Paper on Nursing Process and Culturally Competent Care

Nursing Process and Culturally Competent Care

Globally, the increased discussion of the methods that can be used to increase the effectiveness of nursing practices has over the years led to the enactment of different policies.  Nurses employ the applicable principles of performance for culturally competent care in different areas, including clinical practice, research administration, and education. These methods have both direct and indirect impacts on the different aspects of the environment including family and the community. Notably, these values are based on a social justice framework that promotes fairness, equal rights, and the participation of every member of the community in the social, economic, and educational prospects of the society, particularly in the health sector (Shen, 2015). Essentially, through these principles, different practices may be eliminated from the modern world including ethnic inequality and racial discrimination. With the increase in the shortage of nurses and patient dynamism, it is important to develop mechanisms that would ensure the education of nurses on the importance of delivering culturally competent care regardless of their geographical location.  Thus, this study will elaborate on the application of the nursing process to deliver culturally competent care. Since these practices are applied differently to particular populations, this research will evaluate their execution among the African American people and how it has helped in the improvement of quality care.

Background Information on the Selected Population

Cultural standards occur within different spectrums including economic, communal, and social systems and have prompted different health facilities around the globe to formulate defined care for specific populations. On average, there are about 12 standards of practice that include social integrity, critical consideration, cross-cultural implementation, patient support and empowerment, multicultural staff, health care systems and organizations, and evidence-based practice and research (Purnell, 2014). Considerably, the application of these standards has helped nurses to prioritize on culturally competent health care through using these standards in practicing, education of different populations, and administration of both individual and community-based care approaches.

Historically, a significant portion of the African American population resides in the southern states of the US where they were originally settled. Equally, a large population can also be found in the metropolitan regions of the United States comprising New York and Chicago. According to Shen (2015), the different experiences of this community cannot be compared to those of other immigrants, especially considering the periods of slavery and discrimination they experienced in the country. Understandably, there exist various factors that still affect the level of communication between the African American population with other persons outside the group concerning environmental, physiological, and psychological aspects.

Considerably, from their historical background, African Americans regard other groups as hostile, based on the increased instances of discrimination and violence they experience regularly. This situation has, in turn, limited their level of interaction and discussion across different spectrums of the society. Psychosocial factors, on the other hand, include the perceptions and attitudes that other groups have of the members of this community (Purnell, 2014). The African American population perceives itself as a vulnerable group that is always demeaned by the other groups in the community.  Therefore, they segregate themselves and limit their participation to developmental aspects of the society to limit their level of interaction.   The cultural beliefs of this group have also played an important role in determining the healthcare practices they have developed over the years.

Some of the African American populations believe that diseases are signs of chance, bad lack, domestic turmoil, and unemployment, and they will only consult physicians after the failure of all the available home remedies. Thus, it is important for a medical professional to assess the ‘home remedies’ that the patient from this group has tried before the former decides to prescribe any additional medications. Equally, this community believes that it is essential for nurses to acknowledge the traditional healing methods as it helps in promoting internal healing of an individual (Douglas et al., 2014). Therefore, conducting a proper evaluation of patients and their use of traditional herbs not only helps in providing them quality care but also limits any harmful side effects that might develop through the combination of the two.  However, with the increased promotion of education in the health sector by the federal government, caregivers have intensified their teaching of the modern preventive and healing techniques to the African American population.

Notably, there exist different factors that hinder the effectiveness of the provision of culturally competent healthcare services, including linguistic identities, socioeconomic status, community, and acculturation (Almutairi, McCarthy & Gardner, 2015). Importantly, linguistic identities involve how people group themselves in the society through their language. In most instances, nurses are forced to seek translation due to language barriers that have developed owing to the sociocultural differences of the African American population.

Consequently, socioeconomic status (SES) does not only include the income levels and educational attainment of a group but also issues of financial security and community participation and engagement (Shen, 2015). Understandably, most of the African American population experiences financial restraints that have affected their functioning and the ability to afford quality health care. The different incidents of SES reported in health institutions are propelled by racism that has in turn affected quality care in hospitals.

Healthcare professionals often face ethical dilemmas in the course of providing treatment; the decisions they make during such situations may result in a conflict of interest with other members of the public. One of the ethical dilemmas that may hinder the delivery of culturally competent care is the balancing of cultural aspects and privacy of a patient. Undoubtedly, different patients have distinct cultures that dictate their ways of life and their ethical values. The increased use of technology in the provision of care, including the maintenance of electronic health records, has affected the concept of privacy in hospitals. Most medical institutions use these machines for recording, storing, and transferring sensitive patient information. Since several healthcare professionals can access these devices, they limit the confidentiality of patients’ information. Additionally, the difference in culture among patients requires nurses to understand the best approach in assessing the complications of an individual that may include aspects like the role of family, religion, treatment beliefs, their conceptions of wellness and health, and their belief in food and diet.

Analysis of the Culture Using a Culturally Competent Model

The aspect of culture is used in understanding the existing disparities between different groups, thereby improving the quality of health care regardless of the patient’s needs. It is, therefore, the duty of nurses to the constantly changing demographics to provide ethical and culturally sensitive care (Jeffreys, 2015). Undoubtedly, the notion of cultural competence in health care is defined as the concept of developing awareness of an individual’s thoughts, sensations, and existence without displaying any undue influence of prejudice against other members of the society (Douglas et al., 2014). Moreover, it helps in the understanding of other people’s cultures and in developing respect for other people’s beliefs.

The Culturally Competent Model is composed of various components that elaborate on the broad concepts of its application to quality healthcare provision. Some of the aspects of the model include cultural awareness, knowledge, skills, and encounter, which have different levels of influence on both the individual and the community understanding of healthcare. Considerably, cultural awareness consists of self-examination of one’s professional and cultural background. Moreover, it begins with assessing both a person’s values and healthcare beliefs. Cultural knowledge, on the other hand, involves the understanding of data on various cultural and ethnic groups. Furthermore, this aspect can be expanded through the use of distinct sources such as journals, books, and the internet for accessing information.

Cultural skills consist of unique abilities displayed by nurses to collect varied cultural information from the patients and providing accurate assessment tools that can be used in the formulation of an elaborate treatment plan for the patient. The notion of cultural desire is used to refer to one’s inspiration of becoming aware of various ethnic dynamics, and it involves the willingness to accept, respect, and be open to other people’s values and to learn from their beliefs.

The Sunrise-Enabler Model

The primary duty of nurses is to provide care to the patients. Therefore, it is the nurses’ responsibility to develop and increase their knowledge of the customs, values, and belief of different individuals to help them in the provision of quality care. Undoubtedly, this model helps caregivers to determine the methods to use in approaching any problem presented by their patients. Understandably, this framework provides information on the social and cultural dimensions of several aspects including kinship, religious beliefs, moral views, and economic, legal, and educational factors (McFarland & Wehbe-Alamah, 2014).  Each of these elements has a different level of impact on the health and structural dimensions of the society, which also affects both the language and the environmental influences of the client.

Equally, both language and environmental influences comprise of the traditional practices in health, while the modern approaches are learned in developed institutions such as schools. Since these factors have a direct influence on health care factors affecting individuals, groups, and the community, it is important for nursing actions to be pinned on the three modules including culture presentation, accommodation, and restructuring. The technological aspects of the Sunrise-Enabler Model depict the lack of understanding of first aid safety measures and procedures on complications that can be prevented at home. The kinship and social aspects explain that women are considered as the primary caregivers and are, thus, psychologically burdened by taking care of their sick relatives.

Figure 1: The SunriseEnabler Model

Cultural care worldwide flows to the different dimensions of society including families, individuals, and the community in the vast healthcare systems. Consequently, this knowledge provides specific cultural expressions and meanings that relate to the provision of quality healthcare. Folk medicine, professional care, and current nursing systems offer data about specific features, thus allowing the identification of differences and similarities of cultural care diversity.

The nursing care decisions include the preservation of cultural care and ensure that specific maintenance mechanisms are implemented. Cultural care preservation includes the provision of supportive care services, enabling professional and facilitative actions that help persons with particular cultures to retain relevant values to maintain their good health and recover from illnesses (McFarland & Wehbe-Alamah, 2014). Cultural care negotiations involve the creation of professional approaches that can help people to modify their behaviors and lifestyles to a different healthcare pattern that respects the cultural diversity, values, and beliefs of other people


The implementation and Application of the Nursing Process to Deliver Culturally Competent Care involves an extensive understanding of the concept of culture and language differences. As such, it is important to engage clients in environments and linguistics that they feel comfortable with and can present their problems appropriately. In the modern world, many people still seek herbal remedies that may present chronic complications if they interact with western medicine (Jeffreys, 2015). Therefore, nurses should ask their patients about any alternative treatment mechanism they are using.

As a cultural strategist for the African American population, I believe it is important to observe the implementation of different guidelines that can be used in Culturally Competent Care, including knowledge of the cultures, the training and the education of nurses on competent care, initiating critical reflection, enabling cross-cultural communication, and patient advocacy and empowerment.

The process of understanding the knowledge of cultures involves enabling nurses to understand the distinct perspectives, practices, values, traditions, and family systems of the populations they help in the provision of care. Through this, these health professionals would be able to evaluate the cultural patterns and any other aspects that influence group behaviors, therefore, preventing stereotyping and overgeneralization of specific values (Shen, 2015). The patient encouragement and empowerment concepts advocate for the inclusion of clients’ principles and values in various scopes of care provision. Essentially, patients enjoy the cultural and social freedom that is necessary for their development and dignity, which should be upheld by caregivers.  These strategies will help in the identification of the best methods to use in incorporating the African American health cultures in the modern health care methods. Therefore, to limit some of the barriers identified will require training and empowering this population and helping them understand the importance of accepting some modern care mechanisms.


The evaluation tool that will be used for this study is the Agency Cultural Competence Checklist that will be used to evaluate the policies and attitudes of staff, services, the relationship of the institution to the community, and the training programs initiated by the facility. Notably, this tool is based on different principles that may help in the empowering of the African American population in presenting their beliefs. Some of the principles include the provision of quality healthcare, promoting linguistic and cultural diversity and offering language assistance to enable effective services. Both the patients and the nurses will be issued with questionnaires to assess their interaction experience and the quality of services received. The results would be presented in the form of graphs and tables for easy comprehension of the data.




Culturally Competent Care application involves the understanding of the different dynamics of culture and beliefs of clients. The African American population has different values that not only describe their nature but also describe their understanding of modern health methods. Understandably, different approaches such as the Sunrise-Enabler Model have been used to explain how nurses can increase their effectiveness in understanding cultural dynamics of their patients. To enable efficient implementation process, different strategies such as training of nurses and empowering of their clients may help in the provision of quality care.



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