OHSU StudentSpeak is pleased to share this guest post from Pooja Saini, a student in the Accelerated Bachelor’s to Master’s program in the School of Nursing.
Of all the things I imagined nursing school would teach me, diversity was not on that list. After all, I am a young woman of East Indian heritage, born and raised in a place where I often looked different from many of the people surrounding me. My upbringing involved an amalgamation of both my cultures, American and East Indian, resulting in a unique mosaic of beliefs, values, and traditions that continues to define my identity. Shouldn’t I, of all people, understand what diversity is and all that it encompasses? My presumption, as it turns out, was flawed. Enter nursing school, day one-hundred-something, when I come to the realization that there is much more to understanding diversity than meets the eye.
I have no doubt that cultural constructs – race, ethnicity, religion, class, gender identity, sexuality, disability, and beyond – can be highly influential determinants of both the health of individuals as well as their respective health care needs. In the least, my own personal experiences can attest to this. I can easily recall several doctors’ visits during which wearing a paper gown compromised the modesty I grew up with in ways that caused me profuse embarrassment and discomfort. Perhaps there was even a time in my life when I experienced a great deal of anxiety and sadness, but didn’t feel that it was acceptable to give this a name or a voice. The myriad of ways that culture shapes my life, and as a result my health, are undeniable. I am strongly inclined to believe that health care provided within a sound cultural context would only lead to improved health outcomes for people from all backgrounds.
Martin Luther King Jr. once said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” A few weeks ago, I had the profound opportunity to attend the Western Regional International Health Conference at the University of Washington. The theme of the event was Gender, Sexuality and Social Movements in Global Health. Story upon story spoke of the astonishing inequities in health care that are faced by members of diverse and often marginalized communities. The facts and figures were not as heartfelt, but nonetheless evocative. Many speakers in the conference echoed the message conveyed by the numbers. The health care system was not meeting their unique health needs. One message was evident: Despite their best intentions, the practices of many health care professionals were not often inclusive of diversity.
As a nursing student, a cornerstone of my training has been to recognize the juxtaposition of my personal identity with the unique backgrounds of my patients. Every day, I continue to learn how to check my assumptions and biases at the door (as much as is humanly possible). One way I work on this is by allowing myself to adapt my own schema of culture, the one that is shaped by my ethnic, national, and familial roots. Diversity is not synonymous with ethnicity. Culture can manifest itself in many forms. My encounters with various individuals at the conference, who not only identified as ethnic minorities, but also as refugees, PTSD-survivors, and part of the LGBTQ community, have compelled me to re-conceptualize my simplistic ideas of culture and diversity, and instead, to recognize the intersections of their many layers.
Culture not only affects an individual’s perspectives on illness and wellness, but may also impact how a person perceives and interacts with the health care professionals participating in his or her care. Conversely, how we as students learn about diversity at OHSU can make a profound difference in how we view and treat our patients. By aspiring to be culturally sensitive rather than competent, and learning how to communicate effectively with people from all cultures, we can ensure that we interact with patients who are different from us in respectful and positive ways. By remaining unassuming, person-centered, and open-minded, we can eliminate the harmful stereotypes and generalizations that come out of traditional educational models used to teach students about cultural “norms”. Unlike the established procedures for dealing with medical emergencies in the hospital, there is no set protocol that can guide our practices when we are confronted by situations requiring cultural understanding. Sure, learning cross-cultural communication strategies might be beneficial. However, recognizing the commonalities that we as people share, despite our diverse backgrounds, is key.
As future health care professionals I believe that it is our responsibility to strive towards equitable care and advocacy for our patients. One of the first steps might be to increase our awareness about issues surrounding diversity and inclusion, and to understand the views, attitudes, and biases that we bring to the table as individuals. It is easy to get caught up in perfecting our assessments, interpreting lab values correctly, and making adept diagnoses. We cannot forget, however, that treating our patients as people means acknowledging the role that their cultures play in their lives, health, and healing.
Just as a tapestry is intricately woven from many different threads, the stories of our patients are complex, and woven into the rich fabric of their cultural identities. I hope that this message inspires others to see culture through the lens of the individual, and recognize the worth of embracing cultural inclusion in their own practices. As a future nurse practitioner I am sure that one day I will know a great deal about the patients that I care for. However, it is my hope to always remember how I can honor their individuality, by staying humble in my knowledge as well as remaining a lifelong scholar of diversity.
The Center for Diversity & Inclusion’s Diversity Climate Survey is an important way that the OHSU student community can share its perspectives, experiences, and understanding of diversity on our campus. If all of us identify the need for increased diversity education and training, perhaps this issue can be recognized and improved. I encourage all of my fellow peers to take a moment of your busy day to reflect on something that could truly contribute to a brighter future in health care.
About the Author
Pooja Saini is a student in the Accelerated Bachelor’s to Master’s program in the School of Nursing. With a background in psychology, and a future in advanced practice mental health nursing, she is passionate about understanding people and improving social justice. In her free time, Pooja enjoys cooking, decorating and dancing, as well as exploring all that her new home in Portland has to offer.