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Native Americans and Culturally Competent Nursing Care

Nurses have always been taught that the patient is first, and to do no harm to the patient.

Caring is also a big component of good nursing care. Nurses encounter patients of different ages,

religions, socio-economic statuses, and cultures on a daily basis. The population of clients that

nurses serve is so diverse; therefore, it is necessary for nurses to be knowledgeable and culturally

competent when providing care to patients. Native Americans are a cultural group that nurses

encounter almost daily in the hospital setting.

When beginning the nurse client relationship with the Native American client it is

important to first establish good rapport with the client. Most Native Americans prefer to be

called Indian (Hendrix, 2010). Adults over the age of 65 are considered elders and are highly

respected (Hendrix, 2010). Aunts and uncles are even considered to be parents or grandparents

(Hendrix, 2010). Life, modesty, and privacy are highly valued by the people within this culture.

For that reason, the healthcare professional should not view the Indian client’s reason for seeking

care as a problem (Hendrix, 2010). Addressing their medical condition as a problem makes them

feel like the healthcare professional has more supremacy compared to themselves (Hendrix,

2010). Before beginning any interview or procedure, permission should be asked and an

explanation should be given to the client (Hendrix, 2010). Listening is valued over talking.

Native Americans believe in doing rather than talking (Hendrix, 2010). Handshakes are often

viewed as inappropriate. Direct eye contact is also avoided. Traditionally, Native Americans

look to medicine people, clan leaders, spiritual leaders, or a cultural guide for treatment with

medical conditions. The medicine people and spiritual leaders treat the medical conditions and

give homemade pharmaceuticals to the Indian people. That is why it is very important to make

sure that when medications are prescribed by doctors, that the Indian client finishes the entire

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medication as it was ordered. The Indian client will stop taking a medication the moment he or

she begins to feel better. They interpret feeling better as being saved from the condition

(Hendrix, 2010).

The most common diseases that affect the Native American population are heart disease,

hypertension, and diabetes. Many of these diseases are preventable, but inadequate access to

healthcare and lack of teaching leads to the increased prevalence of these diseases. Many

federally funded programs have been developed in the United States to assist the Native

American people with nutritional guidance and supplementation. The people are receptive to

these programs, but they try hard not to lose their cultural food traditions. Foods such as fresh

fruits and vegetables, soups, and wild meats are daily staples for them. These foods are often

times used in rituals and ceremony. In the hospital setting, it is important for the nurse to try and

accommodate these nutritional needs. It is also important for the nurse to know that these people

may share their food with friends and family, and eat food that has been brought in by visitors.

The Indian culture believes that food should be taken when it is offered and that no food should

be turned away, these cultural traditions are part of their belief that offering food is taking care of

someone (Hendrix, 2010).

Mental illness is not as common in the Native American culture as it is amongst Whites,

Blacks, and Hispanics. However, these people can mask their symptoms. For example, rather

than reporting depression the Indian client may report having a “heavy heart” (Hendrix, 2010).

Dementia is another mental illness that occurs but is not spoken of very much. With dementia

comes the role of having a caregiver (Hendrix, 2010). It is taboo to put the caregiver burden on

family members (Hendrix, 2010). Native Americans are more receptive to going to a long-term

care facility. When Native Americans require end of life care they prefer a natural setting such as

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the home (Hendrix, 2010). The naturalness of the home environment ensures that the spirit

crosses over to the other side safely (Hendrix, 2010). The Indian people believe that the spirit can

be held up by the family members and their inappropriate thoughts and behaviors. Native

Americans normally do not donate their organs. It is their belief that the body should go to the

other side as a whole (Hendrix, 2010).

These are just a few of the cultural considerations that should be considered when

providing care to thebNative American client. However, adherence to these considerations can

improve the healthcare relationship considerably. By respecting the client’s culture, he or she

will be more receptive to the information and treatments that are provided to him or her in the

healthcare setting.

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Reference

Hendrix, L. R. (2010). Health and healthcare for american indian and alaska native elders [Word

document]. Retrieved from Lecture Notes Online Web site:

http://www.stanford.edu/group/ethnoger/americanindian.html