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Transcultural nursing is a mid-level theory of nursing science that states that optimal healthcare delivery is achieved only when it is congruent to the culture of the client. A patient’s sickness, cure and health is as much defined by his or her culture as it is by physiology and medicine. Not just holistically, but fundamentally, an oath-bound nurse can only be certain of “doing no harm” if care is administered with the knowledge that such care is not inappropriate for the patient’s specific culture.
The definition of "culture" is a particular group of people's norms and practices that are learned and shared and that guide an individual’s thinking, decisions and actions. A culture might have unique values in common with no other culture — idealized principles that have isolated its very existence over time. A common practice in one culture might be morally good but might be uncommon and unethical in a different culture. Although race and ethnicity have historically been standard demarcations of culture, modern ethnography, or the study of cultures, generally rejects theories and methodologies of classification.
Although culture is a social construct, its foundation lies squarely in the individual’s mind, body and spirit. Culinary tradition is one obvious example in which the social guidelines of a group of people’s food consumption is deeply rooted in the individual’s spiritual, mental and physical well-being. Insofar that nursing practice entails the care of an individual not oneself, to provide care as oneself or ethnocentrically can be a Hippocratic violation. Despite the best intentions, from simple lack of knowledge, if a nurse inflicts a cultural taboo on a patient, the nurse has fundamentally harmed that patient.
Transcultural nursing proposes that true healthcare must be delivered from within the context of the patient’s culture. The cause of a disease often is related to where the patient comes from, and successful rehabilitation from the disease often relies on the place to which he or she returns. Knowledge of the patient’s culture gives the practicing nurse greater awareness and sensitivity to effectiveness of treatment. Broader cultural perspectives empower the nurse to apply core care through multiple and flexible methods.
One of the prominent theorists, recognized worldwide as the founder of transcultural nursing, is the anthropologist Madeleine Leininger. Following a research assignment to New Guinea and her appointment as Dean of the University of Washington’s School of Nursing for five years, she outlined the main tenets of the theory and created the Transcultural Nursing Society in 1974. Dr. Leininger believed that the universality of the human condition arrives via countless cultural paths, and that nursing’s objectives must therefore necessarily trace that path for any given patient. An additional tenet of transcultural nursing is the admission that the nursing discipline is a culture unto itself, with its own medical language and common practices. Acknowledging this might be a nurse’s first step, to be capable of crossing one’s own learned bubble and into an empathetic understanding of another’s.
More than ever, in the modern world, transcultural nursing is relevant. Countries and societies are increasingly multicultural, and with this diversity, each discreet group has differing cultural conceptions, including the very definition of who qualifies as a nurse and what constitutes care. Globalization has made group boundaries more porous, and managing the health of a society might even require intimate knowledge of a culture half a world away, such as in the case of treating a pandemic. Health care with ignorance of a client’s culture can not only worsen the individual, it can potentially cause inadvertent harm in a wider dimension.