Transcultural Nursing: The Global Agenda

Transcultural nursing must be more than caring for the patients or clients who come through our doors. It is not and cannot be solely about those we serve in our small corner of the world. Just as the fluttering of butterfly wings on one side of the world can contribute to the formation of hurricanes half way around the globe, social, political and economic events in one hemisphere affect the lives of people in the other half. This reality is becoming more evident with each passing day as globalisation becomes more firmly rooted and the internet reaches the farthest corners of our planet.We are becoming global citizens, tied inextricably to each other.What affects one group of citizens has an impact on the lives of every other group. This interdependence, along with a sense of obligation and our common humanity, underlies the imperative for social justice when addressing the health care needs of our fellow world citizens.In the paper by Pacquiao (2008) that follows in this section, the author outlines the skills needed for world citizenship and describes how these skills form the basis for providing culturally competent care for vulnerable populations, particularly those who have migrated because of political, economic or environmental dangers. Within this framework, she explains the concepts of social justice, human rights and compassion in relation to cultural competence. She offers a number of strategies for teaching these abstract concepts and skills to health care students and practitioners.Perhaps the timing of a new millennium has made the desire for change almost palpable in the air we breathe. Old political administrations are being defeated by electorates or parties who want to overturn that which has been, even if the new younger voices have not yet been tested. The mood is one of wanting something different from the old way of doing things, whether it is in Australia or the United States, Kenya, Russia, or the Middle East. But change can also cause chaos if it is not accomplished with care, especially when this change occurs within an unstable social or political context.In the world today there are many examples of change, chaos, unrest and increasing social inequality, which have resulted in many people on the move. Motion and chaos seem to define this current historical period. Whether from war that shifts populations to refugee camps, or the hopelessness of poverty that drives the able-bodied to seek work in more promising economies, many become refugees, pawns in human trade, asylum seekers, or voluntary migrants. Large numbers of nurses are among these resettled migrants, many recruited from the developing countries by the western industrialised countries whose aging populations need increased nursing care. These nurses face tremendous challenges, potential exploitation, and numerous barriers to the optimal use of their professional skills. Transcultural nursing mandates that the principles of social justice, human rights and cultural competence extend as much to our professional colleagues as they do to our patients and clients.In the paper by Mireille Kingma (2008) the author summarizes the scope and magnitude of the international nurse recruitment efforts and identifies the types of abuse, discrimination and exploitation reported by migrant nurses. The position of the International Council of Nurses (ICN) is presented along with its key principles for ethical recruitment and employment practices. In addition, ICN's educational standards for assisting internationally-recruited nurses to adapt to their new environment are cited, as well as strategies for integrating these nurses into the host country's organisational structure. Culturally competent nurses can help make the transition easier for their international colleagues by encouraging their education and professional growth through mentorship, compassion, patience and support. Ultimately, the learning becomes bidirectional; the mentor gains new insights about health care beliefs and practices from the mentee and vice versa. …