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To adequately meet the needs of patients with diverse backgrounds, nurses much use methods that are culturally competent. In 1991, Madeleine Leininger published the The Transcultural Nursing Theory, establishing approaches such as cultural preservation, cultural accommodation, cultural repatterning, and cultural brokering (Andrews & Boyle, 2008, p. 62).

  • Cultural preservation entails a situation where the nurse supports the use of scientifically sound cultural practices of care by their patients (Stanhope & Lancaster, 2014, p. 78). An example would include agreeing to the use of acupuncture by a Chinese patient as an adjunct to pain management using conventional medicines such as opioid analgesics (Huber, 2009).
  • Cultural accommodation entails a situation where the nurse supports the use of cultural practices that have been shown as not harmful (Stanhope & Lancaster, 2014, p. 78). For example, placing a table knife under the bed of a laboring woman to symbolically cut the pain (Smith, 2013). For African Americans in the Delta, alcohol or Vaseline rubs to the chest are utilized for comfort measures (Gunn & Davis, 2011). Within cultural accommodation, these acts would be supported if not contraindicated in the patient’s care.
  • Cultural repatterning entails a nurse working in collaboration with a patient towards helping them change cultural practices that are considered harmful (Stanhope & Lancaster, 2014, p. 78).

In case, when a pregnant Muslim patient intends to fast during the month of Ramadan, but is unaware of the negative impact that it would have upon her and her pregnancy (Wintz & Cooper, 2009, p. 28).

  • Cultural brokering utilizes negotiating between the patient’s culture and biomedical healthcare to ensure that the care is used together as culturally competent (Stanhope & Lancaster, 2014, p. 79).

Community health nurses need to utilize various cultural competence strategies in ensuring that they effectively deliver health care services that are able to meet the individual needs of their patients. Such strategies help community nursing in improving the health outcomes and quality of care provided by the nurse (Betancourt, et.al, 2016). Theses methods also help in the elimination of racial and ethnic health disparities and boundaries that may hinder effective delivery of care. Consequently, the nurse is able to develop and cultivate patient trust, understanding and respect that help significantly in ensuring the realization of the best health outcomes. In achieving the above, community nurses can use a number of approaches such as cultural preservation, cultural accommodation, cultural repatterning, and cultural brokering. Possible barriers in the utilization of the above strategies would be attributed to conflicts arising from different cultures, languages, and beliefs. For example, in the instance of persuading a patient to stop taking a herb that has been used for many years by their native community would be seen as insensitive and rude by the patient.

  • Andrews, M. M., & Boyle, J. S. (2008). Transcultural concepts in nursing care (5th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins Health.

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