DEVELOPING CULTURALLY COMPETENT CARE

 

 

 

IN THIS DAY, THIS AGE where hospitals now term their patients "customers" and cater to the service aspect of business more than practical nursing, the accountability is nonexistent while the authority runs rampant. The resources from authorities to individuals are dwindling, and has created a widening gap: the most readily available, technologically advanced self-care / preventative, prophylactic options ever for those with means, yet simultaneously we have the most expensive, least accountable hospital staff no longer trained in basic first aid. 

DEVELOPING CULTURALLY COMPETENT CARE IN YOUR FACILITY

Identify a need (e.g., better response/understanding of the special needs of vulnerable populations, especially undiagnosed, subtle conditions, including long covid symptoms);

Support creative solutions in your staffing -- training for inclusion, empowering research based, fact-driven options; e.g., equine training to identify predator/prey patterns;

Give each worker the TOOLS AND AGENCY to act -- circle back for accountability and effectiveness.

BATTLEFRONT TACTICS -- in our intelligence unit during the Gulf conflict, we needed to get info, try to cross-correlate with other facts for determining accuracy, and get urgent action-oriented updates to those in command, sometimes to end lives of hostiles and/or sometimes to save lives of allies in danger. The military loves to give even the lowest-ranking members the authority and agency to make split-second decisions that are hopefully rooted in all the training and briefings that came before. And yes, accountability -- whether or not the consequences seemed appropriate for the damage done was always a different story -- but they always found some party or other to be responsible, otherwise there was no way to keep more "accidents" from happening. NO AUTHORITY WITHOUT ACCOUNTABILITY!

 

HIRE FOR ATTITUDE, TRAIN FOR SKILL

My opinion is that we "interview" for our jobs, our businesses, our relationships -- every day. To me there is no time for laying down one's code, no laxity in the way business is conducted anywhere, anytime. It takes much more time and energy! "Win-win or no deal" wasn't just something out of a book once by Robert Kiyosake, it became the way I conducted my LIFE. From Jack Zufelt's 100% rule to Cynthia Kersey's Feel the Fear and Do It Anyway, getting the Big Enchilada from PBS full of philosophy by Wayne Dyer, listening to every horrible recording of Leo Buscaglia that I could get my hands on, is to name a few gems of real advice I found useful in a sea of vague palliative babble. But wading through helped me develop the due diligence at the tail of fact-finding, where most crash out or lose interest, or figure there is nothing more to see... the tail is where the fake shows out! Where the dust from under all the rugs eventually ends up. Following a line of thought or questions to a logical conclusion is a skill even more rare than counting change back -- the proper way, not demonstrating coin identification.

Developing agency of staff means modeling, especially in how to build knowledge around subjects. Here also is where following a line to its conclusion can be demonstrated. Agency is born out of the flow of information with a portable, reproducible system that builds confidence. We must recognize when a conclusion does or does not fit our goal, and act accordingly. Is this supplement good, neutral, or possibly even HARMFUL for someone with RA? Even the extant papers on various questions such as this one admit to MORE RESEARCH NEEDED but there is still helpful material (just have to slog through the unhelpful sometimes).

SAMPLE COMPETENCIES

DEVELOP the ABILITIES of vulnerable folk, support adaptations in physical ways

BEGIN WHERE THEY ARE but first at least find out! Ask questions!

STOP using average handouts, update your info! Personalize solutions, stop generalizing them, and for goodness' sake, stop treating things in isolation, instead of recognizing their interconnectedness. Here is a great place to lean on those conclusions you followed, seeing how that problematic thumb led to that opposite shoulder joint compensation, just like that old song...

Support creative solutions and CIRCLE BACK to close the loop, answer the questions of whether the actions taken were EFFECTIVE and WHY / WHY NOT? This builds on agency and models course correction and data set usage, importance of logging results. Allow agency to act -- intelligently.

VOCABULARY -- are the words you use inclusive? validating? sensitive to other ways of being?

Phrase your questions/comments to be INDUCTIVE not reductive -- KINETIC not static

TOYOTA PRINCIPLES; Kaizen; Sharpen your saw and others of Stephen Covey's Habits

Some websites "for disabled people" whose aim is to "build inclusion" still have ableist subtext; but accountability means NOT "giving room" for yourself to fail; the suffering of another should never be an acceptable cost! Ever! There is something in the phrase "give yourself grace" that smacks of privilege to me. During times of combat or extreme need, your "grace" is license to let feelings preclude action that could cost someone life or limb. If we are following the Four Agreements and always doing our personal best, patients will know. We can tell. Same goes when a caregiver gives themselves a break before doing everything they could during a time of need, including reaching out to other caregivers on the floor. We can tell when people are 'phoning it in,' doing the bare minimum if that.

Any move toward accountability will never feel like a mistake. Open space to make educated hypotheses and circling back for confirmation of success OR confirmation of need to redirect efforts is THE SCIENTIFIC PROCESS and last I checked, Health Sciences are still SCIENCE.

There is a push for leaders to be in charge of both employees and their learning, but this is a conflict of interest. Independent COACHES are needed to prevent further entrenchment of current leadership ideals. MEETINGS are overrated. MODELING is underutilized. Minds who contribute to or continue the status quo are poor sources of solutions. Coaches outside the structure provide more opportunities for equal teaching and learning moments regardless of status.

 

Lastly

As a counterpoint to the ableist perpectives surrounding us, years of overcoming obstacles and daily exercises in adaptive thinking have freed variously abled folks from tying our identities to our inabilities; we sometimes even 'Raku' into having our own special superpowers -- until it is the able-bodied who have become the developmentally delayed/challenged, unable to function in a changing world/reality even for a few minutes, underscored by the number of times we hear "Wow, I don't know how you do it."

The mental and emotional athleticism develops its own type of intelligence. This type of problem-solving and myriad approach to situations has only been mined by a handful of organizations. When groups balk at the "work" calling inclusiveness 'training' or bring up 'time and investment to payoff,' this only obfuscates the synergy created when many small changes begin to take care of the whole -- soon no effort will be required, yet nothing will go undone.