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According to the case study Curbing Tobacco Use in Poland (n.d.), prior to the fall of Communism, tobacco was a major source of revenue in the country, and the Polish community was not educated about the negative consequences of smoking. It was not in the best interest of the government to inform the population of the health risks associated with smoking, due to the economic revenue brought about by the sale of tobacco products. Immediately after the fall of the Berlin Wall, tobacco use increased due to privatization of the tobacco industry and the abundance of international product combined with a much more economical cost. With time, scientists in Poland began conducting research that showed the negative effects of smoking which started the anti-tobacco movement. With free media came information about the negative health consequences of smoking and allowed for the increased knowledge regarding tobacco-control legislation. It also provided advise about what steps to take to quit smoking.
By 1995, the “Law for the Protection of Public Health Against the Effects of Tobacco Use” was passed. The law banned smoking and cigarette sales in health care centers, schools, and for minors under the age of 18. It banned the production and marketing of smokeless tobacco and radio and television advertising. The law also mandated printing of the largest health warnings on cigarette packs at that time and free treatment for smoking cessation. Once smoking was recognized as the killer it is, the government acted appropriately and saved millions of lives.
I would like to think that I treat all patients with the same respect without using stereotypes or bias’, but sometimes I imagine that subconsciously I may still act on preconceived notions. I do not think I exhibit bias based on culture as much as behavior. Cultural diversity is a constant in my practice, and I recognize, and respect difference based on race, religion, age, gender, etc. To be honest, I find it more difficult to set aside bias about IV drug users that stay inpatient for 6-12 weeks for IV antibiotics than anyone else. According to Bucknor-Ferron & Zagaja (2016) unconscious bias is difficult to manage due to blind spots resulting from confirmation bias. Confirmation bias trigger information that supports prior beliefs, reinforcing stereotypes. My experience with IV drug users has made it difficult to overcome my bias, because more often than not, I have had a bad, nearly fatal experience with these patients.
When we learn cultural information about others, it should be to cater our nursing plans to the specific patient, not to lead to stereotyping. Cultural knowledge should influence and change nursing practice and interaction, because recognizing differences in our patients offers another way to advocate for them by assisting with communication, identifying appropriate treatment options, and ensuring their rights are not ignored.
Cultural and environmental influences have a huge effect on how we live our lives. The media, advertisement, and marketing impact what we think is right and wrong. In Poland before an intervention, smoking was largely advertised, while the side effects and consequences of smoking were hidden. Poland had a particularly high rate of smoking due to the large marketing campaigns. Because the government was profiting off of this, unfortunely it took a long time before the effects of smoking became obvious to the public. Finally, after the health effects became known to the world, programs in Poland were developed to fight this trend. Fighting big tobacco is no easy task, but Polish parliament passed groundbreaking legislation that included warning labels, along with a ban on smoking in public, on advertisement, and on sales to minors. An initiative to raise awareness of the dangers of smoking via health education campaigns also became part of Poland’s intervention. After these legislative efforts, the culture changed. Cigarette consumption dropped by ten percent in eight years. (Center for Global Development (N.D.).
In health care centers today, we see people from all different cultures, and we must take each person’s culture and environment into consideration before we judge their health. Much like in Poland, the environment was the real problem, and not necessarily the population. For example, some cultures don’t believe in western medication and some believe that being overweight correlates to good health. Most cultures revolve around food, and not exactly the healthy kind. Some environments also promote dangerous behavior such as drinking, smoking, drug use, and sexual behavior. As public health leaders we must recognize these differences in culture, so that we don’t form a bias about our patients. We should also be careful not to judge someone based on just their cultural background alone.
It can be frustrating to confront a patient about their health and not understand why the patient can’t just take care of themselves. We must acknowledge all of the aspects going on in this individual’s life and treat them accordingly. We must recognize the cultural differences, socioeconomic situation, and the environment in which they live in order to fully assess out patients. (Stanhope, Lancaster (2016).
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