Nurses and other health care workers need to recognize the importance of:

Health as holistic

Healing only occurs when there is wholeness in body, mind, spirit, and actions

Tone of voice

It is common to speak in a low tone of voice. It is expected that the listener will pay attention and listen carefully, so nurses should try to speak with clients in a quiet setting



Time

Traditionally life was run by need and not by the clock. This cultural conflict may exhibit itself by being late for an appointment

Non-verbal communication

Considered important and often a Native person may say very little. In fact, he/she might expect the health professional to deduce the problem without a lot of extensive questions. It is often better to use a declarative statement � �You have a cough that keeps you awake at night� �and allow time for the client to respond



Eye contact

It is important as it is considered rude to not pay full attention to the speaker

Note-taking

May be a sensitive area as traditionally history is passed down by verbal story-telling. Direct quoting is considered intrusive on an individual�s privacy. A conversational approach, with minimal notes, when taking a client history may encourage greater openness



Extended family

A source of support and security
o Family members should be included, and the opinions and ideas of family members should be solicited when discussing nursing care
o Presence of family is especially important if the client is elderly because children are seen as extensions of the elderly

The number four

Very important as it represents the four directions: north, south, east, and west; as well as the four areas in a holistic health approach: physical spiritual, emotional, and mental



Traditional healing:

Whenever possible, it is good to incorporate old ways of treating illness into the tx plan, such as: herbs, healing ceremonies, Shaman, Therapuetic Touch
o Ask and learn what herbs and plants are used for and encourage there incorporation into the medical regime when they are efficacious. Any harmful practices should be carefully explained in a respectful manner
o In a hospital setting, if a healer has been called, privacy should be provided and, if possible, a large area made available so that the family can be present




Information gathered from: Giger, D. (1998). Canadian Transcultural Nursing Assessment and Intervention. St. Louis, Missouri: Mosby.
Spector, R.E. (2000). Cultural Diversity in Health and Illness. (5th ed.). Toronto: Prentice Hall.