a. Discuss how “showing a people as one thing” could interfere with culturally competent nursing practice.
¨Showing a people as one thing¨, as the writer Chimamanda Ngozi Adichie said, creates stereotypes. In order to provide culturally competent care we must avoid stereotypes, not assume that because a person belongs to a specific race or religion, for instance, they follow the same patterns or think the same way as the rest of the people who belong to that specific group. It is important to ask the patient his/her preferences, not to decide for him/her. (Stubbe, 2020).
b. Relate the impact of “nkali” on how we approach groups when providing nursing practice.
Nkali, the Igbo word that means “to be greater than another” refers to power. The novelist referred to how the focus or meaning of a story can change in reference to who is telling it. Applying the concept of power to nursing care, I can see differences in the way that different groups of people react to power. Hispanics, for instance, tend to play a passive role. Hispanics, in a general sense, accept the decisions of doctors and nurses without hesitation. However, Americans tend to be actively involved in their care.
c. Discuss the danger of assumptions made on the basis of a single experience or story
Making assumptions or generalizations on the basis of a single story can have negative consequences. Something that has happened to me personally is to assume that patients with a first or last name of Hispanic descent speak Spanish. This can cause problems in communication with patients and prevent their participation in the plan of care.
d. How can stories be used for positive purposes according to Ms. Adichie?
According to Ms Adichie, stories can also be used for positive purposes, such as when they are used to empower, humanize and restore dignity to people.
Stubbe, D. E. (2020). Practicing Cultural Competence and Cultural Humility in the Care of Diverse Patients. Focus (American Psychiatric Publishing), 18(1), 49–51. https://doi.org/10.1176/appi.focus.20190041
Showing people as one thing” could interfere with culturally competent nursing. It can sometimes create false perceptions and misunderstandings about individuals, groups, or countries. If nurses learn a single-story approach for a certain group of patients or based it on their own or someone else’s and this approach fails, then nurses will not be able to provide quality care for their patients and even could harm those who seek their care. Cultural competency is needed to adequately care for a growing and diverse patient population (Nair and Adetayo, 2019). Moreover, it is vital that nurses have a clear understanding of their own stories such as biases, values, and perspectives to be fully conscious of what they bring to the patient encounter. The self- assessment of one’s own cultural assumptions, values, and beliefs as well as conscious and unconscious biases improve cultural competence in nursing (Marion et al., 2017).
Listening, respecting, and understanding a particular story of a particular patient should be a skill that nurses need to work on through their practice (Harding et al., 2020). As Adichie (2009) says, “Viewing only one story emphasizes how different we seem, not how close we actually are. This creates stereotypes not that they are untrue but that they are incomplete”. If nurses better understand people of other cultures, they are better prepared to help them when they need care.
Adichie sees a connection between the single story and power. She introduces the Igbo word “nkali” to explain the hierarchical relationship between who has the power to tell the single story and who is being told about it. If a single story is constructed and told by those in power, it is going to have a big impact in the general population. “Nkali” could impact how nurses approach groups when providing care. It is possible that even some of the care discrepancies arise from single-story thinking. It creates false narratives about a patient’s character and identity and therefore delivers unfair and inappropriate nursing care.
As Adichie (2009) points out, “The single story creates stereotypes, and the problem with stereotypes is not that they are untrue, but they are incomplete. They make one story become the only story.” With that said, assumptions made based on a single experience or story in the medical field can cause health disparities. In nursing assumptions such as all members of a given culture behave the same way, they feel the same about healthcare, and they have the same values for certain treatment options need to be avoided.
Adichie (2009) ends her presentation with this thought, “When we reject the single story, when we realize that there is never a single story about any place, we regain a kind of paradise.” Each story should be treated as a personal story for a patient and used for a positive purpose, not for making a general assumption. Nurses must be offered many opportunities to engage patients in all dimensions of their multiple stories. Nurses must be repeatedly exposed to the stories of others and be mindful that a single story about another person or country is the single story of our patients.
Adichie C.N. (2009, July) The danger of a single story [Video]. TED Conferences. http://www.ted.com/talks/lang/eng/chimamanda_adich… single_story
Harding, M., Kwong, J., Roberts, D., Hagler, D. & Reinisch, C. (2020). Lewis’s medical surgical nursing: Assessment and management of clinical problems (11th ed.). Elsevier.
Nair, L & Adetayo, O. (2019). Cultural Competence and Ethnic Diversity in Healthcare, Plastic and Reconstructive Surgery. Global Open, 7(5), 19-22. https://doi.org10.1097/GOX.0000000000002219
Marion, L., Douglas, M., Lavin, M. A., Barr, N., Gazaway, S., Thomas, E., & Bickford, C. (2017). Implementing the New ANA Standard 8: Culturally Congruent Practice. Online Journal of Issues in Nursing, 22(1), 1. https://doi.org/10.3912/OJIN.Vol22No01PPT20