Dec 21 2008
Cultural competency in real life
Three months of culture shock at the community clinic gave my ego a mean bruising, but it’s recovered and I’m suddenly enjoying my job there one day a week. I’ve learned to focus my energy on the patients and on my own growth.
For example, I’m having conversations with patients that I had no skills for three months ago. Last week, a patient came in concerned about his blood pressure. I asked him if he smoked and he said yes. I asked him whether he knew that smoking increases his risk for hypertension, coronary artery disease, and stroke. He said no. I scolded him, explained in simple terms how smoking constricts blood vessels, and scolded him again. (All this I learned by listening to a health podcast in Cantonese, over and over again.) A more seasoned Chinese nurse might have pulled out other culturally competent communication tools (listed below), but this time, I was simply happy that I could bring myself to scold him and speak well enough to be understood.
In another cultural setting, I might have taken a different, softer approach, but since working at this clinic, I’ve observed the following about communications between Chinese providers and Chinese patients:
- our patients are deferential to doctors and nurses, and expect us to speak to them authoritatively
- old Chinese people can be sassy — and to be heard you have to be sassy back to them
- it’s not rude or offensive to raise your voice
- sarcasm can be quite effective
These are not communication skills that will get taught at any politically correct school; they come out of real life. Needless to say, we all know that these things are not generalizable to any providers or patients outside of my clinic!!
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