By Laura Raines
Pulse editor

If the purpose of nursing school is to prepare students for real-life practice, then it must address the challenges of working with a multicultural population, says Sharon Grason, nursing instructor at Georgia Perimeter College.

“If you work in an urban setting, it’s a rarity that the patient in the bed will come from your same background,” said Grason, MS, RN, CNS. “Cultural diversity is a growing part of nursing.”

Because she believed the nursing curriculum at GPC only skimmed the surface of cultural diversity, in 2010 Grason launched a senior capstone project to make nursing students more culturally aware. It’s now the last course nursing students take before they graduate.

Grason’s experience working with migrant farmers in Moultrie showed her how important multicultural understanding is for nurses.

“Seeing how migrants lived and worked totally opened my eyes and made me look at how to care for them in new ways,” she said.

To be effective, Grason knew she had to earn their trust.

“When you can show that you have some idea of their lives and what is important to them, the patients’ level of trust goes up tenfold,” she said. “They are more apt to listen and you are better able to help them.”

Grason wants nursing students to realize that diverse patient populations have different health care needs and challenges. To be effective nurses, students need to learn how to take those differences into consideration when caring for patients.

In the capstone project, teams of students choose a different culture to research.

“We begin to learn about the traditions, religious beliefs, social norms, common health problems, foods and the indigenous medical remedies of that population,” said Kristina Palmer, a GPC senior nursing student.

Her group is studying Russian and Eastern European cultures, and they have discovered a large population in metro Atlanta.

“Being aware of patients’ backgrounds and understanding the cultural dynamics can help you give better care,” Palmer said. “For example, in some cultures you have to talk to the dominant male in the family if you want medical advice to be followed. We’re not trying to change the culture, but to make patients more comfortable with how we’re trying to help them.”

Group presentations

The groups will present and share their findings — including a list of facts about the culture and answers to frequently asked questions — at an international cultural day at the end of the term.

“Many teams dress in costume, serve native foods, display cultural artifacts and hand out brochures about their cultures, so that students and guests can benefit from their research,” Grason said.

Nursing student Tarra Clark is studying migrant farmers, a mostly Hispanic population.

“We’re seeing how their eating practices are related to common health problems like high blood pressure or diabetes,” Clark said.

She has learned that glucose and blood-pressure screenings, earlier prenatal care and dietary education is helpful in treating many Hispanic patients.

“We all need to be aware that how we deliver health care to a patient makes a difference,” said Karen Feagin, a senior nursing student.

As a volunteer at a free health clinic, Feagin encounters people from all backgrounds. She’s learned that some cultures consider it rude to make eye contact with the patient. Some cultures require a same-sex practitioner and others have a mistrust of Western medicine.

“Sometimes when patients don’t understand what you are saying, they’ll just agree to be polite. When in doubt, it’s better to find a translator,” she said.

Feagin’s group is studying the culture of Koreans, a large and growing population in metro Atlanta.

“They have a higher risk for hypertension, but a diet that’s high in salt because of preserved foods, so that’s a challenge,” she said. “If they mistrust American health care, they will go to a local Korean practitioner or contact their family back home to get local herbs and medicines. If you know that, you can ask about herbs and help them choose ones that won’t interact negatively with the medicines you’ve given them.”

Valuable lessons

Feagin says the capstone course is enlightening and she looks forward to learning about other cultures from the other teams.

“I didn’t realize how much I didn’t know,” she said. “But you go into nursing to keep people healthy and help them achieve the best quality of life possible. This kind of knowledge will help us provide safer, more-intelligent care.”

Nursing is a second career for Feagin, who spent 10 years in accounting.

“Everyone ends up in the hospital at some point and it’s the nurses that dictate your experience. That’s who the patients remember” she said. “I wanted to be that person who is remembered because she made a difference in someone’s life. This is a great program and I’m thrilled to be in it.”

After three semesters of offering the capstone course, Grason will compile all the cultural information into a manual that the nursing department will give to its clinical partners and hospitals.

“We wanted to do something to give back and we hope that this will be a good resource for their educational departments,” she said.