Madeleine Leininger: Bridging the Cultural Divide Essay

AbstractThis paper leave behind go offline Madeleine Leiningers prominent opening, its origins, and its mathematical function. The objurgate of transethnical treat, its distinctive language, ethno business for investigate method, and Sunrise Enabler gumshoe will also be explored. These components equipped nurses to yield long-sufferings with single(a)ized, appropriate oversee this led to improved wellness outcomes. Finally, the effect of Madeleine Leiningers contributions to nursing will be examined. Her idea of appropriate shell out was the catalyst for a ingroup of federal legislation making culture a requisite, legal friendship and convinced society of the benefits of pagan diversity. Madeleine Leininger Bridging the Cultural Divide through bring off The hall speciate of a true profession is the ability to demonstrate its ludicrous body of knowledge (Mensik, Martin, Scott, & Horton, 2011).Madeleine Leiningers transethnical nursing discipline and its subvert er companion speculation meets this threshold. Counted as the most signifi nookyt breakthrough in nursingin the 20th century, she forever variegated how nurses thought and spoke intimately health upkeep (Leininger, 2002, p. 190). This paper will present a high-level overview of Madeleine Leiningers contributions to nursing and their influence, as comfortably as reveal the authors connection to the theorist.Cultural forethought Diversity and Universality The speculationThe conjecture of refinement trouble Diversity and Universality (hereinafter nicety Care Theory), Madeleine Leiningers seminal work, was conceptualized in the mid-1950s and desire to describe, explain, and predict nursing similarities and differences in relation to care and its role in human culture (Leininger, 2001). To provide significant and effective care, the theorist reasonsed, a nurse had to know what non-homogeneous cultures valued about wellness, health, illness, etc. and affair this understanding to call for their nursing tasks (Clarke, McFarland, Andrews & Leininger, 2009).Inspiration for the TheoryThe theory grew out of the theorists observations during her land tenure as a staff nurse in the mid-1940s (Leininger, 2001). Numerous patients show the nursing care given and remarked how instrumental it was to their recovery from illness (Leininger, 2001, pp. 8, 13). This struck Leininger as curious, since the activities traditionally associated with providing care were just judgeed at this rate in the development of nursing (Leininger, 2001). The concept of care was certainly neer taught, critically explored, or given much credence (Leininger, 2001). Based on the encouraging patient feedback received, care became an integral component of the theorists nursing usage (Leininger, 2001). Her patients health flourished (Leininger, 2001). Leininger deduced that outstanding caregiving alone was non plentiful to facilitate positive health outcomes while working on an insipi d psychiatric ward in the mid-1950s (Leininger & McFarland, 2002).Her clinical floor was a mini-United Nations, with patients from a variety of ethnic backgrounds (Leininger & McFarland, 2002). The children sufficeed differently to her care efforts and, after a flow of time, she realized their demeanour followed distinct ethnical patterns (Leininger & McFarland, 2002). For example, the Russian, Lithuanian, German, and Slovenian children would never harbour to be in pain, though they had very obvious injuries or signs of irritation (Leininger & McFarland, 2002). The Jewish and Italian children, in contrast, always cried fervently, at even the slightest spur prick, without solace (Leininger & McFarland, 2002). Her customary pain interventions were useless and obviously needed to be changed, but she was not sure how (Leininger & McFarland, 2002).Conceptualizing the Theory.The theorist experienced culture shock (a concept she introduced into common vernacular) and was concerned at being ill-equipped to respond to her patients specific needs even though she had obtained her masters in nursing (Leininger & McFarland, 2002). There was no search literature available to armed service make sense of the incidents witnessed, and her colleagues were of limited help (Leininger & McFarland, 2002). After discussing her concerns with the renowned cultural anthropologist and provocateur Margaret Mead, Leininger obtained a Ph.D. in anthropology (Clarke, et al., 2009) she was the first nurse to do so (Leininger & McFarland, 2002).The theorist answered field studies in non-Western cultures for some(prenominal) years afterwards to perfect her new skill-set (Leininger & McFarland, 2002). Having remedied hercultural ignorance, Leininger formalized the Culture Care Theory, establishing the new discipline of transcultural nursing (Leininger & McFarland, 2002). Her goal was to provide knowledgeable care in an increasingly multicultural human beings (Leininger & McFarland, 2002).Purpose of the TheoryThe theorys main purpose was to discover and explain diverse and universal culturally found care factors influencing the health, well-being, illness, or death of individuals or groups (Leininger, 2002, p. 190). It stressed the use of research findings to provide culturally congruous, safe, and meaningful care to those of diverse or similar backgrounds (Leininger, 2002, p. 190). Theory Application Tools. The theorist did not want to embroil platitudes she wanted her discipline to empower nurses and promote their autonomy (Leininger, 2002). To this end, she outlined thirteen assumptive beliefs to explain the focus of the theory and guide nurses in their behave (Leininger, 2001). several(prenominal) key beliefs are outlined below 1. Care is the totality of nursing and a unifying focus2. Care (caring) is essential for well being, health, healing, growthor death 3. Culture care is the broadest holistic operator to know, explain, interpret, and predict nur sing care to guide nursing care practices 4. breast feeding is a transculturalcare discipline and profession with the central purpose to serve human beings worldwide 5. Care (caring) is essential for there can be no curing without caring (Leininger, 2001, pp. 44-45). These assumptions formed the crux of transcultural nursing and what it was intended to do. Leininger also designed three theoretical modalities to guide culturally-based nursing decisions and actions (Leininger, 2001). The first modality, cultural care preservation and/or maintenance, referred to generic/folk behaviors and practices that encouraged wellness and did not need to be changed when supply nursing care (Leininger, 2001, p. 41 Literature review, n.d.).The next modality, cultural care accomodation and/or negotiation, involved nursing care activities which help patients of diverse cultures adapt or negotiate professional care activities (Leininger, 2001, p. 41). It encouraged the nurse to integrate generic/fo lk behaviors and practices when planning care to encourage healthy outcomes (Leininger,2001). low this modality, for example, a nurse would allow a patient to hang a healing amulet above their bed in the hospital because they believed in it and it calmed them (Literature review, n.d.). The final modality that nurses could utlize was culture care repatterning and restructuring (Leininger, 2001, pp. 41-42).This modality involved activities which supporter with the extensive modification, change, or repattering of a patients unhealthy behavior while remaining aligned with their cultural values and beliefs (Literature review, n.d.). This was the most stressful of all the modalities to employ because the nurse must know a keen deal about the patients culture to pass water an optimum outcome (Leininger, 2001). As with any plan of care, the nurse had to discuss their choices with the patient and obtain their agreement (Leininger, 2001).Metaparadigms of the TheorySince the introductio n of Florence Nightengales Environmental Theory, nursing frameworks had traditionally focused on four metaparadigms person, environment, health, and nursing (Dayer-Berenson, 2011). However, the Culture Care Theory broke with convention and selected care and culture as its nameational concepts (Leininger, 2001). Leininger found the standard four metaparadigms limited in scope and unsuitable for use in new discipline (Leininger, 2001). For instance, the theorist could not believe nursings pundits still respondd to acknowledge the indispensible role of care, though they had obviously witnessed its prospered impact on health (Leininger, 2001). She also considered the current trend of trying to explain nursing phenomenon with more nursing phenomenon a logical false belief akin to answering a question with another question (Leininger, 2001).Further, Leininger pointed out that the Western concept of person would be problematic in transcultural nursing because more cultures focused on t he family or an institution, rather than the individual (Leininger, 2001). While Leininger thought environment was important, she opted not to use it as a pillar of her theory because it was not unique to nursing or incitive enough to garner scarce research funding (Leininger, 2001). She discounted the use of health for a similar rationale, citing its commonness and the plethora of existing research (Leininger, 2001). Leininger apsired to enlighten, not emulate (Leininger, 2001).Key definitionsOther nursing theorists and researchers move to shoe motor horn themselves into existing medical models as a means of gaining legitimacy, prestige, and funding (Fawcett, 2002). Leininger, conversely, sought to distinguish her theory from the disease-focused philosophies of the period by not seeking stimulant drug from other disciplines it functioned independently (Leininger, 2001). Always seeking to demonstrate the skill and agreement of nurses, Leininger authored a series of definitions to provide clinicians with their own distinct language and, thus, stay off the incongruous use of medical terminology when practicing transcultural nursing (Leininger & McFarland, 2002). Several of the theorys key explanations are highlighted below 1. Culture Care refers toculturallyassistive, supportive, and facilitative caring acts2. Culture Care Diversity refers to culturaldifferences in care beliefs, meanings, patterns, values, symbols, and lifewaysbetween cultures and human beings 3. transcultural breast feeding refers to a formal area of humanistic and scientific knowledge and practices focused on holistic culture carephenomena..to assist in culturally congruentways 4. Culturally Competent Nursing Care refers toculturally based care and health knowledge in sensitive, creative, and meaningful ways for skillful health and well-being (Leininger & McFarland, 2002, pp. 83-84). Cultural diversity and culturally competent care, terms so common today, were penned by the theorist o ver 50 years ago (Leininger & McFarland, 2002, p. xvii).Influence of the Culture Care TheoryLeiningers theory generated little interest when it was introduced in the 1950s (Leininger, 2002). Nurses practices had begun to shift to take more administration of medication and assistance with complex medical treatments (Leininger, 2001). Additionally, they tried to emulate physicians by wearing stethoscopes, focusing on curative measures, and being very precise in their tasks (Leininger, 2001). Nurses, during this era, were medicines faithful hit man givers (Leininger & McFarland, 2002, p. 76). Needless to say, this mindset was nurtured by physicians, who wanted nurses to remain on the bang of healthcare, subservient to them (Fawcett, 2002).Nurses, in Leiningers opinion, willingly relinquished their power and bony their professional value by becoming so immersed in physicians procedures (Leininger, 2001). With nurses so intent on obtainingmedical validation, it was no surprise they f ound the Culture Care Theory soft, fuzzy, and too feminine (Fawcett, 2002, p. 133 Leininger, 2002, p. 75). The theorist jokingly recalled thinking, Nurses have no time to learn about care and cultures, as they must keep to medical tasks (Fawcett, 2002, p. 113). Patient care was not a precession (Fawcett, 2002).Making the Theory RelevantUndeterred by the initial long pepper reception, Leininger patch upd to make the discipline more relevant to nurses (Leininger, 2001). She knew the situation would change gradually over time and utilized the lull to increase the offspring of transcultural nurses in practice and cultivated the harvest of more cultural data for use in the field (Fawcett, 2002). transcultural Programs of Study. She true and taught courses in transcultural nursing (Leininger, 2001). Building upon this momentum, the theorist then naturalized several degree programs of study in transcultural nursing (Leininger, 2001). She steered nurses toward graduate-level courses i n anthropology as well, and served as their advisor when several of them continued on to doctoral studies (Leininger, 2001 Leininger & McFarland, 2002). Soon, she had amassed a hardy band of transcultural devotees to assist in her tireless announcement and support of the discipline (Leininger, 2001).Ethnonursing Research Method. As her followers began to utilze the theory, Leininger was compelled to develop a natural, inducive, and open research method to help tease out complex, covert, involved cultural data (Leininger & McFarland, 2002, pp. 85, 89). It was called the ethnonursing research method (Leininger & McFarland, 2002). At the time, clinicians utilized research tools and methods borrowed haphazardly from other fields (Leininger & McFarland, 2002). Enablers. The theorist worried that valuable cultural knowledge was lost, concealed, or rendered useless from the improper use of quantitative instruments to perform qualitative research (Leininger & McFarland, 2002). In response , Leininger invented five tools she called enablers to facilitate the mining of cultural data (Leininger & McFarland, 2002). Each enabler was designed to collect a different fount of qualitative information (Leininger & McFarland, 2002). The most popular enabler, The Sunrise Enabler to Discover Culture Care, was a conceptual model of the entire theory (Appendix A).Its purpose was toconsistently guide nurses through seven areas of influence to find relevant cultural knowledge and provide a holistic view during the health judgement process (Leininger & McFarland, 2002). Qualitative Criteria. To further support accurate interpretations and credible research findings, Leininger identified six criteria by which qualitative studies, like those performed with her ethnonursing method, could be evaluated (Leininger & McFarland, 2002). The criteria credibility, confirmability, meaning-in-context, repeated patterning, saturation, and transferability received the endorsement of research exper ts, which led to qualitative datas acceptance as valid scientific evidence. (Leininger & McFarland, 2002, p. 88) Dedicated Resources. Leininger also established the Transcultural Nursing Society in 1974 as a gathering for intelligent discussion among nurses in the discipline, as well as to advocate the dissemination of transcultural information (Clarke, et al.). Finally, Leininger launched the diary of Transcultural Nursing in 1988 to serve as a dedicated publishing source for transcultural nursing research, ensuring the entire nursing profession also had access to her protegs useful findings (Clarke, et al.).Rise of the TheoryAfter existing in go about obscurity for several decades, the Culture Care Theory was thrust into the smear in the mid-1980s (Murphy, 2006). Several factors prompted its emergence from the shadows. First, just as Leininger predicted back in 1950, geographic borders shrank and the U.S. became the adopted country of choice for immigrants from all over the w orld (Leininger, 2002). The healthcare system became innudated with people clinicians did not understand and could not effectively assist (DeRosa & Kochurka, 2006). Desparate to address patients needs in a culturally humble manner, they discovered Leiningers blueprint for congruent care (DeRosa & Kochurka, 2006).The federal mandates of the mid-nineties further catapulted the Culture Care Theory into prominence (Murphy, 2006). The directives were designed to resolve disparities in healthcare and ensure equitable treatment for those from diverse backgrounds (Maier-Lorentz, 2008). This meant that pedantic programs, clinical settings, and healthcare agencies now had to promote, incorporate, and enforce Leiningers ideas of cultural competency (Murphy, 2006).Impact of the Theory on the AuthorThe Culture Care Theory, developed organically from one womans insightful observations, has left an indellible mark on not only nurisng, but education, medicine, law, social science, religion, and so forth (Leininger, 2002). It would be far easier to name the areas of society that the theory has not impacted, for that would be a much shorter list. Amazingly, the author also owes Madeleine Leininger a tremendous nub of personal gratitude. While conducting research, the author was stunned to learn that Leiningers theory was the motivation for her academic scholarship. The theorists emphasis on congruent care and its positive influence led to the Health Resources and Services governing bodys (HRSA) campaign to significantly increase the number of culturally competent healthcare professionals in critical shortage areas. The NURSE Corps intuition Program, which offers a full tuition grant, monthly stipend, and full-time employment to intellectually outstanding nursing students, was founded to accomplish this objective.Because of the theorists tenacity and zeal, this rising clinicians ambition to serve the underrepresented was made a debt-free reality. Leininger passed away in August of last year (Ray, 2012). Ironically, the author was awarded her scholarship during this same month. Janet Jones wrote in Leiningers obituary guest book entry, She truly was a imaginative and her work will continue to be of great significance to many more generations of nurses (Madeleine M. Leininger, Ph.D., 2012). The author could not agree more with this statement and, in tribute, intends to contribute to Leiningers legacy of nursing excellence by maintaining a culturally-informed practice, performing research that offers innovative knowledge to the profession, obtaining an advanced degree, and serving as a staunch advocate for the marginalized. Similar to the theorist, the author also pledges to refuse to accept limitations as to what a nurse can accomplish. The author believes Madeleine Leininger would expect no less.ReferencesClarke, P., McFarland, M., Andrews, M., & Leininger, M. (2009). Caring some reflections on the impact of the culture care theory by McFarland & A ndrews and a conversation with Leininger. Nursing Science Quarterly, 22(3), 233-239. inside10.1177/0894318409337020 Dayer-Berenson, L. (2011). Culturalcompetencies for nurses Impact on health and illness (pp. 9-39). Sudbury, Mass Jones and bartlett Publishers. DeRosa, N., & Kochurka, K. (2006). Implement culturally competent healthcare in your workplace. Nursing Management, 37(10), 18-18, 20, 22 passim. Fawcett, J. (2002). Scholarly dialogue. The nurse theorists 21st-century updates Madeleine M. Leininger. Nursing Science Quarterly, 15(2), 131-136. Jeffreys, M. R. (2010). Teaching cultural competence in nursing and health care inquiry, action, and innovation (2nd ed.). (pp. 9-10). New York springer make Company. Leininger, M. M. (Ed.). (2001). Culture care diversity and universality A theory of nursing. Boston Jones and bartlett pear Publishers. Leininger, M., & McFarland, M. (2002). Transcultural nursing in the new millenary Concepts, theories, research & practice (3rd ed.). New York McGraw-Hill. Leininger, M. (2002). Culture care theory a major contribution to advance transcultural nursing and practices. Journal Of Transcultural Nursing, 13(3), 189-192. Literature review. (n.d.). Retrieved from http//uir.unisa.ac.za/bitstream/handle/10500/1555/02chapter2.pdf Madeleine M.Leininger, Ph.D. (2012). Retrieved from http//www.heafeyheafey.com/newobituary/display.asp?id=7022 McFarland, M., & Eipperle, M. (2008). Culture care theory a proposed practice theory guide for nurse practitioners in primary care settings. coetaneous Nurse A Journal For The Australian Nursing Profession, 28(1-2), 48-63. doi10.5172/conu.673.28.1-2.48 Maier-Lorentz, M. (2008). Transcultural nursing its importance in nursing practice. Journal Of Cultural Diversity,15(1), 37-43. Mensik, J. S., Martin, D., Scott, K. A., & Horton, K. (2011). outgrowth of a Professional Nursing Framework The Journey Toward Nursing Excellence. Journal Of Nursing Administration, 41(6), 259-264. doi10.1097/NNA.0b0 13e31821c460a Murphy, S. (2006). Mapping the literature of transcultural nursing. Journal of the medical examination Library Association JMLA, 94(2 Suppl), E143-51. Ray, M. A. (2013). Madeleine M. Leininger, 19252012. Qualitative Health Research, 23(1), 142-144. doi10.1177/1049732312464578 Sagar, P. (2011). Transcultural nursing theory and models application in nursing education, practice, and administration. New York Springer Publishing Company. Sitzman, K., & Eichelberger, L. W. (2011). Understanding the work of nurse theorists a creative beginning (2nd ed.). (pp. 93-98). Sudbury, Mass. Jones and Bartlett Publishers.Transcultural Nursing Society. (n.d.). Theories and models. Retrieved from http//tcns.org/Theories.htmlAppendix AFigure. Adapted from Transcultural Nursing Society. (2013). Theories and models. http//tcns.org/Theories.html. Reprinted with permission.