Decent Work Employment and Transcultural Nursing.docx

**Decent Work Employment and Transcultural Nursing** **Course Objectives:** - This course will provide student's knowledge and skills in the use of information technology system and data standards based on nursing informatics principles/theories. It further deals with the utilization...

**Decent Work Employment and Transcultural Nursing** **Course Objectives:** - This course will provide student's knowledge and skills in the use of information technology system and data standards based on nursing informatics principles/theories. It further deals with the utilization of clinical information systems in the management and decision making of patient care At the end of the fourth year, given simulated situations and selected settings, the students will: - Apply knowledge of principles, theories and concepts in the use of transcultural nursing and standards in nursing practice. - Utilize the clinical information systems in the management and decision-making of patient care. - Perform basic skills relevant to transcultural nursing and the health care system. - Discuss theories, models and framework in transcultural nursing practice as applied in client care. - Communicate with confidence in writing speaking and presenting using culturally appropriate language. - Work efficiently self-awareness of one's motivations and potentials for future employment. - Commit to the value of life-long learning in one's personal and professional life. - Model for responsible citizenship **Review of Transcultural Theory** **MADELEINE LEININGER** **Transcultural Nursing Theory** Madeleine Leininger - Wikipedia - "Transcultural Nursing Theory" - Her concept/theory borrows its meaning from anthropology. - Anthropology is the study of what makes us human. - Anthropology is the scientific study of humanity, concerned with human behavior, human biology, cultures, societies, and linguistics, in both the present and past, including past human species. - Anthropologists take a broad approach to understanding the many different aspects of the human experience, which we call holism. They consider the past, through archaeology, to see how human groups lived hundreds of thousands of years ago and what was important to them.  **What is Culture?** - Culture is learned, shared and transmitted values, beliefs, norms and lifeways of a particular group that guides the thinking decisions and actions in patterned ways. - Culture can be seen in the actions, words, rules, standards, symbols, and behavior patterns of people and is learned and then handed down from generation to generation - Set of values, beliefs and traditions, that held by a specific group of people and handed down from generation to generation. - Also, beliefs, habits, likes, dislikes, customs, and rituals learn from one's family. - The learned, shared and transmitted values, beliefs, norms and life way practices of a particular group that guide thinking, decisions, and actions in patterned ways. - Culture is learned by each generation through both formal and informal life experiences. - Language is primary through means of transmitting culture. - The practices of particular culture often arise because of the group's social and physical environment. - Culture practice and beliefs are adapted over time but they mainly constant as long as they satisfy needs. **RELIGION** - Is a set of belief in a divine or super human power (or powers) to be obeyed and worshipped as the creator and rules of the universe. **ETHNIC** - Refers to a group of people who share a common and distinctive culture and who are members of specific groups. **ETHNICITY** - A consciousness of belonging to a group. **CULTURAL IDENTITY** - The sense of being part of an ethnic group or culture. **SOME SYMBOLIC EXAMPLES** - Islamic prayer from east Jerusalem represents a way of maintaining **Spiritual Health.** - Wearing of **Red String,** from the tomb of Rachel maybe worn to protect the **Physical Health.** - Herbal remedy from Africa represents aromatic plants that may be used to restore **Physical Health.** - **Tiger Balm,** from Singapore, represents substances that are used in massage therapy as a way of restoring **Mental Health.** - Rosary beads, from Italy, symbolize prayer and meditation methods used in the **Spiritual Restoration of Health.** **CULTURE-UNIVERSALS** - Commonalities of values, norms of behavior, and life patterns that are similar among different cultures. **CULTURE SPECIFICS** - Values, beliefs and patterns of behavior that tend to be unique to a designate culture. **MATERIAL CULTURE** - Refers to objects (dress, art, religious artifacts) **NON-MATERIAL CULTURE** - Refers to beliefs customs, languages, social institutions. **CULTURAL SHOCK** - The state of being disoriented or unable to respond to a different cultural environment because of its sudden strangeness, unfamiliarity, and incompatibility to the stranger's perceptions and expectations as its is differentiated from others by symbolic markers (culture, biology, territory, religion). **CULTURAL DIVERSITY** - Cultural diversity is the key component of Transcultural Theory in Nursing. - Diversity refers to variations of differences that can be found both between and among different cultures. - The differences, the nurse can avoid stereotyping (using general standards) and assume all people will react to the same nursing. **CULTURAL UNIVERSALITY** - The opposite of diversity which refers to commonalities or similarities that exist in different culture. - Examples: Gift-giving, marriage, bodily adornment, incest taboo, and rules of hygiene. **ACCULTURATION** - Is adapting or borrow traits from another culture. The member of non-dominant cultural group is often force to learn the new culture to survive. - Changes of one's cultural patterns of those of the host society. **Examples of Acculturation** - Learning a new language - Adopting new customs - Changing dress and appearance - Adjusting to new foods and cuisine - Modifying behavior to conform to new social norms - Making friends with people from the new culture - Participating in new cultural activities and hobbies - Acculturation is one example of how transcultural nursing concepts need to be better understood. - Immigrating to another country can have significant effects on people's health and health behavior. Acculturation or the extent to which people adopt the belief values and practices of the country to which they immigrate. **What are the 4 Types of acculturation?** There are 4 types major strategies of acculturation. Each of them is used in different situations and each has a different outcome. 1. Assimilation 2. Integration 3. Separation 4. Marginalization **Why Transcultural Nursing?** **Goal** The goal of transcultural nursing has been to prepare a new generation of nurse who would be knowledgeable, sensitive competent, and safe to care for people with different or similar lifeways, values, beliefs and practices in meaningful explicit and beneficial ways. **What is Transcultural and its Significance?** - The phenomenon of merging and converging cultures. - Transcultural is when a society changes because of the influence of new cultural traditions and beliefs. These beliefs can either supersede or modify the existing cultural practices of a group of people. - Transcultural nursing has been integrated into modern nursing education due to the increased heterogeneity of patient population. - As more people from a variety of cultures and with a variety of ethnicities now utilize healthcare facilities, nurses need to be aware of their varying perceptions and levels of tolerance for healthcare. - This situation can lead to departures from the practice norms that would otherwise direct patient care. **MAIN GOAL OF TRANSCULTURAL NURSING THEORY** - The goal of transcultural nursing is to develop a scientific and humanistic body of knowledge in order to provide: - Culture-specific nursing care practices - Culture-universal nursing care practices. **FOUR CULTURAL COMPETENCE MODELS OF TRANSCULTURAL NURSING** 1. Madeleine Leininger Transcultural Sunrise Model 2. Giger and Davidhizar Transcultural Assessment Model 3. Purnell Model for Cultural Competence 4. Campinha -- Bacote Model of Cultural Competence in Healthcare Delivery. **Culturally bases types of nursing actions** **(Madeleine Leininger)** These are consistent with the needs and values of the clients: 1. Cultural care preservation and maintenance 2. Cultural care accommodation or negotiation 3. Cultural care re-patterning/restructuring image  Cultural competency is a vital skill for delivering quality nursing care across culturally diverse groups. **HEALTH PRACTICES IN DIFFERENT CULTURES** - Use of protective objects - Use of substances - Religious practices - Traditional remedies - Healers - Immigration - Gender roles - Belief about mental health - Economic factors - Time orientation - Personal space - The transcultural Giger and Davidhizar evaluation model was develop in 1988 in response to the need for nursing students in an undergraduate program to assess and care for patients who were culturally diverse. Mia\'s presentation revised \| PPT - An orderly method of acquiring knowledge is the Giger and Davidhizar Transcultural Assessment Model, 1 containing the following six distinct domains: 1. Communication 2. Space 3. Biological variation 4. Time 5. Environmental control 6. Social organizations **COMMUNICATION** - Covers the whole world of human interaction and behavior. Communication is the medium through which culture is transmitted and preserved. Both verbal and non-verbal communication are learned in one's own culture. **SPACE** - Space refers to the distance between individuals when they interact. All communication occurs in the context of space. - Rules regarding personal distance vary from culture to culture, Territoriality refers to feeling or an attitude toward one's personal area. Each person has his own territorial behavior. - Feelings of territoriality of the personal and intimate space of the client can cause discomfort and can result in a treatment rejecting a client or returning to receive additional care. **CULTURAL CONCEPT** - Communication varies from culture. Different people speak different languages. - They may also have different interpretation to other elements of communications such as touch, personal space and eye contact. **PERSONAL SPACE** It is the distance people prefer in interaction with others.  - Proxemics -- study of distance between people in their interactions. - Proxemics is an important factor that plays an important role in our overall way of communicating. **4 Distances:** - Intimate -- touching to 1 ½ feet - Personal -- 1 ½ to 4 feet - Social -- 4 to 12 feet - Public -- 12 to 15 feet **PROXEMICS** The distances between two or more individuals. +-----------------+-----------------+-----------------+-----------------+ | Intimate | Personal | Social | Public | +=================+=================+=================+=================+ | \- 2 fists away | \- 1 handshake | \- About 2 arm | -Over 3.6m away | | from your body. | away | lengths away | | | | | | \- The distance | | \- People | \- The distance | \- The distance | you feel | | emotionally | you would stand | you'd stand | comfortable | | close to you | during | with people you | when addressing | | are allowed to | gathering. | don't know | a big group. | | enter this | | well. | | | zone. | | | | +-----------------+-----------------+-----------------+-----------------+ **EXAMPLE OF PROXEMICS** - North American for Example, maintain a protective "body bubble" of space about 2 feet in diameter around them when they interact with strangers or casual acquaintances. - Arabs prefer to stand close enough to touch and smell the other person. - So, you should avoid shaking hands with an Arab with your left hand. - Americans, however, if forced to stand close together, as on a crowded subway, will use their eyes (i.e., distant gaze) to maintain a more proper distance. An arm's length is a good measure of the appropriate personal distance for most people. - Americans prefer an 18-inch distance between themselves and someone else during a casual conversation. - A wife can stand inside her husband's bubble, bet she will be unhappy if another woman invades this sphere of privacy, and vice versa. **TERRITORIALITY** A concept of the space and things that an individual considers as belonging to self. - Ex.: Inside the confines of the house: Curtains in the hospital **ROLES AND RELATIONSHIP** - Roles such as nursing students and instructor, client and health care provider, parent and child also affect the content and responses in the communication process. - The nurse who meets with a client for the first time, communicates differently with a nurse who have previously developed a relationship with the client. **SOCIAL ORGANIZATION** - Social organization refers to the way in which a cultural group is organized throughout the family group. The allocations of family structure and organization, values and religious beliefs, and the role of everyone can be related to ethnicity and culture. **TIME** - Weather is an important aspect of interpersonal communication. Cultural groups can be passed, present or future oriented. Preventive health from future time, since preventive action are motivated by a future reward. **CONTROL OF THE ENVIRONMENT** - Environmental control refers to the person\'s ability to control nature and to plan and direct factors in the environment that affect them. Many Americans believe that the control of nature to meet their needs and therefore are more likely to seek medical attention when necessary. **BIOLOGICAL VARIATIONS** - Biological differences, especially genetic variations, growth and developmental patters, body system, racial anatomical characteristics, skin and hair physiology, disease prevalence, and resistance to disease. - It is a well-known fact that people differ culturally. Less known and understood are the biological differences that exist among people in various racial groups, knowledge about general baseline data relative to the specific cultural group is an excellent starting point to provide culturally appropriate care. **TRANSCULTURAL VS. MULTICULTURAL** As adjectives the difference between multicultural and transcultural is that multicultural is relating or pertaining to several different cultures while transcultural is (sociology and anthropology) extending through more than one human culture. **PURNELL MODEL FOR CULTURAL COMPETENCE** - Larry Purnell developed this competence-based intellectual system in his lecture on the subject of cultural differences. The Purnell Model is made of spheres that contain twelve components that address people's diverse cultures - The inmost sphere captures the patient, followed by another section that embodies the family. The succeeding circle addresses community-based healthcare aspects. The extreme section represents the global society. According to Debiasi and Selleck (2017), this model represents different aspects related to communication, relationship development, and religion, among other areas such as ecology. Figure 1 below shows the Purnell Model's twelve arrow-shaped cultural components. Purnell Model for Cultural Competence in Healthcare - Nursing Paper Examples **5 STAGES OF CULTURAL COMPETENCE** - Cultural Competemility is defined as the synergistic process between cultural humility and cultural competence in which cultural humility permeates each of the five components of cultural competence; cultural awareness, cultural knowledge, cultural skill, cultural desire, and cultural encounters. Dec. 04, 2028 **BARRIERS TO CULTURAL COMPETENCE** - Five causes of cultural barriers - Language - Stereotypes and prejudices - Signs and symbols - Behaviors and beliefs - "Us" versus "them" (ethnocentrism) - Embrace diversity and accommodate cultural differences. - Promote open communication - Lead open discussions about learn norms and sha The Process of Cultural Competence in the Delivery of Healthcare Services (Campinha-Bacote, 1998) is a model that views cultural competence as the ongoing process in which the health care provider continuously strives to achieve the ability to effectively work within the cultural context of the client. **Josephina Campinha-Bacote Cultural Competency Model** - Cultural Desire - Cultural Awareness - Cultural Knowledge - Cultural Skill - Cultural Encounters **GENERATIONAL THEORY** - A sociological theory rather than psychological theory - More applicable and simple to understand - It is based on a 20 year-span of time - Which consist of 5-Generational Cohorts shaped by events of their times. **GENERATIONAL COHORTS THEORY** - Important historical events and social changes in the society affect the values, attitudes and beliefs and inclinations of individuals. ***"Who You Are is Where You Were When"*** **TRADITIONALIST OR VETERANS** Values and Characteristics - Loyalty - Respect for position - Private - Conform to rules - Self sufficient - Reticent to express emotions - Hard work - Frugal - Low abiding - Sacrifice **BABY BOOMERS** - Idealism - Teams orientation - Personal gratification - Big talkers - Socially revolutionized - Image - Personal growth - Media savvy - Health awareness - Skepticism in regard to rules **GENERATION X** - Entrepreneurial spirit - Pragmatism - Self-reliance - Change - Diversity - Risk takers - Choice - Informality - Techno literacy - Individualism **MILLENNIALS** - Positive reinforcement - Media overload - Global citizens - Confidence - Networkers - Techno savvy - Ethical consumption - Street smart **GENERATION Z** - Collaborative and creative - Little concern for privacy - Techno savvy multitaskers - Need for quick information - Thrive on instant gratification - Embrace social and ethnic diversity - Less likely to believe in American Dream - Value contentment/passion over salary - Innovative and entrepreneurial **DECENT WORKPLACE** **Introduction** **WORK** It is an activity involving mental or physical effort done in order to achieve a purpose or result. Work, from a sociological perspective, is anything that a person undertakes with a goal of being productive in a way that meets human needs. Work is the foundation of a better society. - It gives people the opportunity to provide for themselves and their families. - It provides structure and provides a sense of purpose. - Work also allows people to connect with others and learn new things. - Employment definition is termed as a paid mutual work arrangement between a recruiter and an employee. - This term applies to an individual who is hired for a salary or compensation to initiate work or tasks for an organization. Decent work is employment that "respects the fundamental rights of the human person as well as the rights of workers in terms of: - Conditions of work safety and remuneration. - Respect for the physical and mental integrity of the worker in the exercise of their employment.\" - It involves opportunities for work that is productive and delivers fair income, security in the workplace and social protection for all better prospects for personal development and social integration, freedom people to express their concerns, organize and participate in the decisions that affect their lives and equality of opportunity and treatment for all women and men. **DECENT WORK EMPLOYMENT** It is an employment that respects the fundamental rights of human persons as well as the rights of workers in terms of condition of work safety and remuneration, respect for the physical and mental integrity of the worker in the exercise of his or her employment. - Do employers give respect to the basic rights of the workers? - Would the work place offer free PPEs to promote work safety? - Remuneration -- salary and wages are extrinsic motivation to workers. - Physical and mental considers holistic being of the worker. According to the International Labour Organization (ILO), decent work involves opportunities for work that are: - Productive and deliver a fair income - Security in the workplace and social protection for families - Better prospects for personal development and social integration - Freedom for people to express their concerns - Organize and participate in the decisions - Equality of opportunity and treatment for all women and men **WHAT IS ILO?** - The International Labor Organization (ILO) is devoted to promoting social justice and internationally recognized human and labor rights, pursuing its founding mission that labor peace is essential to prosperity. **HISTORICAL BACKGROUND** - The ILO was created in 1919, as part of the Treaty of Versailles that ended World War I, to reflect the belief that universal and lasting peace can be accomplished only if it's based on social justice. - In 1946, the ILO became a specialized agency of the United Nations. - Its unique tripartite structure give an equal voice to workers, employers and governments providing a unique platform for promoting decent work for all women and men. **The ILO has four strategic objectives** - Promote and realize standards and fundamental principles and rights at work. - Create greater opportunities for women and men to decent employment and income. - Enhance the coverage and effectiveness of social protection for all, and - Strengthen tripartism and social dialogue **WHAT IS TRIPARTISM?** Tripartism, as a social dialogue mechanism, which involves 3 sectors: - The government, - The labor groups, and the - The employer sectors Who can come together to discuss and resolve labor and employment issues and concerns. **THE ILO'S DECENT WORK AGENDA** - Productive employment and decent work are key elements to achieving a fair globalization and poverty reduction. - The ILO has developed an agenda for the community of work looking at job creation, rights at work, social protection and social dialogue, with gender equality as a crosscutting objective. **FOUR OBJECTIVES OF THE ILO'S DECENT WORK** **1. To create Jobs** - Greater Jobs opportunities - For better sustainable development - To boost the economy **2. To provide guarantee in worker's rights and rights at work** - Employees should be well recognized - There should be no discrimination **3. To extend social protection to workers of all categories** - Safety condition of all aspects - Right to rest day offs **4. To help workers in resolutions in conflicts and promotion of social dialogue** - Conflicts will always arise in work environments but should be well managed. **LABOR LAW** - The Labor Code of the Philippines is the legal code governing employment practices and labor relations in the Philippines. - It was enacted through Presidential Decree No. 442 on Labor Day, May 1, 1974, by President Ferdinand Marcos in the exercise of his then extant legislative powers. **BASIC RIGHTS OF EMPLOYEES** **Equal Work Opportunities for All** - The state shall protect labor, promote full employment, provide equal work, opportunity regardless of gender, race or creed. - Regulate employee-employer relations **Security of Tenure** - Every employee shall be secured of security of tenure - No employee can be dismissed from work except for a just authorized cause and only after due process. **Labor Code of the Philippines** **BOOK THREE** **CONDITIONS OF EMPLOYMENT** **Title 1** **WORK CONDITIONS AND REST PERIODS** **Chapter 1** **HOURS OF WORK** Art.83. Normal hours of work. The normal hours of work of any employee shall not exceed eight (8) hours a day. Health personnel in cities and municipalities with a population of at least one million (1,000,000) or in hospitals and clinics with a bed capacity of at least one hundred (100) shall hold regular office hours for eight (8) hours a day, for five (5) days a week, exclusive of time for meals, except where the exigencies of the service require that such personnel work for six (6) days or forty-eight (48) hours, in which case, they shall be entitled to an additional compensation of at least thirty percent (30%) of their regular wage on the sixth day. For purposes of this article, "health personnel" shall include resident physicians, nurses, nutritionists, dietitians. **TYPES OF WORK IN THE PHILIPPINES** **1. Regular or Permanent Employment** - Will not be fired immediately, unless you violate rules - They enjoy the benefit of security of tenures - You will have the job, unless you resign - After retirement, there will compensation or retirement pay. **Under the Labor Code (Art. 281)** - The maximum probationary employment shall be six months and is counted from the date of employee started working - After 6 months the person should already be candidate for regularization - For professors, the manual for regulations for private schools, a teaching personnel in private educational 1. Must be a full-time teacher. 2. Must have rendered 3 consecutive years of service. 3. Such service must be satisfactory before he or she can acquire permanent status **2. Term or fixed employment** - It is when the employee renders service for a defined period of time and the employment contract must be terminated after such period expires - Minimum time of service is 6 months - It is up to the employers if they would the employee or not. **3. Project Employment** - An employee is hired for a specific project or undertaking and the employment duration is specified by the scope of work and length of project. (Architects, engineers, nurses or researchers) **4. Seasonal Employment** - The seasonal -- the work to be performed is only for a certain time or a season of the year and the employment is only for duration. - There is a peak season where employees are hired. Board examiners; hospitality industry. (temporary staff during summers) **Additional Remunerations:** **NIGHT DIFFERENTIALS** - Every employee shall be paid a night shift differential not less than 10% of their regular wage for each hour of work between 5:00 o clock in the morning and 6:00 in the morning. **OVERTIME WORK** - An additional compensation equivalent to their regular wage plus at least 25% thereof. **UNDERTIME** - Undertime work not off set by overtime on any other day. - Over time does not fix undertime **EMERGENCY OVERTIME WORK** - When the country is at war - When it is necessary to prevent loss of life or property (imminent danger to public safety) - When there is urgent work to be performed - When there is work necessary to prevent damage or loss to perishable goods (food delivery service) **WORKING CONDITIONS** - Nurses should only work 8 hrs a day /40 hour a week (5 days) - Some hospitals have fix hours (4 days of duty only) of duty especially in special areas - **Article 83** **-- normal hours of work** - The normal hours of work of any employee shall not exceed 8 hours a day - **Article 85 -- meal periods** - It shall be the duty of every employer to give his employee not less than 60 minutes off for their regular meals. **REST PERIODS** **Right to Weekly Rest Day** - It shall be the duty of the employer whether for profit or not, to provide each of his employees at rest period of not less than 24 consecutive hours after every 6 consecutive work days - The employer shall determine and schedule the weekly rest day of his employee subject to collective bargaining agreement. - The employer shall respect the preference of employees as to their weekly rest day when such is based on religious grounds **Art. 92. When employee may be required to work on rest day** - In case of actual or impending emergencies caused by serious accidents, fire, floods, typhoon, earthquakes epidemics or disaster or calamities to prevent loss of property. - To prevent loss or damage to perishable goods - Where the nature of work requires continuous operations even when the employee is on leave or on rest day. **Compensation for Rest Day, Sunday or Holiday Work** - Employee shall be paid on additional compensation at least 30% of his regular wage. An employee shall be entitled in such additional compensation for work on a Sunday when it is his Rest day.