Abstract

Hospitals are not closed structures; they are affected by powerful outside social forces. In these high-pressure environments constrained by time and resources, staff draw on a range of discourses such as “treating people the same,” seeing difference in a negative way as well as essentialising when working within unpredictable cross-cultural situations. This paper explores the impact of dominant values in society, systemic constraints, organisational and professional cultures and individual factors on how staff at a children’s hospital in Sydney, Australia work with children and their families from culturally and linguistically diverse backgrounds. The practices that doctors and nurses use in caring for families demonstrate the effect of the professional cultures of biomedicine and liberalism which encourage staff to treat all families the same, or in an individualised way. The staff tried to accommodate cultural differences if, and when, they became apparent but were often reliant on social workers. This paper highlights the implications of current policies which require staff to be sensitive to the cultural backgrounds of patients (and their families) and demonstrates how staff need a range of skills to effectively negotiate culturally sensitive care.