Culture Issues in School Nursing

Schools are very culturally diverse places, and the school nurse must be prepared to address many cultural issues.

The function of a nurse is to care for the patient as a whole person. This is known as holistic care. In holistic care, nurses ensure that patients receive care that is compatible with their social, spiritual, and moral standards. For this reason, cultural competence is a vital focus in nursing. In the school environment, the nurse's ability to adapt to the various different cultures, beliefs and practices of the children in the school population is the key to providing effective and respectful student care.

Recognize Difference in Diets

Many cultures have their own guidelines for acceptable food choices that may not always align with school dietary regulations. For example, Jewish students who observe a kosher diet may have an aversion to cheeseburgers; the kosher diet does not allow for the combination of meat and dairy. Some students may practice a religion that encourages occasional fasting. Other students may live in a home with limited financial resources and so have limited access to nutritional food choices. In any case, the school nurse should monitor the overall health and mental function of the child for any signs of malnutrition without making judgments about the child's religion or socioeconomic status.

Be Aware of Differences in Acceptable Nursing Interventions

For example, students who are vegans or Muslims may not be willing to take medications or consume products that are gelatin-based. This includes most liquid gel capsules, jello and some cough drops. Students who are Jehovah Witnesses may refuse blood products, so in the event of bleeding from a serious injury or blood disorder, they may refuse to accept a blood transfusion.

Be Aware of Cultural Norms in the Manner of Expressing Pain or Discomfort

Studies conducted by several organizations, including the International Association for the Study of Pain (IASP), have shown that Latina females are more vocal about pain, while Japanese males are less vocal. Both of these students could be in the same amount of pain, but the Japanese student would be less likely to verbalize his discomfort. In this case, the school nurse should be careful not to assume that the Latina female is over-exaggerating her amount pain or that the Japanese student is not in pain at all.

Acknowledge Cultural Expectations for Social Interactions

A female student of any culture may not be as willing to talk to a male school nurse about menstrual concerns or issues, and a Mormon or Muslim female student will be even more reluctant to discuss this issue with a male school nurse.

References

• University of Minnesota: How Does Culture Affect Health Care?
• Current Nursing; Transcultural Nursing; March 2011
• CultureDiversity.org: Transcultural Nursing -- Cultural Competence
• IASP; Culture and Pain; December 2002