Episode 2: Developing care skills across cultures

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Eunice: Welcome to Journeys in bilingual nursing education, the podcast where voices from cross culture and languages come together to share stories of growth, resilience and purpose. I’m your host, Eunice, a trainee at Metropolia University of Applied Sciences, and in each episode, we explore the lived experiences of nursing students navigating the unique bilingual pathway in TOKASA where Finnish and English blend into a rich journey of becoming a nurse in a multicultural world. Let’s dive in in today’s conversation. What does it mean to care cross culture, and how can bilingual nursing education prepare you for that? In this episode, we speak with Nishanie Reckermann, a third year student whose multicultural perspective enriches her role as a student nurse. Hello, Nishanie.

Nishanie: Hi, Eunice. 

Eunice: From navigating diverse patient interactions to building culturally competent care practices, we uncover the powerful connection between identity, empathy and education. Nishanie, you will share your personal experiences, challenges and triumphs in your journey to becoming a nurse in Finland. 

Nishanie: Sure. 

Eunice: So let’s dive in. Can you tell us about your cultural background and how it influences the way you approach nursing? 

Nishanie: Well, honestly, Eunice, that’s a tough question for me because I’ve lived in very different places growing up. I’m originally Sri Lankan, but I was brought up in Dubai, and I actually only lived in Sri Lanka a few years before moving to Finland. So culturally speaking, I feel like I don’t really belong to one place. I carry pieces of different cultures with me and the fast-paced international environment of Dubai and the beautiful traditions of Sri Lanka and now the openness and equality I have experienced in Finland. So I think that this background makes me more adaptable and more curious about other cultures. This helps me approach nursing with a mindset of wanting to understand where people come from without making any assumptions. 

Eunice: That’s such a meaningful perspective. Thank you for sharing that. Let’s explore that a little more. Have you encountered situations in your clinical training where culture differences have played a role?

Nishanie: Oh, yes, most definitely. I remember one situation where a patient didn’t speak Finnish nor English. And I felt an instant connection because I knew what it’s like to be in a foreign place and struggle with the language. I’m sure you understand what I mean [utters a laugh]. So I found myself paying more attention to nonverbal cues and trying to communicate in a more patient-respectful way. Also, I’ve noticed that different cultural attitudes towards things like touch, modesty or family involvement really affect care. So being sensitive to those differences is really important. But luckily for my cultural background, this helps me navigate such situations quite well. 

Eunice: It’s amazing how your background shapes the way you care. How has studying in a diverse bilingual group helped you develop culture competence? 

Nishanie: Well, it’s been the best part of my education, to be honest. So we all come from such different backgrounds and in every group project or simulation or lab or class discussion, it feels like a mini cultural exchange in a way. So it’s made me more aware of different perspectives, and it’s taught me to communicate more clearly and more respectfully, of course, across cultural and language differences that we have. I also think it’s made me more reflective about my own cultural biases and assumptions. 

Eunice: I like that you mentioned about assumptions. I mean, those are some of the things that truly resonate with me as well. Many of us make the assumption that you can just go into somebody’s culture and make a comment or something, but it’s important to have those in check, to always remember that your culture is your culture and when you come to a different culture, you need to adapt. So I like the fact that you mentioned about those assumptions, and I’m glad that you know how to navigate using those assumptions. Moving forward. In what way do you think cultural diversity among nurses benefit the health care system? 

Nishanie: Well, I think it’s such a great strength because diversity brings different ways of thinking and problem solving into the team. So when nurses have different diverse backgrounds, they can relate to a wider range of patients, especially since Finland is becoming more international and it’s now a multicultural society. So this is quite important. It also helps to break down stereotypes and encourage more inclusive patient care. So I’ve seen how having diverse voices makes conversations around care more thoughtful and more holistic. 

Eunice: Building on that thought, are there challenges you have faced being a student nurse from different culture? 

Nishanie: Oh, most definitely, Eunice. I would think that the biggest challenge is the language. I’m sure you understand what I mean.

Eunice: Definitely.

Nishanie: So even though I speak English fluently, not speaking Finnish at the beginning made my clinical placements quite intimidating. I also feel that sometimes I’m caught between cultures. So I don’t fully fit into the local Finnish culture, but I also feel distance from where I came from. Like, for example, during my hospital placements, I’ve noticed that the break rooms are unusually quiet or the discussions between nurses are very short. Now, I’m used to walking into a loud break room where people are eating together, they’re sharing stories and they’re laughing about something. It’s quite loud and it’s quite lively. So this was a bit of a culture shock for me, but it’s totally fine. And of course, there are small things like different communication styles or expectations, especially as a new nursing student in the Finnish health care system. But at the same time, these challenges have helped me grow and develop resilience. So now after two years in Finland and after various internships in many hospitals, I’ve actually learned how to make a place for myself wherever I go. 

Eunice: Thank you so much for that. I’m glad that you also mentioned about the resilience that you gain in this culture, multicultural environment. That’s something that I can relate to as well as a student in this field of nursing. I also feel it’s important to build that resilience because when you’re coming here from a different country, you have your own experiences and your own understanding of things. And then you come to this country where you have to break the barrier between the languages. And so with that, it’s very important that you maintain that resilience. That’s something that propels you to even work harder, even in this field. So I feel your experiences, I mean, a lot of students face different experiences, but your journey is unique. I’m glad…

Nishanie: Yeah, exactly.

Eunice: …that’s how you are navigating this journey, which brings us to the next point. Have patients responded differently to you than to native Finnish based on your language or culture background?

Nishanie: Well, to be honest, this hasn’t happened many times, but it has happened. Most of the time, patients are very open and curious when they hear my Finnish accent or when they learn where I’ve come from. And this is a really good icebreaker. They’re the ones who want to know my story. So I have questions like when and how and why did I move to Finland. And one person actually was so amazed to meet a Sri Lankan because apparently, they’ve only heard of Sri Lanka on TV. So it’s always nice to experience those kind of things. However, there have been moments where patients seemed hesitant or preferred to speak someone who looks Finnish or doesn’t look like me or someone who sounds more familiar to them. So I actually try not to make this personal because I am in Finland. I am not in my own country, so I cannot make this personal. What I can do is know that trust in the health care system can be deeply connected to culture and to comfort, which I respect. And honestly, this just motivates me to keep improving my Finnish, learning more about their culture and just try to connect better with patients. So that’s the best I could do. 

Eunice: I’m glad you mentioned that. Yeah, it’s something that I resonate with as well. I can give an example of one incident in my very first practice. I was just new. I mean, I’ve lived in Finland quite a bit, but then I never used the Finnish language in my previous work experience. But then when I started studying in this nursing and went for my first practice, it was very challenging that the language, because then I can’t speak the language very well, and then the patient is like, what are you saying. And then I don’t understand what he’s asking. That kind of affected how I will provide the service or patient care. So with that thought in mind, I put it upon myself that this is something that I really need to work on, and I’m really grateful for this bilingual education because over time, I’m able to actually articulate and speak to patients and be able to speak to the doctors in the language. So I am really grateful. And I don’t really put it to heart when a patient does not want to speak to me based on that, because I understand. I mean, how would you feel if somebody is not speaking to you very well when you need something, especially help.

Nishanie: Yes, of course.

Eunice: And that brings us to the next question. What do you think the Finnish nursing field can learn from the diverse student experience? 

Nishanie: Well, I think that diversity challenges us to rethink what’s normal and standard in health care. I believe that diverse students bring new ideas and challenges, assumptions and push for more culturally sensitive care. Like I mentioned, Finland is moving towards a multicultural society, and in the nursing field, I think it’s beneficial to listen to these perspectives and to make health care more inclusive for everyone. It also shows the importance of flexibility and openness in nursing education and also in practice. So, I mean, after all, no matter where someone comes from, every single person has something good to bring to the table. So I think that that’s how we should approach this. Diversity is not always bad. It’s a great thing.

Eunice: Yeah, it is. I agree with you. Diversity is great. And I’m so glad that Metropolia is always promoting inclusion and diversity in their strategic goals, as well as long life learning, which is something that I really appreciate. And even in this bilingual education, you find that this inclusiveness and the diversity aspect of it, I mean, is very prominent. So really, I appreciate that with this. What message would you share with other multicultural students entering this field?

Nishanie: Well, I would like to tell them that their background is a strength. Even if it doesn’t feel that way when you move here, your background gives you empathy, adaptability and a unique perspective, and that is really, really valuable in nursing. It’s not always easy, but I would say don’t be afraid to speak up. Share your experiences and let your identity shape the kind of nurse you want to be. Do not underestimate the power of connecting as well. You have multicultural people here, Finnish people. So I would say that go out there, meet people and create that network because network is so important. It’s such a good support system. Mostly, Eunice, I would like to tell them is to be brave. There’s a Finnish saying, I don’t know if you know it, but it’s pieni askel on askel eteenpäin. Are you familiar with that?

Eunice: No, not really. What does it mean?

Nishanie: OK, so it actually means a small step is a step forward. That has been my motto. It has really helped me to get to where I am today, both linguistically and culturally and just as a person in general. So my advice to people is to be brave and take that step forward, because honestly, every single step counts. 

Eunice: There you have it. Every step counts. So we know, I mean, in bilingual education, in the beginning, you’re so scared how this Finnish language is going to go forward, but we’ve had Nishanie’s story and she articulated it very well and shared her story of bravery and resilience, and we are truly grateful. Thank you for joining us on this episode of Journeys in bilingual nursing education. A heartfelt thanks to Nishanie for sharing her inspiring story and reminding us how bilingual education shapes not only skilled nurses, but also compassionate caregivers who bridge cultures through empathy and understanding. And thank you to you all our listeners. Thank you, Nishanie, for coming. 

Nishanie: Thank you, Eunice, for having me. It’s been really a pleasure.

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