Professionalism and Cultural Sensitivity in Healthcare to All

Populations

Presented by: Saneta Maiko, Ph.D.

March 16th, 2015

Sponsored by St. Joseph Community Health Foundation

Healthcare Professionalism

Creating a work environment that welcomes diversity, is inclusive of those who are different from the ‘main stream’, and allows individuals to utilize their talents in a mutually satisfactory way.

◦(Mor Barak, E.M. 2014).

Agenda

Objectives:

IntroductionDiversity TrendsCultural SensitivityCultural Humility StagesRacism, classism, and InclusivismQuestions

Big Question Best Answer

Background/Question Best Answer Possible

https://youtu.be/dNLtAj0wy6I

How does globalization shape our thoughts, behaviors and reactions?

How do we become professional and sensitive to healthcare practices?

• By increasing our opportunities to interact with culturally different people/situations

• By engaging rational management with emotional sensitivity

(Mor Barak, E.M. 2014).

Changes in Human Resource

Conventional Human Resource (HR) practices tend to produce and perpetuate homogeneity in workforce as a result of A-S-A (attraction-selection-attrition) cycle.

Realizing this doesn’t work in the 21st century, HR has now recognized the value to enlarge differentness, offer sensitivity trainings and conduct cultural audit.

(Mor Barak, E.M. 2014).

Let us look at CLAS document in your folder.

National Demographic Trends

Factors to Think about

Steady growth of non-white populations - “diversification” of America (Atkinson, Morten and Sue, 1993)

Projections show a “minority majority” by 2050, meaning non-Hispanic Whites will make up less than 50% of the U.S. population

(Jerry V. Diller, 2011)

Factors that impact healthcare professionalism

Likely employment gaps

Increased longevity and improved

medical conditions

U.S. business shift

Immigration

Improved medical condition and lower

mortality rate Lower Birthrates

Likely employment gaps

Explanation of those factors

Immigration: Unprecedented increases in immigration, particularly from South and Central America and Asia

Birthrates: Higher for Hispanic, Africans & Asian populations than for Whites Increased longevity and improved medical conditions: People work more years than

before due to long life High unemployment: Developing nations unemployed massive university graduates likely

to migrate to the west Improved medical condition and lower mortality rate: More people globally pushing for

more migrations U.S. business shift: Traditional global cheap labor changes, no moving of jobs overseas Likely employment gaps: Graduation and retirement rates don’t match current

employment needs

(Jerry V. Diller, 2011, Mor Barak, 2009, Maiko, S. 2013)

Levels of cultural sensitivity

Jerry V. Diller, 2011,

Cultural Destructiveness

People whose practices are actively destructive to clients and their culture

They see the difference, clomp it outThey ridicule cultures that are different from theirs

Cultural Incapacity

Elevating the superiority of their own cultural values while suppressing those of other cultures

Elevating the superiority of their own cultural values while suppressing those of other cultures

Cultural Blindness

They see the difference, act as if they don’t.Applying the dominant cultural approach to all community facilities may send diverse people away for* lack of trust*unwelcoming environments*Different perceptions of help

Case Study #1 (Rose, 2013)

An African American woman has just found a lump in her breast. Taking precautionary measures, she does some research to find the best oncologist in the area and schedules an appointment for the first available opening. Because the oncologist is the best in the area he is also very expensive. The woman arrives at the office for her appointment. She notices she is the only patient of color in the waiting room. She sifts through the magazine pile and does not see a diverse selection of reading material. The patient also notices that all the staff she has seen so far is white. After completing the necessary paperwork the patient is escorted by the radiation technician for her initial mammography. While they are walking to the exam room the radiation technician engages the patient in a conversation about the lump she discovered on her breast. During the days leading up to her appointment the patient did some research on breast cancer and is well versed on the disease. Towards the end of the conversations the radiation technician tells the patient she is very “articulate.”

Any problems in this case? What cultural sensitivity failures do you see here? How can they be overcome?

They see the differences, respond incompetently

They recognize that lack of understanding of other cultures limits ability to effectively interact with them

Cultural Pre-Competence

Cultural Competence

They see the difference and appreciate it

They interact with other cultural groups in ways that recognize and value their differences

Cultural Proficiency

They see the difference and respond constructively.

They honor the differences, viewing diversity as a business strategy, respecting other diverse individuals and groups.

Case Study # 2

In a group of 3 take 7 minutes to discuss these questions.

Identify three problems related to this case

Where does age, gender, language and culture impact the interpersonal and intrapersonal relationships in this case?

What three strategies that are needed by the hospital to overcome this challenge in the future?

Examples of Professionalism in healthcare service delivery is one that:

Values and utilizes individual and inter-group differences within its workforce

Cooperates with, and contributes to, its surrounding community

Alleviates the needs of disadvantaged groups in its wider environment

Collaborates with individuals, groups, and organizations across national and cultural boundaries

(Mor Barak, 2014)

Let me Test you now

One of your white male coworkers has been told he will be getting a new black colleague as his officemate. Before the white man has even met his new office mate, he is heard grumbling and groaning about all the trouble he will have and how he doesn’t have time to offer the new man all the help he knows he will need. You are standing nearby when he vents his feelings.

1. What can be done to address the white male employee’s feelings and concerns? A. Change the officemate to meet the white male coworker concerns. B. Encourage him to be more appreciative of differences while connecting him t o awareness

and mindfulness trainings C. Challenge him to change from his prejudgments and be more open-minded D. Let him know the value of differences awhile challenging his biases.

Let me Test you now

The “mainstream” supervisor calls in the “Burmese” employee for a semiannual evaluation. After the supervisor offers some positive aspects of the evaluation, she begins to discuss areas of improvement. Since the “Burmese” employee looks down at the floor during the entire feedback session, the supervisor concludes that the employee is hiding something. When the supervisor tries to draw it out of him, the employee begins to giggle.

1. How might this behavior be explained?

a. The “mainstream” supervisor is culturally competent and sensitive

b. The Burmese Employee is culturally incompetent and insensitive

c. Both the “mainstream” supervisor and Burmese employee need cultural awareness and sensitivity training

d. The company needs to be clear about how to conduct evaluations

Racism, Classism and Inclusion

John is 24 years old who has been with the company for 3 years and his 61 year old officemate Claudia has been with the company for 39 years. A new computer software has recently been installed and every employee should learn as quick as possible to start using it. John sees this as the easiest and best thing the company has done while Claudia feels like the company is taking away its traditional culture on how to do things. The IT director recommends that John mentors Claudia who obviously is challenged by this new software, however Claudia’s Nigerian culture does not allow a minor to mentor a mature grown adult and refuses to be mentored by John requesting for an adult to mentor her.

What needs to be addressed in this situation?A. Fire Claudia and hire someone like John B. Find another mentor for Claudia C. Set and apply clear work related policies about age diversity D. Encourage Claudia to accept John as a mentor while supporting John to be patient with Claudia

Racism Approached differently

Colorblind Approach: When people see differences but act as if they don’t see it by applying the dominant cultural values and practices (ineffective).

Multicultural/Diversity Approach: When people see differences and try to make the minority representation the key solution to diversity challenges (One way solution).

All-Inclusive Approach: When people see differences and act positively to be all inclusive by creating opportunities for everyone to access (effective).

Case Study # 3

In a group of 5, read the case study number 3 in your folders and discuss the questions following.

Choose one person to be the secretary/spokesperson Does Racism still exist, yes, Can it be eliminated? No Can it be managed? Yes Please watch: ttps://www.youtube.com/watch?

v=uMA_qmtqzIA

Best practice that lead to professionalism

Utilize both styles of communication Create and be aware of more diversities Participate in decision making trainings Learn how different people value time and events Be updated in legislations and people’s values, ethics

and needs Be a good student of language, accents and meanings Be sensitive to our history, race, ethnicities and cultures

you work with

Thank you

Saneta Maiko, PhD.