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Globalization of Nursing

Monday June 2, 2003
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The scope of the patient care environment has broadened - beyond the patient and his or her immediate surroundings, beyond the unit, the classroom, the organization, or even one's country. Today, patients, staff, students, and faculty, are diverse in all ways - culturally, ethnically,
linguistically, and spiritually. And because of this, nurses must see beyond the confines of geography and integrate cultural influences into standard nursing practices.
Globalization of nursing education, research, practice, and healthcare policy is upon us - and the ability to demonstrate a global perspective has become an essential nursing leadership skill.
The Challenge for Nursing
World view is one way in which we see "our world" and our relationship with the global community. It's made up of our beliefs, values, assumptions, behaviors, life and learning experiences, and knowledge. In the past, the predominant world view of nursing has been the Western view, with the exception perhaps of community health nursing, which focuses on populations rather than individuals. As nurses, we pride ourselves on providing individualized patient care and most often define the patient care environment as the patient's immediate clinical or home surroundings. All that we do in nursing is within that carefully defined environment. However, this "isolationism and protection" approach to nursing may actually hinder our ability to deliver care in a demanding global market.
The world view of nursing is changing in response to the influences of diversity, mobility, customer demand, and economics. To adapt to this change nurses must broaden their views of the world. Globalization requires nurses to adopt a global spirit, to see the big picture, and try to find a common bond among people to lessen the impact of cultural differences. Systems thinking, seeing the larger view, and reflecting on patterns and interrelationships are critical to development of this global perspective.
To provide culturally congruent care, we need to respect and acknowledge the cultural and linguistic differences of others. We must develop a comprehensive plan of care that incorporates cultural practices into our admission, preoperative, and discharge-planning practices.
When we are able to see the big picture, we begin to think in terms of patient outcomes and the effects our nursing care has on others - and the world around them. And when we realize that culture isn't defined by a common language, we begin to see that individuals who speak the same language aren't necessarily from the same culture.
To truly adopt a global spirit we must search beyond American nursing literature for sources and evidence to support our nursing practice. And
we must look at how nurses from other cultures arrive at different, yet
worthwhile decisions and how these nurses incorporate various outcomes
in patient care.
If we look at how nurses and faculty from different parts of the world define nursing, nursing practice, the role of the nurse, and the skills and educational levels they bring with them, we can appreciate the variety of
learning and communication styles among our own nursing staffs. Once common core values are established, diversity can more easily be explored.
Setting Global Goals
Today, visionary nursing leaders in both practice and educational settings must take a global view. The challenge is to -
∑ Redefine "community" as the global community
∑ Articulate a vision, mission, and philosophy of nursing to recognize and celebrate the mosaic of nursing, healthcare, and the global community
∑ Incorporate globalization, transcultural principles, intercultural communication, and information technology in the vision, mission, philosophy, and curriculum of nursing and the "organization"
∑ Establish a common nursing language for describing nursing practice, interventions, and outcomes
∑ Conduct cross-cultural research to explore cultural attitudes and values and their impact on learning and patient outcomes
∑ Investigate culture's impact on learning styles and clinical reasoning
∑ Expand cultural analyses to include the healthcare provider and the patient
∑ Compare nursing data across populations, settings, geographic areas, and time
∑ Create a global nursing evidence data bank
∑ Generate and disseminate knowledge that is valid for different cultures using reliable cross-cultural methods and concepts
∑ Empirically explore and define leadership competencies for multicultural settings
∑ Actively engage in interdisciplinary theory development
∑ Support international partnerships for practice, education, research, and healthcare policy
∑ Allocate and manage resources for the globalization of education, practice, and research
Nursing, like all professions and disciplines, is influenced by and must respond to global trends, needs, challenges, and opportunities. And it is these strategies that will help shape the future of the global nursing community and healthcare in the international arena.