How can community health nurses apply the strategies of cultural competence to their practice?

According to Abualhaija, (2021), Cultural competence in nursing academia and practice is needed due to the increase of multiculturalism in the U.S.; hence, it was proposed as a strategy to reduce health disparities among ethnic minorities and vulnerable population. As a community nurse,  to be able to practice cultural competency, first you must be culturally competent about you own belief and be opened to accept other people’s belief within the community. Health professionals working in and within community groups and organizations will need to increase their skills by taking time to reflect on strategies for acculturation and barriers to fostering integration or assimilation while honoring diversity and respecting all peoples. Also, community health nurse must practice cultural competence, use communication and relational strategies that respect clients’ values, expectations, and goals without diminishing the nurses’ own values, expectations, and goals. For example, the nurse must use strategies that would allow her to effectively communicate with the client and modify nursing interventions that are based upon culturally informed nursing science, also understands that the client has the right to judge whether she has received the care she wanted and to follow up with appropriate action if she did not receive that care (Stanhope & Lancaster, n.d.)

                                           Cultural preservation /Barriers

Example: Acupuncture, an ancient Chinese practice of inserting needles in specific points on the skin through which life energy flows, is used to relieve pain or cure diseases by restoring balance of yin and yang (Stanhope & Lancaster, n.d.). The barrier to this strategy is that it leads to prejudice because in as much as acupuncture is an ancient Chinese practice of pain management, not everyone in that community practice it.

                                         Cultural accommodation/Barriers

Example: In some cultures, they belief that if a baby is born with some ammonitic sac on their face, is a vision that something special was going to happen in the person’s life. The barrier to this strategy is stereotype.

                                         Cultural re-patterning/ Barriers

Example: A culturally competent school nurse who works with Mexican Americans knows of the high incidence of obesity among women 20 years and older. Using this information, she developed a health education program for Mexican teenagers in the local high school. While respecting their cultural traditions, the nurse discussed weight management strategies with the teenagers (Stanhope & Lancaster, n.d.). The barrier to this strategy is racism.

                                    Cultural brokering/ Barriers

Example: A public health nurses also advocate for the rights of migrant workers to receive quality health care. The barrier to this strategy is stereotyping


Abualhaija, Nashat. 2021. “Clarifying Cultural Competence in Nursing: A Concept Analysis Approach.” Journal of Cultural Diversity 28 (1): 3–14.

Stanhope, M., & Lancaster, J. (n.d.). Public Health Nursing. Retrieved from


Dimensions of Cultural Competence

Nursing professionals cannot underestimate the importance of cultural competence during the provision of nursing care. The critical outcome of cultural competence is to help in effective communication and interaction with the patients, which is vital in creating therapeutic relationships. Cultural competence is not relegated to tolerating the culture and practices but rather celebrating them through care personalization. The components of cultural competence are varied; however, they are based on five core building blocks: cultural awareness, knowledge, skills, and encounter (Pedrero et al., 2020). A nurse can become culturally aware after dropping some individual prejudices formed against other cultures. The cultural knowledge underscores the need for searching for information about the beliefs of different cultures. Cultural skills entail the ability of the nurse to collect relevant data while processing it to facilitate cross-cultural interactions. A cultural encounter requires nurses to work with new cultures other than those they are conversant with. Finally, nurses should possess the desire and strong motivation to learn about different cultures.

There are strategies employed by culturally competent nurses and include cultural preservation, accommodation, repatterning, and brokering. Nurses using cultural preservation employ key approaches that would aid the client to maintain some critical aspects of culture, which would promote healthy behaviors (Pedrero et al., 2020). For example, nurses may encounter a patient who practices meditation as a cultural practice that enhances spiritual elevation. Cultural accommodation entails using critical aspects of culture critical in satisfying care. For example, a nurse may encounter a patient who uses alternative therapies to manage pain. The nurse should support some approaches while encouraging medical adherence to pain management.

Cultural repatterning strategies entail working with the clients when developing health-promoting behaviors. For example, a patient’s culture may bar someone from participating in playful outdoor activities since they may equate them to being childish. Repatterning would entail educating the patient on physical activity while reducing a sedentary lifestyle. Finally, cultural brokering would involve advocating, mediating, negotiating, and intervening between the patient’s health care practices and cultural practices (Sharifi et al., 2019). A good example includes working with a chronically ill diabetic patient who believes certain traditional practices would help lower blood sugar levels. The cultural brokerage would involve mediation of this conventional belief while acknowledging the role of medical adherence to diabetic medication to control blood sugar.

Some barriers may make cultural competence attainment difficult. One of the critical barriers to cultural preservation and accommodation comes in the context of cultural conflict. A misunderstanding between the clients and nurses perceived through a denial of cultural differences may create hindrances to the best practices (Sharifi et al., 2019). On the other hand, barriers to repatterning and brokerage may involve disorientation when trying to understand and effectively adapt to cultural values and beliefs mentioned by the patient. Avoiding these barriers would involve an appreciation of uniqueness in patient characteristics and critical cultural practices.