans (Scott, 2017). The assessment of the external environment is linked to achieving competitiveness in providing care through adoption of effective methods. Sustainable development and management of medical organization is dependent upon establishing the trends in the society which can improve the understanding of the changing care continuum. This demographic faces unique health challenges compared to other Americans. This essay examines their statistics, healthcare resources accessible to them, their high-risk behaviors, communication issues, and workplace issues vis-a-vis nursing care.

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Statistics

According to Kulka (2014), the number of living Vietnam War veterans as of 2013 is 6.4 million. They represent 32 percent of the total 22 million veterans and 2.9 percent of the entire US civilian adult population. The youngest person at the end of the war may have been about 17 years old. They are 61 years old in 2019. Since some supervisors had fought in World War II and were in their forties in the Vietnam War, their median age stands at 65 years old (Kulka, 2014). An overwhelming majority of them are male - 92 percent are male, while the remaining eight percent are female. None have been reported or claimed to be transgender or binary. Ninety-seven percent of them are native to the US; only three percent were born in a different country (Kulka, 2014). The majority of Vietnam War veterans live in small towns and low-density areas. One such place is Killeen-Temple-Fort Hood in Texas, as well as border towns in states like California and Florida. Ohio and Pennsylvania complete the list of the most preferred places to live for Vietnam veterans.

Healthcare Resources

An impressive 99 percent of Vietnam veterans have access to medical care through insurance packages, be it public or private. More than half - 54 percent - have both (Elliott, 2015). Only one percent lacks such insurance. These statistics indicate a prioritization of healthcare within this group. Their coverage notwithstanding, these veterans face disabilities, the most outstanding of which are deafness or other hearing difficulties and trouble walking (Elliott, 2015). Issues such as disabilities create logistical hurdles to medical care access, which, compounded with stigma and weak social support systems, make the sexagenarian veterans significantly less healthy than they otherwise would be (Kulka, 2014). Insufficient knowledge also makes it difficult for veterans to access medical care. Their distribution throughout the country makes the diversity of their issues a matter of concern. Resolving these issues should begin with reducing knowledge gaps by providing numerous resources to the medical practitioners themselves. Additionally, experienced nurse practitioners should pair themselves with less experienced ones to restrict the amount of time and resources necessary to fix these challenges. Whatever solutions one decides to put in place, they should suit different people appropriately.

VA Medical Centers are an integral health care organization that provides specialized care to the veterans. Veterans have special health needs and the VA Medical Centers are designed to provide care to the veterans to improve their lives and promote healthy retirement for our service men and women. The organization has an integrated care system with 1700 clinics, hospitals, community centers, counselling centers and domiciallies that are equipped to meet the healthcare needs of veterans. VA Medical Centers offer financial assistance to the service members and there dependants across the country. Vocational rehabilitation services are amongst the most important services that veterans are able to access in VA Medical Centers which is very important in integrating former servicemen and women back to the society. The VA Medical Centers are vital for the healthcare system in general because they extend their services to the nearby communities and most important the dependants of servicemen and women. Over time, VA Medical Centers have developed to play a major role in medical education. In surgery management and medical management the organization continues to play a major role especially in complex surgical cases that involve the neck, head, chest, and the gastrointestinal tract. Most of the medical students in VA Medical Centers are given an opportunity to acquire important skills and experience. VA Medical Centers can continue to lead in healthcare delivery if it manages the challenges in the external and the internal environment. This paper seeks to establish the external environment of where VA Medical Center operates to assess the opportunities and threats to the organization (Veterans Health Administration. 2008).

Technology development has significantly revolutionized how healthcare is received and managed. Different digital transformations are taking place in healthcare which are aimed at improving healthcare services and their management. New technological applications such as customer relationship management have improved healthcare organizations management of patient care and patient satisfaction. Real time data from technological solutions contains to shape the healthcare environment by providing real time intervention decision making tools for healthcare providers. On the other hand, telemedicine and telecare has improved the healthcare delivery and response to patient needs. Technological innovation will continue to shape healthcare and it is important for healthcare providers to integrate technology in practice (Meyer, 2018). Healthcare organizations are greatly investing in technology to improve care convenience and efficiency.

Workforce Issues

Generally, veterans receive significantly higher levels of education than civilian nonveterans. As mentioned above, Vietnam veterans mainly live in rural areas, which are often characterized by limited job opportunities (Scott, 2017). Furthermore, the advancing age of veterans brings with it physical and mental health complications, some of which are closely connected to their service in the military. Some are also unable to access medical services due to the high costs associated with it (Elliott, 2015). Women also experience similar, albeit slightly differentiated, challenges. Case in point, due to their decision to live in rural areas, employment opportunities are limited, as are childcare facilities. On average, urban veterans earn $6,000 more than rural veterans (Scott, 2017). A potentially effective solution is supporting rural community organizations in capacity building. Nurses should strive for medical solutions that align with the specific veteran's budgets. Since, as mentioned above, Vietnam veterans primarily live in small towns, it suffices for the nurse to consider services that are less costly than for those living in urban areas. The demand for qualified primary care and geriatric physicians in the United States of America continues to grow and there is needs for more innovative approaches to train and equip physicians with necessary skills. Training facilities for physicians that can provide them with the necessary experience to ensure quality care is a significant challenge. As the demand for care continues to grow it is important for healthcare stakeholders to create approaches of training and providing experience to the primary care and geriatric physicians.

High-Risk Behaviors

Heroin and opium were used widely during the Vietnam War among members of the US armed forces. A study by Scott (2017) shows that 35 percent of soldiers attempted to use heroin. Of this proportion, 19 percent later became dependent. The primary reason for using these drugs at the time was to enhance performance. Today, veterans use these drugs to cope with the stresses of life or in response to addiction. In 2010, Scott (2017) conducted an investigation in which they discovered that 27 percent of soldiers that had participated in the Vietnam War binge-drank weekly. The author further argues that a substantial number of Vietnam veterans have sought treatment for drug addiction. There is a strong correlation between drug addiction and post-traumatic stress disorder (PTSD) because 20 percent of veterans with PTSD also face substance use addiction. Tackling PTSD with drug and alcohol have the opposite effect. An overdose is likelier than active coping, which puts their health at risk. From the nurse's perspective, resolving drug abuse issues should take into account the specific drug. For alcohol, medication and counseling should suffice while medication and patches may help with tobacco cessation (Elliott, 2015). Opioid addiction should be tackled by medication and therapy. These interventions should precede family and peer relationship reparations, which are caused by these addictions.

Spirituality

The link between spirituality and protectiveness is unclear. In a study by Elliott (2015), religiousness and spirituality led to less proneness to exploit veteran services. It suffices to appreciate the connection between PTSD and religiosity. According to Sylvester (2019), PTSD symptoms were sometimes associated with spiritual alienation or guilt. Currier, Drescher, & Harris (2014) investigated the correlation between spirituality and PTSD among veterans and found that problems with forgiveness, which is tied with morality and hence spirituality, caused increased symptomatology. Furthermore, the more spiritual the vet, the severer PTSD symptoms were. Spirituality is often used to negotiate the meaning between reality and the trauma that soldiers undergo during the war. It suffices for the nurse to appreciate the unique impact of spirituality in the Vietnam veterans' coping mechanisms. Doing so should begin with the nurse creating an environment where the patient is comfortable to talk about their experiences and beliefs. The intervention should extend beyond the physical aspect and inquire from the patient how they are coping with treatment and, if possible, avail a spiritual priest or similar person.

Conclusion

Vietnam veterans face trauma, drug and alcohol addiction, and other challenges associated with their specific demographic. Helping them work through these issues requires the nurse to incorporate cultural diversity that applies to the group. Those with alcohol and drug addiction issues should be treated with medication in combination with counseling or therapy. Spiritual ones should work with a spiritual leader of some kind, and those with employment challenges should work with cheap treatment alternatives. Since healthcare resources are not always accessible, nurses should equip themselves with the appropriate knowledge and work with more experienced ones. These interventions may improve healthcare among Vietnam veterans considerably.

References

Currier, J. M., Drescher, K. D., & Harris, J. I. (2014). Spiritual functioning among veterans seeking residential treatment for PTSD: A matched control group study. Spirituality in Clinical Practice, 1(1), 3-15. doi:10.1037/scp0000004

Elliott, B. (2015). Caring for Vietnam veterans. Home Healthcare Now, 33(7), 358-365. doi:10.1097/nhh.0000000000000261

Kulka. (2014). Trauma and the Vietnam War generation. doi:10.4324/9781315803753

Meyer, C. (2018, February 08)....