In the 21st century, nations all over the world experience increased diversity that has been associated with various opportunities and challenges for policy makers, health care and health care systems. Among the challenges experienced in many nations due to the increased diversity is the ability of the decision-makers, caregivers, and the entire health care system to develop and deliver culturally competent services to consumers. Cultural competence in this perspective refers to the ability of an organization or a provider to provide effectively health care services that meet the social, cultural, and linguistic needs of patients. By providing a culturally competent health care service, the organization or provider improves the quality and outcomes of health care, and this might be a driving force that would eliminate ethnic and racial health disparities. In this regard, Purnell model for cultural competence is a framework made up of twelve cultural domains developed in a bid to direct cultural competence in the health care sector. As such, this paper provides comprehensive information about my cultures pattern of communication using Purnells domains of culture as a guide.
My cultural ancestry is Colombian. My country of origin is the Republic of Colombia that is located in the northwestern part of South America and bordered by Venezuela and Brazil on the east, Panama on the North West, and Ecuador and Peru on the South. Ethnically, I am a mestizo - an ethnic group of mixed European and Indian descent. The mestizo makes up the majority of the Colombian population, and those residing in the traditional rural landscape are known for their agricultural prosperity as they cultivate small plots of corn and coffee among other crops. Colombia has a broken and rugged topography with the diverse climatic region such as savannas, steppes, tropical rainforest, deserts, and mountainous regions. With climate change being faced globally, Colombia has also been affected, as there are increased risks of droughts and interference of agricultural production. Additionally, there are seasons, during which there are floods in settlement areas, which has impacted economic activities and population health negatively.
Spanish is the most spoken language in my country. Moreover, it is the national language of Colombia. 99% of the Colombian population speaks Spanish, while the remaining population percentage is made up of between 60 and 80 indigenous languages. Compared to the Spanish spoken in Spain, the Colombian Spanish is typical because its accent is a variance of the Spanish language and emphasis spoken in Colombia. In Colombia, sign languages such as Colombian numerals and Colombian and Providence Island sign language are widely used. Apart from the national language, some languages of Colombia's ethnic groups are considered as official languages. These languages are Ticuna, Kuna, Cuiba, San Andres-Providencia Creole, and the Arawakan languages among others. The Colombian Spanish has some dialects that include the Caribbean, Andeana, Paisa, Tolo, and valley dialects. These dialects are defined on a regional basis. For instance, the Andeana dialect is common in the southwest region of Colombia.
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In our culture, like others in the world, communication is vital in strengthening family bonds and other relations. As such, the willingness of individuals to share their thoughts, feelings, and ideas is usually fostered by the family. For Colombians, the family is the fundamental pillar of the social structure. Therefore, young individuals learn to express and share their thoughts, feelings, and ideas from the family. The learning process is not a one-day activity but it is acquired over an extended period as the family members interact between themselves, their neighbors, and foreigners.
There are areas of discussion that we, Colombians, consider taboo. One of the areas of discussion that has not been accepted by many traditional families is the one that concerns sexual education. This medieval approach has been upheld for a long time by many traditional families in Colombia as they regard it as immoral and irrational. As such, discussing sexual health in such families is prohibited, which has made teenagers less informed about sexual health. However, there have been efforts made by the Colombian administration to eradicate this medieval mindset, but the efforts have not succeeded due to the opposition by the locals. For instance, in the 1990s, sexual education became obligatory in our country with an aim of providing young individuals with an avenue of learning about sexual health. This effort was countered by the 'Red Families' group that urged the parents to curb their children participations in sexual health education programs.
Another cultural uniqueness of our culture lies in the utilisation of non-verbal communication. An example of non-verbal dynamic that is unique to us is the practice and meaning of touch. In this case, the practice and meaning of touch between individuals vary depending on the relation and gender of people who are involved in the practice. For friends, family members, and other close relations, individuals are involved in giving each other hugs, also known as abrazo, and backslapping. Women tend to grasp ones forearm, whereas among men, handshakes are common. The use of handshake is also used when persons say good-bye and part. Moreover, persons of opposite sex and young females exchange kisses when they meet and when they say their good-byes. Additionally, in the health care setting, touch is accepted as it is in line with our cultural medicine practice where a caregiver has to be in contact with the sick individual from time to time.
A second example of the elements of non-verbal communication that is unique to our culture is space. In this context, space refers to the physical portion that an individual refers it to be theirs psychologically. In the Colombian culture, this personal space is important to observe when communicating to others. For friends, family members, and other close relations individuals, it is acceptable to stand close to each other when communicating. However, the distance is not as close as that of individuals from other South American cultures. On the contrary, when communicating with strangers, individuals maintain their personal space. This space should be maintained as far as the conversation goes on because stepping backward is considered rude and moving closer means invading ones personal space.
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Another form of nonverbal communication that is unique to our culture is eye contact. This refers to a situation where individuals while communicating look at each other at the same time. Eye contact is vital in communication, especially when it is complemented by body language during interaction. Per se, over the years, our culture has learnt to appreciate the importance of eye contact, as it is acceptable and common in communications between family and friends. In this case, when communicating with family and friends, any instance of indirect eye contact may mean that an individual is either guilty or ashamed about the topic of discussion or the other person. For strangers, maintaining eye contact is the best way to begin a conversation as it creates trust and makes good impression on the other person. However, when communication takes place between individuals belonging to different age groups, the younger individual needs to maintain indirect eye contact. This is common in the Colombian traditional communities as they view eye contact as a sign of dominance.
In the Colombian culture, gestures and facial expressions with varying meaning are used widely when communicating, a uniqueness that is attributed to our formality and appreciation of sophisticated mannerism and posture. When one wants to call or point another person, one uses his or her mouth or hand with the palm facing down. However, pointing an individual with the index finger is considered disrespectful. Another gesture that is unique for our culture is referring to someone as crazy by making small circles with the index finger close to the head in the ear region. Thirdly, to appreciate the efforts of an individual or say that all is good, thumbs up is used as a gesture. In addition, when one is pleased or disappointed with an individual, one will be faced with excited or angry faces respectively. Along with gestures and facial expression, my people display their emotions. This is evident as we are warm in nature and we tend to get close to one another, touch, and hug when communicating. These are expressions of remorse or affection.
As Colombians, we have an acceptable way standing and greeting people, which is dictated by the existing relationship between individuals. When meeting a person for the first time or welcoming a visitor, one is expected to stand up and bend forward when greeting the other person. However, the way one greets the other is dependent on the gender. For men, a handshake and maintaining direct eye contact is common, especially when greeting strangers. However, when greeting friends and family, light hug is common. For women, grasping ones forearm and, sometimes, soft handshake are common. In addition to this, they may kiss each other on the cheek. Lastly, greetings between individuals of the opposite sex are done by shaking hands and, at times, hugging and kissing.
The Colombian culture is present oriented. This is a temporal relation that favors and values the present. As such, time is usually viewed as a resource and everything needs to be handled in the present time. This is evident because most of us are known not to be punctual but we usually make sure we arrive for the appointments within a reasonable time frame and excuse.
The above-mentioned cultural practices that are unique to Colombians have had an impact on my nursing practices. One of the notable impacts is that I tend to be emotional when dealing with patients who suffered for a long time. As such, I am naturally programmed to offer such patients extra attention. Secondly, I am usually cautious when discussing sexual health related issues with my patients. This is due to the medieval approach of sexual education in my culture, which makes me judge the patient or individual before discussing the matter. Thirdly, the strong cultural communication style has influenced me in my practice as I can communicate effectively with patients. Patients need someone to be closer in their personal space so that they may feel they are being cared for in the right way. As such, the cultural practice that relates to space enables me to care for the patients on a personal level.
In conclusion, cultural competence is a vital factor for nurses in both educational and professional practices. This is because it an impact on how an individual gets a task done and relate to others within the healthcare environment. As such, nurses and other workers in the healthcare environment need to uphold cultural competence so that they may cater for the culturally diverse nature of the healthcare environment.