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For this paper, the discussion will focus on the distinctive barriers nurses encounter while in the process of initiating effective communication with cancer in-patients in Singapore. The research has concentrated on Singapore cancer patients because the country is a developing nation and thus, will provide a formidable environment for Registered Nurses to learn the way cultural competence is exercised with such a fast rising nation. Additionally, the research has focused on Singapore because of its fairly-known indifferent society composition that lack respect for nurses, which is deemed to be a result of the government contribution through the Singapore’s “user-pays” healthcare system and a substantial number of lowly-paid nurses. Following this line of reasoning, the research’s decision to embark on Singapore will provide insightful information on how nurses, in Singapore, are able to survive and initiate professional communication skills despite of the aforementioned challenges.

Cultural competence, in its entirety, is paramount within the nursing profession since it allows individual nurses to acquire skills and resourceful knowledge and attitudes, which is useful in the course of providing care to different members of the society while paying attention to their respective cultural differences (Bearskin, 2011). Most notably, cultural competence amongst nurses allows for a heightened understanding of oneself and others within the larger society. Thus, such attributes as cultural awareness, cultural skills, cultural encounters and desire are incorporated within in order to facilitate effective levels between nurses and patients at any given environment. Consequently, the end result of exercising cultural competence should lead to adoption of congruent attitudes and behaviors as well as formulation of policies to enable nurses combine efforts for the purpose of working effectively in a set of cross-cultural environment. However, it should be noted that cultural competency does not require such healthcare professionals as nurses to understand everything about other people’s culture or retrospectively, abandon their cultural identity. It basically transpires to respecting wide differences and thus, being in a position to appreciate the fact that there are many ways of perceiving the world at large (Sainio & Eriksson, 2003).

Summary of Article

According to Li, Ang &Hegney (2011) effective communication is a two-way process that allows for both sending and receiving the right content of a message in order to facilitate positive comprehension by each of the parties involved. In Singapore, the level of cancer patients increased to 29.3% of overall deaths in 2008 and thus, the need for adequate nurses with higher levels of professional communication skills and sensitivity touches. Effective levels of communication are considered fundamental in oncology nursing since it allows for immediate identification of a patient’s psychosocial needs. It also improves on their therapeutic nurses-patient forms of relationships and also, it facilitates a positive perception of quality care provision amongst patients (Li, Ang & Hegney, 2011).

Accordingly, the article argues that provision of psychosocial care to cancer patients is, in most cases, associated with monotony and compassion fatigue among the oncology-based healthcare professionals, which can facilitate less effective models of communication and inefficient duty performances. The article ascertains that a patient’s cultural background, within Singapore healthcare setting, is able to influence to whom they want to communicate with and the manner for which information is to be availed to them. On the contrary, the cultural taboo amongst these patients allows inhabitation of effective communication since patients often discuss their emotions with family members rather than their nurses (Li, Ang & Hegney, 2011).

The article articulates the different levels of effective communication by analyzing the differences in social, economic and culture amongst the Asiatic populations present in Singapore. The study, which was conducted to determine the perception of oncology nurses towards their patients, revealed a substantial level of facts. First, it was ascertained that the patients, in their end-stage palliative, were reluctant to engage in resourceful communication despite intense efforts by nurses to offer comfort (Li, Ang & Hegney, 2011). Ostensibly, they depicted a lack of respect to nurses. It was noted with substantial evidence that these patients devalued nurses since they believed that doctors were the only ones with sufficient knowledge capacities to handle their situation.

The patients depicted divergent reactions to different situations as more expressed anger on nurses due to a number of reasons. It was found out that most of them obtained attention inappropriately while others expected way too much from nurses barely because they had paid substantially for their hospitalization (Li, Ang & Hegney, 2011).

On the contrary, nurses were afraid to pass most of information especially unfavorable information pertaining to the conditions of the patients. This inhibited the level of communication. Subsequently, female nurses were not allowed to discuss sexuality matters with their male patients. This was hugely attributed to the conservative Asiatic culture.  Thus, nurses within Singapore healthcare facilities should be impacted with knowledge to understand that the Asiatic culture does not allow patient to define their present state (Li, Ang & Hegney, 2011).

Application to Practice

Intense research is, therefore, apparent for individual nurses to devise ways of passing information about their health. In respect to religion, the nurses should be made to understand that death is defined differently depending with the cross-religions present. Another thing for nurses to note rests with their abilities to learn and speak some of the local languages in Singapore. It was noted that some of the patients admitted were not well-conversant with English and this passed as a challenge to the nurses especially the expatriate nurses. Significantly, it was noted that nursing support management should devise policies that was to discourage negative consumer orientations in perceiving healthcare as any other business (Sainio & Eriksson, 2003).

Embodiment is an element that can be fairly deployed to expound on culture sensitivity amongst patients from cross-cultural settings.

This element integrates both the object body and lived body thereby allowing patients a feeling of emotions of equal weight to their respective symptoms. It ascertains to the fact that both objective and subjective knowledge should be deployed within a healthcare setting despite of cultural differences and diversities (Kurtz, 2002).

This means that nurses should be, at all times, ready to comfort and teach patients about the situation at hand. Also, the engagement can be employed in such cultural sensitive situations so that both the patient and the nurses are able to come to a consensus and thus, have a meaningful comprehension of each other’s plight and experiences (Gray & Thomas, 2005). For this case, nurses are encouraged to exercising sharing of the patient’s burden by maintaining vulnerability to their sufferings. This is well known as exercising practical wisdom. Mutual respect should also be encouraged between these two parties so that patients can allow nurses conduct their duties with due diligence.

From the discussion above, it can be ascertained that cultural sensitivity is important because it fosters effective levels of communication between nurses and patients. The multi-diversified cultures in Singapore exercise indifferent levels of communication while limiting others that are considered a taboo. For instance, sexuality matters are never discussed with female nurses. Thus, it is important that nurses devise their own ways of initiating communication platforms in order to exercise their duties diligently. The capacity to learn and speak a given dialect fairly well is encouraged amongst nurses in order to prevent communication barriers. 


  1. Bearskin, L, B. (2011). A critical lens on culture in nursing practice, Nursing Ethics Journal, 18(4), 548-559
  2. Gray P and Thomas D. (2005). Critical reflections on culture in nursing. J Cult Divers, 13(2): 76–82
  3. Kurtz S.M. (2002). Doctor–patient communication: principles and practices, Canadian Journal of Neurological Sciences, 29(2), 23–29
  4. Li, H, T., Ang, E & Hegney, D. (2011). Nurses perceptions of the barriers in effective communication with inpatient cancer adults in Singapore, Journal of Clinical Nursing, 21, 2647-2658
  5. Sainio, C & Eriksson, E (2003). Keeping cancer patients informed: a challenge for nursing. European Journal of Oncology Nursing 7, 39–49

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