Interviews 101: Answering that CULTURE Question!

I’ve got interviews on the brain this week.

One of my FAVORITE parts of being a clinical instructor is participating in exit interviews as the associate degree of nursing students graduate – nurses who are just about to graduate and take RN boards. They come in and are interviewed by several instructors to practice interviewing for a real job.

It is so fun to see students that I’ve had in clinicals and known throughout their time in the nursing program check off their final task on their checklist on their way to graduation. We are holding a pinning ceremony for them on Thursday which is also one of my favorite parts the semester and then I’ll start in January with a new group of students!

Throughout the interviews this week, a few things really stuck out to me and I wanted to share them with any new grads or really any nurse who is job seeking. I’m going to do a series of tough interview questions that nurses are usually asked in interviews. Today I’m focusing on that culture question.

The Culture Question

Culture is defined as the customs, arts, social institutions, and achievements of a particular nation, people, or other social group.

We live in rural northeast Iowa – I mean RURAL northeast Iowa. In 2017, the major city/town I work in had a total of 93.8% WHITE alone residents. Most of the population we work with APPEAR to have the same culture as I do as a white woman. I cannot honestly think of a black man or woman who works in our facility. My students have very few opportunities to work with students of “other cultures”… or so they think.

Usually the question comes up in interviews about how the nurse would provide trans culturally congruent care across the life span in a variety of healthcare settings. So many of my students said “I’ve never worked with anyone of a different culture.”

WRONG. Pediatric patients are their own culture. Elderly patients are their own culture. Childbearing women are their own culture. Farmers are their own culture. The list goes on and on. We may appear to be the same, we are not. Just because we are white, does not mean we belong to the same culture.

I have a friend who grew up with a single mom and has no idea who her dad is. I have a friend who was adopted. I have a friend who is a twin. I have a friend who is a vegetarian. I have a friend who is a Jehovah’s Witness. I have a friend who has a deaf mom. I have a friend with autism. I have a friend who grew up in the military and moved frequently. I have a friend who has survived childhood cancer.

Each of us bring our own unique set of experiences and values to the table. We may appear the same, but we do not all belong to the same culture.

Can you imagine the difference in my Thanksgivings?

I have my family – I am the youngest of 5, both of my parents came from families of 5 or 6 children, we can’t possibly fit our entire family in one building. It is loud and we drink alcohol and graze all day and the boys end up in the garage smoking.

On Craig’s side of Thanksgiving, we can fit his entire mom’s side at one kitchen table. He has a Great Grandpa, a Grandpa and Grandma, and both parents. I don’t even have a full set of parents and my two grandparents that I knew passed away before I graduated high school.

But Craig is white and I am white so some might assume we belong to the same culture or set of beliefs.

I would not approach caring for an elderly demented patient the same way I would care for a woman who just had a baby. I wouldn’t even care for a woman who had her 7th baby and a woman who just has had her first baby the same way.

How to Answer the Interview Question

The safe answer to this question is first acknowledging that we all bring our own set of beliefs and culture to the table regardless of what we look like or where we grew up.

The best way to make sure you are honoring your patient’s beliefs and wishes is to get to know them. That way you can identify any language barriers, educational barriers, maybe they are under a huge amount of stress etc. This can help you coordinate resources and make sure you’re providing effective teaching. You can also identify any barriers they may have for caring for themselves and for maintaining compliance with medications and self care.

What if I haven’t taken care of someone with a different culture than mine?

Re-read what you’ve just read – you HAVE taken care of someone of a different culture!

Talk about having to float to a different department and caring for a subculture of patients you aren’t used to such as caring for OB moms.

Talk about having to tailor your care/conversations to dementia patients by playing along in their world.

Talk about the important role the chaplain has played in your facility and how incorporating the patient’s cultural beliefs in the dying process is not only important for the patient but also for the family.

Talk about how you will always respect the patient’s wishes and beliefs even though you may not share those same values.

Make sure you sound politically correct

I’ve had a couple students say “the patient was Spanish.” Well that’s not exactly the proper terminology. While I don’t claim to be the most politically correct person in the room, “Spanish” is a language and does not always properly explain the patient’s ethnicity.

Not only that, but they may all speak Spanish but have their own accent or way they speak the language – just like we have a northern accent, a southern accent, a British accent, and English accent etc.

For example, the patient may speak Spanish but is actually from Guatemala which would make them Guatemalan. Or they may speak Spanish but be from Mexico making them a Mexican. They may speak Spanish but be from Honduras.

Now you may not know all of the right ways to pronounce every culture, but if you know that you want to talk about a patient interaction with a childbearing Somalian woman, when you are rehearsing your answers for the interview make sure you look up the proper way to describe their ethnicity.

AND OF COURSE…

The proper way to summarize and conclude any interview question is with “And that is how I provide culturally congruent care” or “And that is how I blah blah blah” so the interviewers know you are DONE with your response. “and so yeah” is not a proper conclusion.