Community health nurses

How can community health nurses apply the strategies of cultural competence to their practice? A nurse can be a part of helping a patient’s cultural preservation in their practice. For example, some people in the Jamaican culture hold nine-day wakes for deceased persons. The wake is a time for respecting and honoring the departed soul. For nine nights, relatives and friends share food and sing hymns, thus saying goodbye to the departed one (). A nurse can advocate for a patient from Jamaican cultural by coordinating with the hospice facility a way for the wake to take place as the Jamaican culture sees fit.

A nurse can also apple cultural accommodation into their practice. For example, in Jamaican cultures herbal medicines are popular, and herbal medicine practitioners and balmists, who practice bush medicine, provide treatment for a wide range of ailments.

A nurse can advocate for cultural accommodation by working with the health care team to accommodate the use of herbal medicine preferences.

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Health care team members a nurse can involve with this cultural accommodation may include the Physician, pharmacist, or nutritionist. A nurse can also also apply cultural repatterning into their practice. For example, Jamaica's most popular dish is jerk, a term that describes the process of cooking meats smothered in tongue-searing marinade, and barbecued slowly in an outdoor pit over a fire of pimento wood, which gives the meat its distinctive flavor. Unfortunately, jerk contains high levels of salt and sodium. If a patient has health issues that include congestive heart failure or hypertension, they may need to be on a low sodium diet.

A nurse can help with cultural repatterning by teaching the client how to reduce the salt or sodium in their diet, but at the same time maintaining their cultural food preferences.

A nurse can provide recipes for jerk with less salt, or work with a nutritionist to tweak the client’s recipes to maintain cultural flavors but lower the sodium content. A nurse can also take part in cultural brokering in their practice. For example, Christianity is the religion that the majority of Jamaican’s practice. Jamaica is known to have the most churches per square mile than any other country ( ). A nurse can intervene for a Jamaican client to ensure they receive culturally appropriate care by working with the health care facility to coordinate care to allow for a Christian minister to come visit with the Jamaican patient and their family.

Barriers to applying cultural preservation, accommodation, repatterning, and brokering include time, money, and health risk factors. The health care facility may not have the means/money to allow for the tradition Jamaican wake for a deceased family member. The use of traditional herbs may be a risk to health if they interact with medications the patient is taking. A visit by a Christian minister may interfere with scheduled care such as diagnostic testing or no visitation/rest time. A nurse is responsible for respecting and maintaining a patients cultural preferences as much as possible. They must advocate for a patient’s cultural desires when possible. Cultural Brokering

Cultural brokering means to intervene for clients to ensure that they receive culturally appropriate care within the Western health care system. The nurse understands the client's values and the system's values, and can therefore advocate, mediate, or negotiate for the client (Stanhope & Lancaster, 2008). When any of these actions are practiced with the intent to advocate, stand up for, support, intervene, or negotiate for the culture of the individual, families, aggregates, or community, then cultural brokering is being carried out.

Health Education

Provide at least one example from each of the following four strategies: cultural preservation,
cultural accommodation,
cultural repatterning
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.

Jamaicans use fruits and vegetables for their healing properties. Papaya helps relieve indigestion, while guava leaves treat diarrhea, and tamarind soothes itchy skin and chicken pox. Herbal medicines are popular, and herbal medicine practitioners and balmists, who practice bush medicine, provide treatment for a wide range of ailments. Herbs are administered as an infusion (tea), a poultice or bath. A popular treatment is bush tea, which can contain many ingredients such as lemon, fever grass, sour sop, breadfruit leaves and pepper elder.