Transcultural Concepts in Nursing Care

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Chapter 11 Culture, Family, and Community

work with refugee agencies to provide classes for emergency evacuation for recently arrived refu gees as well as protecting the well-being of other underserved populations, striving for health equity, and advocating for those who are at risk when responding to a crises, natural disasters, or other health emergencies. Mitigation Community nurses can help to assure that plans for all major categories of emergencies respect the culture of the community and/or populations involved. They can identify and plan for ethical and cultural issues that may arise during a disas ter. During the COVID pandemic, some fami lies were unable to be at the bedside of a dying family member who was confined to an assisted care facility. Photos of grieving family members holding cell phones for a videoconference with a dying family member were widely circulated dur ing this time. Caring appropriately for a patient who is dying in a care facility and their family during a pandemic or any other crisis that calls for an evacuation is a discussion that should be ongoing. In addition, community nurses can help to educate those persons who might be “vaccine hesitant,” thus decreasing the risk for infections as well as counseling and supporting clients to alleviate fear and anxiety during a pandemic (Veenema et al., 2020). Response Nurses demonstrate leadership by working with leaders, both formal and informal, in diverse communities. Leadership means reaching out and building relationships with individuals of diverse cultures. Different cultural groups may have different ways of negotiation and resolv ing conflict. It is imperative that nurses discuss, understand, and build these relationships before a disaster or mass casualty event occurs. Nurses can identify cultural issues that may affect an individual’s or community response to disasters or other emergencies. They are at the forefront in providing clinical care and medications; they

can assess and triage victims; allocate scarce resources; and monitor ongoing physical and mental health needs. In a community setting, nurses can work with community leaders to open and manage shelters, organize blood drives, and provide outreach to underserved populations (Heagele, 2017). They may also assist with the care of older adults with health needs (Heagele & Pacqiao, 2018; Kleier et al., 2018), assist with childbirth to ensure that pregnant people have healthy babies during a disaster (Badakhsh et al., 2010), and work to reunite families who have been separated during the disaster or other crises. As an example, leaders of the Navajo Nation say their strategies have become a model for fighting the COVID-19 pandemic. At the beginning of the pandemic, the Navajo Nation made national news, first because of how hard it was hit, then because of how seriously leaders took the threat of COVID-19. The infection rate among Diné (Navajo people) was aggravated by several issues, including chronic illnesses, food and water insecurity, and a lack of electricity among a third of households. Many Diné live in homes with extended families where COVID-19 can spread quickly. Diné families had to endure more curfews than any other group of people in the United States. The Navajo Nation instituted a 57-hour weekend lockdown from Friday evening to Monday morning, as well as nightly curfews beginning at 8 p.m. or 9 p.m. and ending at 5 a.m. (Becenti, 2022).

Tribal officials worked to give out food and supply boxes and kept everyone informed through weekly town hall sessions broadcast on the Nation’s radio stations. Involving tribal out reach organizations was a critical strategy. Chizh for Cheii is a reservation-based organization that has been delivering wood to native elders in need during the winters for years. Its workers are rec ognized and trusted by the people they serve. Tribal officials decided to use Chizh for Cheii to deliver emergency food and other supplies to elderly Diné and tribal members who lived in remote areas. To ensure that each of the Chizh for Cheii crew members were responsible and did not take any chances, they made a pact with Copyright © 2023 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited.