Question

How can community health nurses apply the strategies of cultural competence to their practice? Provide at least one example from each of the following four strategies: cultural preservation, cultural accommodation, cultural repatterning, and cultural brokering. What is a possible barrier to applying the strategy/example chosen? Use an example that is different than the postings of other students. This example should include an evidence-based article that addresses a cultural issue. Response should include an APA reference.

Answer 1

Application of Cultural Competence in Nursing:

In nursing, cultural competence involves nurses offering health care services to a culturally diverse society by recognizing and respecting the healthcare practices of others. Community health nurses need to have a sound knowledge regarding the culture of the particular community or region. This can be achieved by interacting freely with the client or patient. A brief history of the patient's background would help in this regard. Nurses can combine the scientific and cultural knowledge of the patient with the health care protocol for the speedy recovery of the patient. In this view, health practitioners should not make assumptions about the beliefs of other people, and it is important to ascertain patients' level of health knowledge and the position of men and women in society. Given that cultural competence involves interacting with patients from different cultures, it is imperative that medical practitioners practice sensitivity and proper communication in their field (Vaughan, Jacquez, & Baker, 2009).

Cultural Preservation enables the patient and family to safely incorporate part of their culture into care promoting healing and recovering (Grand Canyon University, 2015). Different patients have diverse cultural beliefs about a particular health issue. An example of these could be from the Latino America culture where the “Evil Eye” (mal de ojo) is said to be caused by admiring looks from a more powerful person and predominately affects children. To prevent from “evil eye” mothers made their child wearing a special amulet, avoid eye contact with the person who is known to have “evil eyes” or to ask this person to refrain from admiring in any way the child. Likewise, “evil eye” treatment includes prayer and direct contact with the perpetrator who will need to place his hand on the affected child’s head and other types of rituals. Nurses can allow this practice and support this believe as long as does not interfere in any way in the medical treatment. A barrier in this case could be a delay of treatment since occasionally the mother postpone seeking medical attention attributing the child symptoms and illness to this credence (Vaughan, Jacquez, & Baker, 2009). Another barrier could be stereotyping since not all Latinos believe in “evil eye”.

Cultural Accommodation is when health care providers assist or support the use of certain cultural practice or believe (Grand Canyon University, 2015). For example, some cultures request to have a faith healer coming into their hospital room to perform different rituals and ceremonies that according to them could assist in their healing and recovering process. In the Latino Americans there are different types depending on the culture, Mexicans called “Curanderos”, Puerto Ricans “Espiritistas”, Cubans “Santeros” and massage therapists are called “Sobadores”. The important factor when enabling these practices is communication and ensuring that nothing that occurs between traditional and western medication is contraindicated and would be harmful to the patient. A barrier in this case could be not to be able to facilitate this accommodation in certain health circumstances, such as patients in the intensive care unit.

Cultural Repatterning involves encouraging patients to change cultural behaviors that may be harmful for them, at the same time as considering and respecting their beliefs (Grand Canyon University, 2015). Some cultures believe that certain practices are not harmful to the wellbeing of a person or sometimes they just have a wrong perception of health (Vaughan, Jacquez, & Baker, 2009). For example, in many cultures eating well is presumed to promote good health, but this does not always equate to a well balance diet. For example, in the Cuban culture, the main dietary staple is rice, beans and pork, therefore when teaching about diabetes, heart diseases, and obesity, the exact definition of well balance diet should be discussed. Nurses, as an educator does not only should explain them the importance of modifying their dietary habits, but also should be able to provide them with healthier alternatives such as brown rice, lean meats, fish, etc., as well as the importance of meal portion always keeping in mind patient and culture preferences. A barrier in this case could be that the patient is reluctant to make changes in his dietary habits or in some cases economic situation since, as we know, many of this healthier choices are more expensive.

Cultural Brokering allows nurses to intervene and advocate for their patients, so their culture and heritage is incorporated into the plan of care. Notably, the method is mostly used to mediate between a patient and a health care system to achieve a beneficial health plan (Grand Canyon University, 2015). For example, some cultures do not believe in medicine as a remedy for sickness. In such a case, a nurse from this community is an ideal broker for reducing different positions of the two. Nurses use this strategy to mitigate resistance from dissenting cultures in the provision of health care. The possible barrier to the utilization of this strategy is the effort to identify a suitable broker from the community.

All in all, cultural competence is an important aspect of the nursing field since it guides nurses in handling patients' diversity while ensuring they provide adequate health care services. However, each competence strategy has its drawbacks (Vaughan, Jacquez, & Baker, 2009).

References:

Grand Canyon University. (2015). Tools for community health nursing practice.

Retrieved from https://lcugrad1.gcu.edu/learningPlatform/user/users.html?operation=loggedIn#/learningPlatform/

Vaughan, L. M., Jacquez, F., & Baker, R. C. (2009). Cultural health attributions, belief and practices: effects on healthcare and medical education. The Open Medical Education Journal, 2, 64-74.

Retrieved from http://benthamopen.com/contents/pdf/TOMEDEDUJ/TOMEDEDUJ-2-64.pdf