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Epilogue
Advancing Transcultural Nursing Through Collaboration
Akram Omeri
Adjunct Associate Professor, School of Nursing, College of Health and Science, University of Western Sydney, Parramatta NSW
Article Text
Collaboration is evident in today's organisational, government and business life (Huxham & Vangen 2000) and skills to work across boundaries and to form alliances and partnerships are sought in today's leaders. The healthcare arena is no different and the concept of boundaries to be crossed is implicit in the very nature of transcultural nursing. Successfully negotiated partnerships, coalitions and collaborations between participating healthcare groups are at the heart of advancing transcultural nursing knowledge.
Extending the healthcare research capacity and capability beyond national borders and across professions through global collaborative endeavours spreads the work load and accelerates the production of knowledge (Pearson 2007) for nursing and other disciplines. Such desirable outcomes can result from effective collaborative efforts.
Most countries in today's world require quality health care interventions and practices that can be justified or based on research evidence of superior efficacy and efficiency. Responsibility for providing such interventions and practices lies with the health care professionals who are looked to for the development of such interventions and the provision of guidance for best practices. Most countries also have difficulty in reconciling the increasing demand for the health care influenced by the speedy international knowledge exchange via the World Wide Web and the imperative of doing more with less as resources become scarcer. These factors combined with the understanding that most ‘nations and cultures are more alike than they are different' (Pearson 2007: 69) suggest that greater collaboration on a global level would be productive and beneficial to all partners in a collaborative effort.
Essentials of a successful collaborative effort
Effective collaboration is premised upon setting worthwhile goals of mutual benefit to consumers, service providers and other stake holders. It means achieving the desired outcomes by reducing or removing boundaries that impede the realisation of goals that benefit consumers and others. Collaboration involves joint effort and implies joint ownership (Linden 2002) for all partners and means the commitment of each to the goals of an enterprise/project to gain worthwhile benefits.
Essential to a collaborative endeavour is a clear expression, understood and agreed by all parties in the alliance, of the joint purpose of the collaborative effort, its goals and objectives (Clegg et al 2005 cited in Brown et al 2006) and the development of a strong sense of common purpose. In our joint collaboration, as guest editors, we adopted the goal of transcultural nursing in order ‘to prepare a new generation of nurses who would be knowledgeable, sensitive, competent and safe to care for people with different and similar lifeways, values, beliefs, and practices in meaningful, explicit, and beneficial ways' (Leininger & McFarland 2002: 6).
A sense of common purpose underpins the development of strong, balanced relationships, based on trust and respect, between the partners. A key element in collaborative endeavours is effective communication and the development of strategies to ensure shared decision making (Kantar 1994). Successful development of an alliance also depends upon engaging the best possible people in the task with the authority and autonomy to speak (Huxham & Vangen 2000). It also requires time and sufficient resources to establish a project and to sustain it (Huxham 1996a, 1996b; Linden 2002).
Collaborative challenge
Transcultural nurses recognise that we live in a multicultural world and that ‘all health care must be transculturally based to serve people appropriately from different cultures in the world' (Leininger 1995: 681).The challenge is to provide research based transcultural knowledge to guide practice and to be effective in helping others and for the development of transcultural education of clinicians and faculty.
As Leininger (Leininger & McFarland 2002: 578) has identified that it is the coming generation of nurses, who experience cultural diversity in their daily interactions that see the need for transcultural nursing knowledge; they turn to their educators for knowledge to assist them in their practice. As Leininger (Leininger & McFarland 2002: 7) has stated: ‘Nursing students expect their faculty to be knowledgeable and competent in transcultural nursing so they will be effectively guided in their practice.' Leininger has also identified that the challenge is to prepare students who are ‘knowledgeable, sensitive, competent, and safe to care for people with different or similar lifeways, values, beliefs, and practices in meaningful, explicit, and beneficial ways.' This challenge can only be met if faculty are themselves transculturally qualified and prepared to contribute, on the one hand, to the development of transcultural knowledge and, on the other, to teach it to their students to assist them to meet the pressing demands for care that is culturally safe, meaningful and effective. Leininger predicted that ‘by the year 2020 more nurses will be prepared in graduate transcultural nursing studies which will facilitate meeting consumer expectations and transcultural nursing education and practice goals' (Leininger & McFarland 2002: 578).
Nursing in Australia in recent years has much to be proud of given the immense changes in nursing practice and education it has embraced and sustained, and the developing and growing body of nursing knowledge through research concomitant with the higher education of nurses (Halcomb, Patterson & Davidson 2006).The future development of nursing still has numerous challenges ahead. These challenges are the globalisation of health care, and the contemporary demands on health care (Pearson 2007). In response to these challenges transcultural collaborative effort is called for from the nursing profession.
As Pearson (2007) has noted international collaboration is not well established in nursing. Much of nursing research is small in scale and local in application which severely limits its capacity to make a substantive contribution to advancing nursing science. A much greater contribution could be made to global health problems by nursing science through the medium of transcultural concepts. It remains for us in the coming decade to become more global and strategic in our thinking and research efforts, to seek and nurture research across national boundaries in collaborative partnerships, not only with other nurses but also with other professions.
Our commitment
As transcultural nurses our pursuit of excellence continues as a major objective in the transcultural nursing journey by our continued leadership in research and education informing practice at the highest levels and sharing such worldwide knowledge across boundaries. It is our commitment to continue, and grow, as key participants in contributing to the profession of nursing, and to advocate for the culturally meaningful and congruent/competent health care needs of the sick and well, to promote social justice and human rights of people towards equality of access to health and welfare services, and health as a right not privilege of all.
This Contemporary Nurse special issue on transcultural nursing, Advances in Contemporary Transcultural Nursing, 2nd Edition (ISBN 978-0-9757710-5-1) is one major collaborative endeavour aiming to advance shared and evidence- based transcultural nursing knowledge toward improving care in culturally meaningful ways to clients and nurses. It has taken two years of planning, and organisation to bring this collection of research-based transcultural nursing knowledge in the volume of Contemporary Nurse in two issues which could be shared globally. This volume provides a collection of fresh ideas and research in transcultural nursing education, research and practice in diverse contexts.
We, as guest editors, are both certified transcultural nurse specialist and scholars, mentored by the Founder of the discipline of transcultural nursing, Madeleine Leininger, from culturally diverse backgrounds, worlds apart. Having had previous joint partnership in a number of collaborative projects in Australia, USA and other countries, our collaboration in this major project was well advanced. From the early planning stages, we were assured to possess qualities of strong, balanced relationships, based on trust and respect, good and effective communication, and a shared decision-making as stated by (Kantar 1994) essential in the success of this collaborative plan.
Our association dates back to the early 1990s, two decades ago, when we met during the first joint venture, attending the first transcultural nursing theory conference at Madonna University, Livonia, Michigan. At the time we were both pursuing graduate studies in transcultural nursing with mentorship from Dr Madeleine Leininger. Since then, our mutual interests in transcultural nursing have continued to grow. We have continued working collaboratively to strengthen and advance transcultural nursing knowledge through education, research and leadership.
As part of our collaboration, we have travelled to joint transcultural nursing conferences and educational activities in Australia and USA as well as other countries, on numerous occasions. We have also been actively involved as members of committees of the Transcultural Nursing Society including Leininger Award Committee, Certifications Committee and the Nomination Committee of the Transcultural Nursing Society.
In addition to conferencing, we have consulted and collaborated in the design and teaching strategies for the development and delivery of courses in transcultural nursing. We have exchanged ideas, philosophies, pathways of how best to deliver the message of transcultural nursing for students and faculty in BN, MN, PhD as well as in continuing education programs, in diverse contexts and in culturally and educationally meaningful ways.
We have sought ways of advancing transcultural nursing through research, conference presentation and joint projects. Joint guest editing for this Contemporary Nurse special issue in transcultural nursing, Advances in Contemporary Advances in Transcultural Nursing, 2nd Edition, has been a major joint commitment in collaboration international collaboration. We have consulted online via email and telephone in order to compare our views on editing and suitability of manuscripts for this special issue.
We guest editors, are well advanced in our collaborative endeavours. Plans are in place for two joint projects including; Collaboration in supervision of post-graduate nursing students online and Nurse practitioners and their roles in rural-remote areas. Nurses are realising that what we teach and how we care for people necessitates having transcultural nursing knowledge and skills to be effective and helpful to others. Living in a multicultural world challenges nurses to understand trends and cultural realities. Meeting the challenge will be greatly facilitated by collaborative effort and shared endeavour in the discovery of transcultural knowledge.
Leininger has stated that by 2020: ‘all health care must be transculturally based to serve people appropriately from different cultures in the world' (Leininger 1995 cited in Leininger & McFarland 2002: 577). In a multicultural world the challenge for the health professions and the systems that support them, is to ensure enough health professionals are available with the skills, knowledge and attitudes to provide culturally meaningful and safe care. When this comes to pass, Leininger's prediction that: ‘Transcultural nursing will continue to soar to many places in the world in the 21st Century to serve humanity' (Leininger 1960 cited in Leininger & McFarland, 2002: 577) will be realised.
References
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