Abstract: This article is a synthesis and interpretation of field work from a transcultural nursing immersion experience in Italy. The main focus of the field work was to understand the cultural influences on health systems with interpretations related to nursing education. The major recommendations of the paper include strategies for nurse educators to promote cultural competence throughout curricula by providing students with meaningful clinical experiences and addressing healthcare needs of diverse populations in the U.S. and abroad.
Key Words: Transcultural Nursing, Immersion Experience, Nursing Education, Nursing
As globalization of people around the world increases, there is subsequent growth in culturally diverse populations living in the U.S. who require health care (Smith & Curry, 2011). Therefore, nurses in the United States (U.S.) nurses need to be skilled at providing culturally congruent care to a variety of people. The National League for Nursing Accreditation Commission (NLNAC) mandates mat schools of nursing include "cultural, ethnic, and socially diverse concepts and may also include experiences from regional, national, or global perspectives" (NLNAC, 2008, p. 94). The American Association of Colleges of Nursing (AACN), as cited in Sanner, et al. (Sanner, Baldwin, Cannella, & Parker, 2010) has identified cultural sensitivity as an essential curricular component in the preparation of new nurses. Moreover, the Institute of Medicine's Core Competencies mandate healthcare providers, "identify, respect, and care about patients' differences, values, preferences, and expressed needs. . ." (Institute of Medicine, 2003, p. 45). Schools of nursing must strive to provide students with opportunities to develop and refine these important skills. Students may feel uncomfortable or stressed while engaging in clinical experiences within culturally unfamiliar environments; however, this may be an effective strategy to promote cultural sensitivity. Such experiences evoke feelings of vulnerability and allow students to reflect on the perspectives of diverse patients accessing care within the U.S. healthcare system. A trip abroad by nurse educators serves as the basis for this article. The week-long immersion in Rome, Italy helped the educators gain insight into the cultural differences and influences of culture on health and healthcare practices. The following analysis and synthesis of field observations and experiences highlights the need to prepare all nursing students to be culturally competent by assimilating experiences with diverse populations into nursing curricula.
THE IMMERSION EXPERIENCE
During the cultural immersion experience, nurse educators interacted with Italians while conducting daily business, touring the city, and visiting health care facilities. The educators explored two hospitals in Rome and communicated with Italian health care professionals to learn about their healthcare system. Each educator kept detailed field notes of observations and experiences, then came together to discuss the observations and identify common themes. Analysis of the collective field notes revealed five prevalent themes and implications for nursing education in the United States.
The themes identified were:
1 . Communication
3. Culinary Practices
5. Public Environment
The inability to communicate effectively due to language barriers may lead to feelings of vulnerability and frustration for patients and healthcare providers alike. This can result in miscommunication regarding patients' health conditions, treatments, medications and important directives. Health care providers may find it difficult to obtain an accurate health history, address specific health concerns, obtain informed consent for medical and surgical treatments or provide important patient education. …