Community health nurses play a critical role in providing culturally competent care to diverse populations. Cultural competence is an essential component of effective nursing practice, as it aims to promote the provision of equitable and high-quality healthcare to individuals from different cultural backgrounds. This essay will discuss how community health nurses can apply the strategies of cultural competence to their practice, providing an example from each of the following four strategies: cultural preservation, cultural accommodation, cultural repatterning, and cultural brokering. Additionally, a potential barrier to applying the chosen strategy/example will be identified and analyzed.
Cultural preservation is a strategy that community health nurses can employ to respect and preserve the cultural beliefs, practices, and values of individuals within a community (Leininger, 1991). It involves ensuring that cultural traditions and customs are honored and respected in healthcare encounters. An example of cultural preservation in practice is the recognition and promotion of traditional healing practices by indigenous populations. For instance, community health nurses can collaborate with traditional healers to integrate their practices into healthcare settings, offering both traditional and western medical approaches to address the healthcare needs of indigenous communities (Hartwig & Drexler, 2020). By incorporating traditional healing practices, community health nurses can enhance the cultural safety and acceptability of healthcare services for indigenous individuals, while also promoting community engagement and empowerment.
Cultural accommodation is another strategy that community health nurses can utilize to adapt healthcare practices to meet the sociocultural needs of diverse populations (Purnell, 2014). It involves modifying healthcare approaches to align with the beliefs, values, and preferences of individuals from different cultural backgrounds. An example of cultural accommodation is the provision of language and communication services for individuals with limited English proficiency. Community health nurses can ensure that interpretation services are readily available, either through trained interpreters or the use of language interpretation technology, to facilitate effective communication with patients (Office of Minority Health, 2019). This can help to bridge the language barrier, improve patient understanding of healthcare information, and promote patient engagement in their own care.
Cultural repatterning is a strategy that involves assisting individuals and communities in making changes to their cultural practices that may be detrimental to health outcomes (Leininger, 1991). It entails working with individuals to identify and alter harmful cultural behaviors and beliefs in order to improve their health and well-being. An example of cultural repatterning is the promotion of healthy dietary choices and lifestyle modifications in communities with high rates of diet-related chronic diseases. Community health nurses can collaborate with community leaders, organizations, and individuals to develop culturally relevant health promotion programs that address the specific dietary preferences and cultural norms of the targeted population (Kim et al., 2020). This approach helps to empower individuals to make informed choices about their health and encourages positive behavior change.
Finally, cultural brokering is a strategy that community health nurses can employ to facilitate effective communication and negotiation between individuals from different cultural backgrounds and the healthcare system (Purnell, 2014). It involves acting as intermediaries who bridge the cultural gap and promote understanding between healthcare providers and patients. An example of cultural brokering is the use of culturally competent care navigators or patient advocates. These individuals, who preferably share the same cultural background as the patient, can provide essential support and guidance throughout the healthcare journey, ensuring that patients understand their rights, navigate the healthcare system effectively, and receive appropriate care (Marsh, 2020). By serving as cultural brokers, community health nurses can promote trust, facilitate communication, and enhance the overall patient experience.
Despite the importance of these strategies, there can be potential barriers to their application in practice. One possible barrier to applying cultural accommodation, for instance, is the availability and accessibility of language interpretation services. In some healthcare settings, there may be a lack of trained interpreters or limited access to language interpretation technology, which can hinder effective communication and compromise patient care. This barrier may be exacerbated in resource-limited settings, where healthcare facilities may face financial constraints in providing comprehensive language services. Overcoming this barrier requires the allocation of resources to ensure sufficient language support, including training interpreters, investing in interpretation technology, and promoting the use of multilingual healthcare professionals.
To exemplify this potential barrier, a study conducted by Karliner et al. (2007) explored the impact of language barriers on healthcare access and outcomes for limited English proficient (LEP) patients in the United States. The authors found that language barriers were associated with decreased access to healthcare, poorer quality of care, increased risk of medical errors, and limited patient satisfaction. The study highlights the significant impact of language barriers on patient outcomes and emphasizes the importance of addressing this barrier in order to provide equitable and culturally competent care.
In conclusion, community health nurses can apply various strategies of cultural competence, including cultural preservation, cultural accommodation, cultural repatterning, and cultural brokering, to their practice. These strategies aim to promote equitable and high-quality healthcare for individuals from diverse cultural backgrounds. However, potential barriers, such as the availability of language interpretation services, may hinder the application of these strategies. By addressing these barriers, community health nurses can enhance their ability to provide culturally competent care and improve health outcomes for all individuals.