Contributor: Natalie J. Serrano, MSN, RN, ACUE

Reflecting on diversity and caring through the lens of our experiences reveals that these experiences are not just crucial, but transformative. They shape our unique voices and expressions within our cultures, and they have the power to inspire and motivate others. It took me time to grasp the true essence of contribution to theory and philosophy as shaped by societal constructs. Being inherently holistic, nursing allows each practitioner to bring something original and unique to the table. Recognizing this, I have chosen to discard the cloak of imposter syndrome, embracing my experience, culture, and voice to inspire those who come after me within the field.

This empowerment, rooted in cultural diversity, is a beacon of hope for single mothers and minority females, showing them that their unique experiences and perspectives are not only valid but also invaluable in the field of nursing. I have a renewed appreciation for Leininger’s theory of cultural care diversity and universality, which further fuels my passion for advocating cultural diversity in nursing.

Madeleine Leininger’s theory of culture care diversity and universality highlights the importance of embracing transformation; one must harness their unique gifts and the experiences gathered throughout life and culture. Culture comprises a group’s values, beliefs, norms, and practices, which are learned, shared, and transmitted, influencing thoughts, decisions, and actions. This approach is essential for promoting and supporting diversity and reimagining and redefining equity initiatives.

As an educator and mentor, my mission extends beyond my role as a nursing faculty member, simply teaching about how to be caring. I am dedicated to supporting all students, but especially those who identify as single mothers, minority females, and those striving to create opportunities for themselves and their families to truly express cultural-congruent care in all that they do as their contribution. Their unique experiences enrich nursing and enhance or provide alternative nursing care services to individuals from diverse or similar cultural backgrounds. My past journey as a single minority female and mother profoundly inspires and motivates me to help students provide care rooted in their cultural backgrounds and personal experiences.

The primary aim of Leininger’s theory is to identify and explain cultural diversity and universal care factors that affect individuals’ or groups’ health, well-being, illness, or mortality. It aims to utilize research findings to offer culturally congruent, safe, and meaningful care to clients from diverse or similar cultures. Reflecting on my experiences, I recognize the significance of my current position. It provides a unique opportunity to give back, understanding firsthand the challenges many students face. The power of empathy, born from shared experiences, allows me to support, guide, and encourage them towards success. This is particularly relevant for single parents and minority females pursuing nursing careers. By embracing and sharing our experiences, we foster change within the educational system, help to preserve community integrity and promote equity. These individuals care for patients within the community who may benefit from someone who understands their cultural and life experiences.

Leininger (2002b) underscores the nurse’s role not only as a mediator or intermediary but also as someone who possesses deep understanding of the client’s culture and the diverse factors that influence their needs and way of life (p. 119). This is exemplified in the interconnected circles representing nursing care, which bridge generic or folk systems with professional systems—two fundamental constructs of the Culture Care Diversity and Universality (CCDU) theory. Leininger has consistently advocated for a holistic approach to nursing care, predating the term’s popularization (Limbo, 2011). I have learned to embody this holistic perspective by becoming a living pattern, bridging gaps in understanding and facilitating culturally congruent care. I have drawn from my experiences as a first generation American female of Afro-Caribbean decent where I’ve learned firsthand the significance of cultural understanding in providing adequate care. For instance, growing up in my family’s household, I witnessed how cultural beliefs and practices shaped my family’s approach to health and wellness. I learned how to appreciate the experiences deep rooted in the members of my family giving even more meaning to one’s life and legacy. These experiences have taught me the value of incorporating cultural considerations into nursing practice, as it directly influences the well-being and outcomes of individuals or groups.

While the United States views itself as a unified nation, significant diversity exists within its population, influencing the structure and delivery of health care (Dreachslin, Gilbert, & Malone, 2013). This perspective aligns with transcultural nursing theories and the broader theory of caring. Socio-cultural factors shape individuals’ health care decisions (Lenardt et al., 2021). Therefore, understanding people’s values, beliefs, lifestyles, and life experiences is not just important, but essential for developing knowledge about nursing and health practices.

We no longer need to question why we were born into certain situations or why we possess certain characteristics and experiences. These elements drive us to create opportunities for change. When shared, the lived experience provides a path for others to overcome their circumstances, thereby enhancing diversity holistically. There is nothing as authentic and impactful as experience transformed into lived expression. Culture and social structure factors, including technology, religion, family and kinship, politics, cultural beliefs and practices, economics, physical conditions, and biological factors, play a crucial role in shaping care and influencing health and wellness patterns and overall well-being (McFarland, 2019). As healthcare professionals, it is our duty to understand and respect these factors, as they are integral to delivering quality healthcare that is culturally congruent and sensitive.

References

Dreachslin, J., Weech-Maldonado, R., Jordan, L., Gail, J., Epané, J., & Wainio, J. (2017). Blueprint for Sustainable Change in Diversity Management and Cultural Competence: Lessons From the National Center for Healthcare Leadership Diversity Demonstration Project. Journal of Healthcare Management, 62(3), 171-185. https://doi.10.1097/JHM-D-15-00029

Latif, A. S. (2020). The importance of understanding social and cultural norms in delivering quality health care – a personal experience commentary. Tropical Medicine and Infectious Disease, 5(1), 1–8. https://doi.10.3390/tropicalmed5010022

Leininger, M. (2002). Culture Care Theory: A Major Contribution to Advance Transcultural Nursing Knowledge and Practices. Journal of Transcultural Nursing, 13(3), 189–192. https://doi.10.1177/10459602013003005

Lenardt, M. H., Michel, T., Betiolli, S. E., Seima, M. D., Baran, F. D. P., & Brito, C. da S. (2021). Production of knowledge based on the Theory of Culture Care Diversity and Universality: Documental research. Revista Brasileira de Enfermagem, 74(3), 1–8. https://doi.org/10.1590/0034-7167-2020-0732

Limbo Sagar, P. (2011). Madeleine Leininger’s Theory of Culture Care Diversity and Universality. In Transcultural Nursing Theory and Models (p. Transcultural Nursing Theory and Models, 2011). United States: Springer Publishing Company, Incorporated.

McFarland, M. R., & Wehbe-Alamah, H. B. (2019). Leininger’s Theory of Culture Care Diversity and Universality: An Overview With a Historical Retrospective and a View Toward the Future. Journal of Transcultural Nursing, 30(6), 540–557. https://doi. 10.1177/1043659619867134

About Natalie J. Serrano

I am a third-year PhD student in the TWU School of Nursing PhD Program and Doctoral Research Assistant. I am dedicated to understanding the lived experiences of minorities, specifically focusing on Black (African American, Afro Caribbean, Afro-Latina) minority women. My research explores their perceptions of and experiences of trust with healthcare providers, as well as how it influences decision-making processes.

In addition to my research endeavors, I serve as a faculty member, working closely with ADN and BSN students. This role has honed my ability to operate strategically and efficiently, essential skills for executing rigorous research projects. I am involved in efforts to integrate social determinants of health into the nursing curriculum at the university level, serving on a sub-council to the committee responsible for shared governance. My leadership experience has equipped me with the knowledge needed to foster collaborative relationships among colleagues, ultimately contributing to positive research outcomes.

Outside of academia, I am actively engaged in my community, particularly in organizations dedicated to maternal and mental health. Currently, through my diverse roles, I am committed to advancing healthcare equity and promoting holistic well-being within our communities.