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Q: I am a clinical nurse working with newly arrived international nursing students who speak English as a second language. I am looking for information on how culture shock may affect newcomers. What do I need to know?

Response

Culture shock is real and may affect newcomers differently. It is the anxiety associated with moving to a new environment. Four stages of culture shock have been identified as: incubation stage, culture shock stage, integration stage, and acceptance stage. Common manifestations include: lack of direction, the feeling of not knowing what to do or how to do things in a new environment, and not knowing what is appropriate or inappropriate. Culture shock is a great opportunity for learning and acquiring new perspectives. It can provide one with a better understanding of oneself and stimulate personal creativity. Failure to acknowledge and accommodate culture shock can lead to high levels of stress and even culture clash. The Centre for addictions and mental health has published a resource “Alone in Canada” that maybe of use for newcomers to Canada.

What is it?

Culture shock may arise when people travel or move to different regions or countries. People move to different countries for many reasons including family reunion, business, political reasons, or for fear of religious or political persecution. Stewart & Leggat (1998) studied culture shock and travelers. They noted that wherever people go and for whatever reason they go, people take their culture with them. This is because culture, like language, is acquired innately in early childhood and is then reinforced through formal and complex informal social education into adulthood. Culture provides a framework for interpersonal and social interactions.

There are different schools of thought on the definition of culture shock. Regardless of the difference, most definitions emphasize the fact that culture shock involves human and environment factors. Arthur (1996) defines culture shock as “an experience that may occur in all spheres of life in which individuals are confronted by world views and life styles that differ from their own whether in terms of health, education or occupation amongst others”. This definition looks at culture shock as something that can occur locally or within a national territory, and places little emphasis on the new environment. A more descriptive explanation of culture shock is that of the Anthropologist Oberg (1960): “It is the shock of the new. It implies that the experience of the new culture is an unpleasant surprise or shock, partly because it is unexpected and partly because it can lead to a negative evaluation of one’s own culture”. Therefore, culture shock results when contact with a new culture is not the exciting or pleasurable experience anticipated. Phrases such as cross cultural adjustment are often in the literature, which refer to that period of anxiety and confusion experienced when entering a new culture.

Manifestations of Culture Shock

Culture shock affects both adults and children. Common manifestations include: lack of direction, the feeling of not knowing what to do or how to do things in a new environment, and not knowing what is appropriate or inappropriate. With culture shock, people tend to suffer alone, thinking that they are the only ones not coping well with their new circumstance. This is enhanced by the fact that when immersed in a different culture, people no longer know how to act when faced with disparate value systems. Everything is different in a new culture, for example, language, not knowing how to use banking machines or the telephone, finding a family doctor, dentist and so forth. The feeling of culture shock generally sets in after the first few weeks of coming to a new place.

Symptoms of culture shock include:
Sadness, loneliness, melancholy, longing for family
Preoccupation with health
Aches, pains, and allergies
Insomnia, desire to sleep too much or too little
Changes in temperament, depression, feeling vulnerable, feeling powerless
Anger, irritability, resentment, unwillingness to interact with others
Identifying with the old culture or idealizing the old country
Loss of identity
Trying too hard to absorb everything in the new culture or country
Unable to solve simple problems, Lack of confidence
Feelings of insecurity or inadequacy
Developing obsessions stereotypes about the new culture
Developing obsessions such as over-cleanliness
Feelings of being lost, overlooked, exploited or abused

These symptoms can appear at different times, and may manifest differently depending on the individual.

Stages of Culture Shock

Newcomers usually go through four stages of culture shock. Each stage can be ongoing or appear only at certain times.

1. Incubation Stage

Here, newcomers are excited about their new lives. Everything is wonderful and they are having a great time learning about their environment. This time is also called euphoric or “honeymoon” stage, as everything encountered is new and exciting.

2. Culture Shock Stage.

In the culture shock stage, the newcomer may start to encounter some difficult times and crisis in daily life. The differences between the new and the native cultures become more apparent. Communication difficulties may occur such as not being understood, differences in pronunciations, and accent. Some persons tend to be shy and may limit their participation in a group conversation. Students feel overwhelmed at this stage as they are unfamiliar with their new surroundings, unreadable social signals, and new sounds. In a healthcare settings new workers may be unfamiliar with codes, technology and equipment use, overhead paging, fast pace of work etc. In this stage, there may be feelings of discontent, impatience, anger, sadness, incompetence. Transition between the old methods and those of the new country is a difficult process and takes time to complete. Newcomers in this stage of culture shock need time and patience from their supervisors.

3. Integration Stage.

This stage is characterized by gaining some understanding of the new culture. The newcomer learns to integrate their own beliefs with those of the new culture, replacing old values with new ones. At the same time, others will begin to find ways to exist with both cultures. An individual may no longer feel lost and start to develop a sense of direction; this is a sign of psychological balance. It is at this stage that most migrant parents start to become alarmed as they do not want their children to lose their language and culture.

4. Acceptance Stage.

During the acceptance stage, the newcomer is able to identify good and bad things from the new culture. Depending on the number of cultures that the person has to process, this stage can be one of double or triple integration accompanied by a feeling of belonging. Healthcare workers have adjusted to the pace of work and are comfortable with certain procedures and technology at this stage. In general, people accept their own culture and the new culture and combine them both into their lives. In the case of students, some will adopt the mainstream culture at school and follow the values of the home culture outside of school. During this stage many immigrant parents make it clear to their children that they do not want them to adopt the mainstream culture. Conflicts may arise between child and parent.

When a newcomer returns to their own culture after a period of time abroad, they have to readjust. This readjustment to own culture has been termed “reverse culture shock” or “re-entry shock” (5th stage of culture shock).

Tackling Culture Shock

The majority of newcomers from other countries have the ability to positively confront the nuances associated with a new environment. This ability may depend on an individuals’ knowledge of languages, ethnicity, religion, gender, age, social class, education. The following are suggested ways to combat stress as a result of culture shock:

• Be alert, remember there are resources that you can use.

• Don’t try too hard, do what is right and not what pleases people.

• Relaxation and meditation can help you recover from stress.

• Maintain contact with your ethnic group. It will give you a feeling of belonging and reduce feelings of loneliness and alienation.

• Recognize the sorrow of leaving your home country, accept your new country and focus on getting through the transition.

• Pay attention to relationships with family and at work. They will help you at difficult times.

• Set simple goals for yourself and evaluate progress over time.

• Find ways to live and work with the things you don’t fully agree.

• Maintain confidence in yourself, develop a power of positive thinking.

• Include a regular form of physical activity in your routine (exercise, play).

• If the situation persists, look for help (consult a psychologist, counsellor).

Conclusion

Culture shock is a great opportunity for learning and acquiring new perspectives. It can help develop a better understanding of oneself and stimulate personal creativity. Failure to acknowledge and accommodate culture shock can lead to high levels of stress and even culture clash. In the workplace, when cultures clash, regardless of the cause, things inevitably evolve into a ‘them’ and ‘us’ environment. What happens next is people go around collecting ‘evidence’ to prove that they are right and the others are wrong. A good place to start is identifying and concentrating on improved communication, followed by mutual respect, co-operation, and a shared vision.

Bibliography

1. Arthur, M.L (1996). The implications of culture shock for health educators: reflections with Barer-Stein. Curationis, 19(4):47-51

2. Mumford, D.B (1998). The measurement of culture shock. Social Psychiatry and Epidemiology, 33(4):149-154

3. Stewart, L.; Leggat, P.A (1998). Culture shock and travellers. Journal of travel Medicine, 5(2):84-88

4. Judie, H. How culture shock affects new comers. Retrieved Monday May 14, 2007 from http://www.everythingesl.net/inservices/cultureshock.php

5. Camen, G. (1998). Culture shock. Retrieved Monday May 14, 2007 from http://edweb.sdsu.edu/people/CGuanipa/cultshok.htm

6. Oberg, K (1960). Culture shock & the problem of adjusting to new cultural environments. Retrieved Monday May 14, 2007 from http://www.worldwide.edu/travel_planner/culture_shock.html (link no longer available)




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Diversity and Alberta Health Services Home Diversity Competency Resources Publications Demographics Programs & Services Health Info. for Diverse Populations Community Partners Contact Us	Diversity and Alberta Health Services Diversity Resources Diversity FAQ'S On-line Diversity Competency Self-Assessments \| Diversity FAQ's \| Diversity Library \| Diversity Definitions \| Health and Diverse Populations \| Research & Publications Q: I am a clinical nurse working with newly arrived international nursing students who speak English as a second language. I am looking for information on how culture shock may affect newcomers. What do I need to know? Response Culture shock is real and may affect newcomers differently. It is the anxiety associated with moving to a new environment. Four stages of culture shock have been identified as: incubation stage, culture shock stage, integration stage, and acceptance stage. Common manifestations include: lack of direction, the feeling of not knowing what to do or how to do things in a new environment, and not knowing what is appropriate or inappropriate. Culture shock is a great opportunity for learning and acquiring new perspectives. It can provide one with a better understanding of oneself and stimulate personal creativity. Failure to acknowledge and accommodate culture shock can lead to high levels of stress and even culture clash. The Centre for addictions and mental health has published a resource “Alone in Canada” that maybe of use for newcomers to Canada. What is it? Culture shock may arise when people travel or move to different regions or countries. People move to different countries for many reasons including family reunion, business, political reasons, or for fear of religious or political persecution. Stewart & Leggat (1998) studied culture shock and travelers. They noted that wherever people go and for whatever reason they go, people take their culture with them. This is because culture, like language, is acquired innately in early childhood and is then reinforced through formal and complex informal social education into adulthood. Culture provides a framework for interpersonal and social interactions. There are different schools of thought on the definition of culture shock. Regardless of the difference, most definitions emphasize the fact that culture shock involves human and environment factors. Arthur (1996) defines culture shock as “an experience that may occur in all spheres of life in which individuals are confronted by world views and life styles that differ from their own whether in terms of health, education or occupation amongst others”. This definition looks at culture shock as something that can occur locally or within a national territory, and places little emphasis on the new environment. A more descriptive explanation of culture shock is that of the Anthropologist Oberg (1960): “It is the shock of the new. It implies that the experience of the new culture is an unpleasant surprise or shock, partly because it is unexpected and partly because it can lead to a negative evaluation of one’s own culture”. Therefore, culture shock results when contact with a new culture is not the exciting or pleasurable experience anticipated. Phrases such as cross cultural adjustment are often in the literature, which refer to that period of anxiety and confusion experienced when entering a new culture. Manifestations of Culture Shock Culture shock affects both adults and children. Common manifestations include: lack of direction, the feeling of not knowing what to do or how to do things in a new environment, and not knowing what is appropriate or inappropriate. With culture shock, people tend to suffer alone, thinking that they are the only ones not coping well with their new circumstance. This is enhanced by the fact that when immersed in a different culture, people no longer know how to act when faced with disparate value systems. Everything is different in a new culture, for example, language, not knowing how to use banking machines or the telephone, finding a family doctor, dentist and so forth. The feeling of culture shock generally sets in after the first few weeks of coming to a new place. Symptoms of culture shock include: Sadness, loneliness, melancholy, longing for family Preoccupation with health Aches, pains, and allergies Insomnia, desire to sleep too much or too little Changes in temperament, depression, feeling vulnerable, feeling powerless Anger, irritability, resentment, unwillingness to interact with others Identifying with the old culture or idealizing the old country Loss of identity Trying too hard to absorb everything in the new culture or country Unable to solve simple problems, Lack of confidence Feelings of insecurity or inadequacy Developing obsessions stereotypes about the new culture Developing obsessions such as over-cleanliness Feelings of being lost, overlooked, exploited or abused These symptoms can appear at different times, and may manifest differently depending on the individual. Stages of Culture Shock Newcomers usually go through four stages of culture shock. Each stage can be ongoing or appear only at certain times. 1. Incubation Stage Here, newcomers are excited about their new lives. Everything is wonderful and they are having a great time learning about their environment. This time is also called euphoric or “honeymoon” stage, as everything encountered is new and exciting. 2. Culture Shock Stage. In the culture shock stage, the newcomer may start to encounter some difficult times and crisis in daily life. The differences between the new and the native cultures become more apparent. Communication difficulties may occur such as not being understood, differences in pronunciations, and accent. Some persons tend to be shy and may limit their participation in a group conversation. Students feel overwhelmed at this stage as they are unfamiliar with their new surroundings, unreadable social signals, and new sounds. In a healthcare settings new workers may be unfamiliar with codes, technology and equipment use, overhead paging, fast pace of work etc. In this stage, there may be feelings of discontent, impatience, anger, sadness, incompetence. Transition between the old methods and those of the new country is a difficult process and takes time to complete. Newcomers in this stage of culture shock need time and patience from their supervisors. 3. Integration Stage. This stage is characterized by gaining some understanding of the new culture. The newcomer learns to integrate their own beliefs with those of the new culture, replacing old values with new ones. At the same time, others will begin to find ways to exist with both cultures. An individual may no longer feel lost and start to develop a sense of direction; this is a sign of psychological balance. It is at this stage that most migrant parents start to become alarmed as they do not want their children to lose their language and culture. 4. Acceptance Stage. During the acceptance stage, the newcomer is able to identify good and bad things from the new culture. Depending on the number of cultures that the person has to process, this stage can be one of double or triple integration accompanied by a feeling of belonging. Healthcare workers have adjusted to the pace of work and are comfortable with certain procedures and technology at this stage. In general, people accept their own culture and the new culture and combine them both into their lives. In the case of students, some will adopt the mainstream culture at school and follow the values of the home culture outside of school. During this stage many immigrant parents make it clear to their children that they do not want them to adopt the mainstream culture. Conflicts may arise between child and parent. When a newcomer returns to their own culture after a period of time abroad, they have to readjust. This readjustment to own culture has been termed “reverse culture shock” or “re-entry shock” (5th stage of culture shock). Tackling Culture Shock The majority of newcomers from other countries have the ability to positively confront the nuances associated with a new environment. This ability may depend on an individuals’ knowledge of languages, ethnicity, religion, gender, age, social class, education. The following are suggested ways to combat stress as a result of culture shock: • Be alert, remember there are resources that you can use. • Don’t try too hard, do what is right and not what pleases people. • Relaxation and meditation can help you recover from stress. • Maintain contact with your ethnic group. It will give you a feeling of belonging and reduce feelings of loneliness and alienation. • Recognize the sorrow of leaving your home country, accept your new country and focus on getting through the transition. • Pay attention to relationships with family and at work. They will help you at difficult times. • Set simple goals for yourself and evaluate progress over time. • Find ways to live and work with the things you don’t fully agree. • Maintain confidence in yourself, develop a power of positive thinking. • Include a regular form of physical activity in your routine (exercise, play). • If the situation persists, look for help (consult a psychologist, counsellor). Conclusion Culture shock is a great opportunity for learning and acquiring new perspectives. It can help develop a better understanding of oneself and stimulate personal creativity. Failure to acknowledge and accommodate culture shock can lead to high levels of stress and even culture clash. In the workplace, when cultures clash, regardless of the cause, things inevitably evolve into a ‘them’ and ‘us’ environment. What happens next is people go around collecting ‘evidence’ to prove that they are right and the others are wrong. A good place to start is identifying and concentrating on improved communication, followed by mutual respect, co-operation, and a shared vision. Bibliography 1. Arthur, M.L (1996). The implications of culture shock for health educators: reflections with Barer-Stein. Curationis, 19(4):47-51 2. Mumford, D.B (1998). The measurement of culture shock. Social Psychiatry and Epidemiology, 33(4):149-154 3. Stewart, L.; Leggat, P.A (1998). Culture shock and travellers. Journal of travel Medicine, 5(2):84-88 4. Judie, H. How culture shock affects new comers. Retrieved Monday May 14, 2007 from http://www.everythingesl.net/inservices/cultureshock.php 5. Camen, G. (1998). Culture shock. Retrieved Monday May 14, 2007 from http://edweb.sdsu.edu/people/CGuanipa/cultshok.htm 6. Oberg, K (1960). Culture shock & the problem of adjusting to new cultural environments. Retrieved Monday May 14, 2007 from http://www.worldwide.edu/travel_planner/culture_shock.html (link no longer available)
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