Simply stated, diversity is variety. It is the unique combination of every single trait, characteristic, idea, belief, and preference that sets each individual apart from all others. The ways in which humans differ are virtually infinite, and precisely for that reason, no one can make any assumptions about any individual based solely on minimal information, such as where they were born or how they look.
In healthcare settings, sensitivity to the infinite scope of diversity has become as integral as patient safety, quality improvement, and error prevention. Specific aspects of diversity that must be accommodated in healthcare include religious beliefs, family relationships, and dietary preferences. Similarly, some patients have culture-based preferences about various treatment options.
The impact of diversity on healthcare is also coming into sharper focus. Why? More and more studies are showing that our minds connect directly to our bodies when it comes to health and well-being. There is considerable evidence, for example, that emotional traits influence susceptibility to infection. Following systematic exposure to a respiratory virus in a controlled setting, individuals who reported higher levels of stress or negative moods developed more severe illness than those who reported less stress or more positive moods.1 Recent studies also suggest that the tendency to report positive emotions may be associated with greater resistance to objectively verified colds. These findings are supported by longitudinal studies pointing to associations between psychological or emotional traits and the incidence of respiratory infections.1
The diversity of diversity
Many discoveries about the mind-body connection's effect on health and recovery link to various facets of diversity, such as cultural heritage. For example, African-Americans have more than double the incidence of peripheral arterial disease (PAD) than do Caucasians of European descent. "For reasons that are still unclear, something related to African-American ethnicity raises the risk of PAD," notes researcher Michael Criqui, MD, MPH, in a news release.2 Similarly, the incidence of diabetes mellitus is dis-proportionately high among Native Americans, while, on the other hand, systemic lupus erythematosus is extremely rare among the Asian population.3
Learning how various diversity factors influence disease and treatment can only enhance care delivery and contribute to optimal patient outcomes. Research continues with an eye toward including as many cultural groups as possible. This has not always been the case, however. A striking example is the failure to include Native Americans in multiple studies of drugs for depression, bipolar disorder, schizophrenia, and attention-deficit (hyperactivity) disorder over many years.4
Think before you speak
Beyond an awareness of the research on diversity's effect on health issues,
it simply takes common sense to accommodate diversity in patient care. When others respect our beliefs, values, and families, we feel more relaxed and respected. Indeed, this is the best frame of mind and emotional state for patients, and really, for everyone we encounter in all aspects of life. It is especially important, for example, to carry over that same respect for diversity to working with others.
If you consider yourself a "typical American" (a distinction that is fading fast as our understanding of how we all differ deepens), even just an awareness of some coworkers' lack of familiarity with colloquialisms like "check it out" and "good to go" will help you form more positive working relationships with them. And that is only the beginningÂ…
A good way to understand someone with another cultural background is to ask questions, but tread carefully, as there are some DOs and DON'Ts to this method:
* DO get to know the person a little before asking questions about culture, race, beliefs, or heritage.
* DON'T just walk up to a newly hired nurse from India and ask her if she can bring samosas to the next potluck.
* DO spend some days working with your new colleague, discussing the ins and outs of the job in a friendly, helpful way.
Respect, respect, respect
Quizzing a coworker about beliefs or culture can feel like an attack. Wait until you have worked together for a while, and then begin by sharing a social time, like having a meal or taking a break together. It is impossible for nurses to study every possible situation of diversity that they may encounter ahead of time. But certainly, having a working knowledge of those you are most likely to encounter can be helpful. For example, if you have a new coworker from India, it is the perfect time to learn a little about India, no matter where you are from. Visit your local library or see what you can find on the Internet. Being a little more knowledgeable about your new coworker's heritage can keep you from making assumptions that could possibly be offensive – and from being startled by a response that you did not expect.
When in doubt and trying to understand a patient or coworker better, begin by asking a simple question, phrased with respect, in a way you would like to be asked a question about your own life. Decide if your question is about something you need to know relative to patient care or your work situation, or if it is something that has simply aroused your curiosity. The curiosity questions are best avoided unless your relationship with the person has deepened. Also, keep in mind that certain questions are more appropriate for coworkers than for patients.
Strive to be aware of the many differences among people in virtually infinite ways and avoid assumptions and generalizations. Nurses instinctively know that practicing this sensitivity is the best way to promote patients' recovery and to form positive relationships with the entire healthcare team. And, whether you are interacting with patients or coworkers, all of whom differ from you in some way, think about the many ways diversity enriches your life. It gives to us all.
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