The nurse is taking care of a client from a culture different from the nurse's culture. How might the nurse best provide culturally competent care?

Boarding refers to the practice of holding patients in the emergency department (ED) for extended periods, often beyond the recommended timeframe, due to a lack of available mental health treatment options or appropriate placement. In this scenario, the nurse is notifying the manager about the presence of clients with mental health disorders who have been in the ED for more than 48 hours. This situation suggests that the hospital is likely practicing boarding for these clients.

Boarding of mental health patients in the ED can have significant negative consequences. It can contribute to overcrowding in the ED, leading to delays in care for other patients. It can also compromise the quality of care and exacerbate the distress and discomfort experienced by individuals with mental health disorders. Additionally, it is not an optimal environment for mental health treatment and recovery.

By discussing the issue of boarding with the manager, the nurse is addressing the need for timely and appropriate placement for clients with mental health disorders. This conversation may involve exploring solutions such as improving access to mental health services, establishing dedicated mental health units or crisis stabilization centers, and collaborating with community resources to ensure a smooth transition of care for these clients.

The other options mentioned are not directly related to the issue of clients with mental health disorders being present in the ED for over 48 hours:

● Temporary detaining orders for clients: This refers to legal mechanisms that allow for the temporary detention of individuals with mental health disorders who may pose a risk to themselves or others. While it may be related to the care of these clients, it does not address the issue of prolonged stays in the ED.

● The revolving door for clients: This concept refers to the frequent readmission or return of clients to the ED or hospital due to ongoing mental health issues. While it is a concern in mental health care, it does not specifically pertain to the issue of clients remaining in the ED for an extended period.

● The cost of holding clients in the ED for over 48 hours: While the cost implications of extended stays in the ED are relevant, the primary concern in this scenario is the quality of care, appropriate placement, and the impact on both the clients and the ED's functioning.

Culturally competent care involves understanding and respecting the diverse cultural backgrounds of clients. It requires the nurse to acquire knowledge about the client's specific culture and how it influences their healthcare preferences and practices. By taking the time to learn about the client's cultural background, the nurse can better understand their unique needs, beliefs, and values related to health and healthcare.

While continuing education and gaining knowledge about different cultures are important aspects of providing culturally competent care, it is essential to go beyond generalized expectations about cultural groups. Each individual within a culture can have unique beliefs and preferences, so it is crucial to approach each client as an individual rather than relying solely on broad cultural stereotypes.

Behaving as appropriate for the nurse's own culture may lead to misunderstandings or misinterpretations of the client's needs and preferences. It is important for the nurse to be aware of their own cultural biases and to approach care in a culturally sensitive and respectful manner.

Therefore, the best approach for the nurse to provide culturally competent care is to find out as much as possible about the client's specific cultural values, beliefs, and health practices. This

knowledge can guide the nurse in tailoring care that is respectful, responsive, and appropriate for the client's cultural background.