Challenging old notions of professionalism: how can nurses work with paraprofessional ethnic health workers?

Despite a recognition that health care systems in western countries need to become more responsive to their culturally diverse populations, health professionals have been slow to change their dominant monocultural work practices. Paraprofessional ethnic health workers have been employed in Australia to increase the access of non-English-speaking background communities to health services; however, they have generally not been able to form effective teamwork relationships with health professionals. Research into the use of ethnic health workers is explored to propose changes in the way that professional nurses practise alongside these workers. Concepts within professionalism and within a primary health care approach are considered against a framework of cultural differences between nurses and non-English-speaking background clients. It is unrealistic that nurses should expect to attain the cultural knowledge required to provide total care to all their clients in a diverse society, without a partnership with cultural intermediaries. Such an expectation is likely to produce lists of cultural traits that stereotype ethnic clients, rather than lead to an understanding of each client's individual needs. More effective teamwork between professional nurses and paraprofessional ethnic health workers is proposed so that together they can ensure health care is delivered in ways that are flexible and responsive to cultural differences.