Nursing Paper on Purnell Model for Cultural Competence

Purnell Model for Cultural Competence

In the current multicultural society, there is a need for health care centers to stress the importance of diversity. Furthermore, cultural sensitivity is crucial in meeting all the needs of the clients. This is the reason why the current health care system stresses the importance of culturally sensitivity teamwork and competent care in order to improve the ways in which services are offered to the client. It is predicted that diversity will remain the same in the future as the world continues to become globally connected. The health care providers, therefore, will  need to become more culturally competent in their practice. In the year 1995, the Purnell Model for Cultural Competence, applicable to the health care system, was established (Purnell, 2000). Several cross-cultural and trans-cultural models fall under the Purnell model, some of which are related to workforce issues while others to bio-cultural ecology. The aim of this paper is to describe the 12 domains of the organizational framework in the health care industry and explain the role that each of the domains plays in the health care diversity. The ways in which the models can be applied in the work environment where there are different cultures that require the health care providers to be more culturally competent, will be described.

The Purnell Model for Cultural Competence was established as an organizing framework that would enable nurses  to utilize clinical assessment tools (Purnell & Faan, 2002). At the same time, meta-paradigm concepts together with cultural competence scales were also added in the framework. In this regard, the model became schematic which was then combined with the organizing framework making it relevant to all health care disciplines within a practical set-up. Some nurses classified the model as holographic and linked it to complexity theory. In order for a health care provider to be classified as culturally competent, she or he must be aware of their existence, environment, sensations, and thoughts, without allowing these factors to have any effect on the kind of care that they provide. Cultural competence in this case is the manner in which an organization adapts to care in a way that is consistent with the client’s culture, leading to a conscious process that is nonlinear (Josepha, 2002).

The 12 domains of cultural competence include heritage, which in this case comprise of the client’s country of origin or their current residential place which affects their belief in the ways in which healthcare should be provided. The second is communication, which comprises the dominant language that a person uses. This can comprise of the tone, intonations, shared thoughts or the feelings of the patient, which can affect the ways in which a patient and health care provider understand each other. The third model is family roles, which comprise of gender roles and households that affects the lifestyle of the client in either a positive or a negative way. The fourth model is workforce issues, comprising  assimilation, individualism, ethnic communication styles and the gender roles that affect the ways in which a healthcare provider contributes towards the organizational goals. The fifth model is bio-cultural ecology such as skin coloration, ethnic and racial origins that some people use to judge others, based on their level of competence in the workplace (Purnell & Faan, 2002).

The sixth model is high-risk behaviors that comprises the use of recreational drugs, not using safety measures and lack of physical activity factors, which reduces the level of competence within a cultural environment (Purnell & Faan, 2002). The seventh model is nutrition, which includes enough food choices, taboos, or rituals that may prevent a patient from acquiring sufficient healthcare. The eighth model is pregnancy and practices of childbearing that includes use of birth control and fertility practices, which may restrict an individual from achieving sufficient care. The ninth model is death rituals that comprises the manner in which an individual behaves while in grief or their burial practices. Health care providers need to respect these rituals to remain competent in the work place.

Spirituality is the tenth model and it involves incorporation of religious practices in the work place. For instance, Muslims have a certain period and time of prayer, it is important for the healthcare providers to respect their faith and allow them to practice their faith at all times. The eleventh model is health care practice, which comprises  the medical beliefs and health care responsibilities of the healthcare provider that may affect the ways in which they view other cultural healthcare practices. The twelfth model is health care practitioners that comprise the health care providers and their significance in the delivery of health care services to the public, in particular, individuals from various cultures.

The Purnell Model for Cultural Competence can be applied in health care when a person is working with a patient from a different culture by understanding that all people are different and their behaviors are determined by their cultural, religious, ethnic, racial, educational, and personal beliefs. In order to remain culturally competent as a health care provider, one needs to learn the ways in which the patient or workmate is behaving and try to understand the reasons behind their behavior. This will make it easier to cooperate with them, leading to quality delivery of services.

In conclusion, cultural competence is an essential part of today’s health care system. The Purnell Model for Cultural Competence was established to be applied in cases where a healthcare practitioner is working in a place with different cultural groups. In order to remain competent, the healthcare provider needs to respect and understand other people’s cultures in order to be able to meet their healthcare needs in an appropriate way.



Josepha, C. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing 1, 1.

Purnell, L. & Faan, R. (2002).  The Purnell model for cultural competence. Journal of Transcultural Nursing, 13(3), 193-196.

Purnell, L. (2000). A description of the Purnell Model for cultural competence.  Journal of Transcultural Nursing 11(1), 1