Psychological and cultural mediator
William Johnstone
PP: 036 - 037
Article Text
Some of our psychiatric clients are treated as outsiders; the rules of social interaction are in accordance with Anglo-centric communication patterns with little allowance for the meanings of people who have different cultural backgrounds. Such was the case for an Aboriginal client whose background had a pervasive traditional Australian Aboriginal influence. Having lived on Aboriginal 'stations' as a mediator and having studied several units of Aboriginal Studies, I was able to use my mental health nursing skills to understand the meanings that particular behaviours had for this client By so doing, I was able to increase the rapport between us in our nurse-client relationship. This was done in an open, trusting, and learning way (with me as the learner) under the umbrella of an unconditional positive regard.
Whilst working in a security ward I walked up to Mr T and said 'Good-day, my name is Bill. I am one of the nurses on this ward. I have been told that you are Mr T'. He said, after looking at me and then averting his eyes in a downward motion, 'Yes, so what Chief?'. I gained the immediate impression that I had to break this 'you Chief and 'me Indian' communication pattern. This assumption was based on my previously mentioned knowledge base. Thus I decided to let him teach me how to communicate with people of his cultural background. My goal was to develop and improve my interpersonal skills whilst helping him relate to the staff.
Over the next two weeks I made it a point to have a conversation with Mr T during every one of my shifts. Our conversations would last approximately 20 minutes. I was conscious of my nonverbal communication so I asked him whether any of my specific behaviours had a particular cultural meaning for him. Eventually, he and I adopted an open and honest nurse-client relationship. I would sit or squat at the same level as him. I would avert my eyes in a similar fashion as he had done to signify respect for his 'norms' or cultural specific behaviour. Rather than ask a direct question, I would phrase a statement in the past tense. For example, 'Many times I have seen you talk to (so and so) ... (pause)'. He would then clarify this statement and add additional information.
In addition to my increased understanding, this man had let me experience what it was like to be a client of his cultural background. What was significant to me was that although he had been isolative in communication with other staff, he was increasingly interactive verbally and nonverbally with me after each of our conversations. He had realized that nurses do indeed care.
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