Joint Commission Releases Revised Restraints Standards for Behavioral Healthcare--The Role of Culture

The Joint Commission released new standards in behavioral care in May that will go into effect January 1, 2009. Now, I don't need to go into the details of the new standards, but I did want to highlight one particular piece that was intriguing from a culturally competent care perspective.

The standard includes (paraphrased):
staff must demonstrate an understanding of the factors that influence behavior and may result in the need for restraints and seclusion.

What was intriguing is that many behavioral factors as we know are related to culture. For example, in my work with hospitals a client once told me that there was situation where a young 36 year old man was told that he had cancer and it was aggressive and then basically left there without the care of someone who would communicate with him. He was black and in a predominantly white staffed hospital facility. Upon being told he began to talk very loud and forcefully and demand some answers. His escalating tone and demands prompted the care staff to call security who immediately called the police. He was put into restraints which made him become more irate.

Later a black nurse came to him (after being requested) and he explained that he was scared, felt all alone, and no one was answering any of his questions. The less they responded, the angrier he became. He was released from the restraints almost immediately after the black nurse arrived and began to get his questioned answered.

Culture and behavior go hand in hand. If your cultural competency and cross-cultural communication skills are on par to where you want them to be this new standard the Joint Commission is putting into effect will be taken care of in the course of how your organization operates each and every day. Patient-centeredness and this new standard are very much in alignment; as such there is no patient-centeredness without cultural competence.

If you want to learn more about tools for Cross-Cultural Communication, email me at amrijohnson@gmail.com.