NR 501NP Week 6: Culture and Caring Theories

NR 501NP Week 6: Culture and Caring Theories

Sample Answer for NR 501NP Week 6: Culture and Caring Theories Included After Question

NR 501NP Week 6: Culture and Caring Theories

Dr. Jackie and class,

The Purnell Model for Cultural Competence is the theory that most resonates with me in my practice as a future nurse practitioner. This theory came into play in 1989 after Purnell took a group of nursing students to a hospital setting to perform clinical rotations. Most of the students were from white upper-class families, and the employees and patients at the hospital were from lower-class families. This was a cultural shock for both groups as they struggled to understand one another. Purnell then put together a model to help educate both the students and the hospital staff and patients on the importance of cultural diversity. This model has been used in many different practice sites, education, research, and administration. Other disciplines such as Physical and Occupational therapy have used this as well ( Butts & Rich, 2017).

This model explains that every culture is different, but one culture is not any better than another. There are differences and similarities within each culture. It proves that no matter the culture,  if the patient is actively involved in his/her own care, the outcome is likely to be more positive. Every culture needs to be respected by the nurse practitioner, even if it is not the belief of the nurse practitioner providing the care. It is important for the nurse practitioner to be culturally competent and to continue to learn about other cultures. Different races often have differences in their cultural beliefs and practices. It is important for the nurse practitioner to be able to understand and adapt to that patient’s culture. It is also important for the nurse practitioner to have cultural competence, which means that he or she must be aware of his/her own thoughts and feelings. The nurse practitioner must accept the patient’s cultural beliefs and have some knowledge about the patient’s culture. The Purnell theory integrates the nursing paradigm because it includes many concepts of society across the globe and includes families, the person and the community as a whole ( Dian Ellina et al., 2022).

Pertaining to this theory, I am a white middle-class female who was born into poverty due to my parents not finishing high school. They worked in nurseries from daylight until dark for very little money due to not having an education. We lived in government housing up until I was 13 years old. My mother went back to school to obtain her GED which allowed her to get a better-paying job in a factory to provide for her children. My parents always pushed me to do better than them by encouraging my sister and me to get a high school diploma followed by a college education. My parents always wanted me to have a better life than they did. In this theory, I identify with once being the poor kid whose family could not afford all of the fancy things my peers had (although I never went without food, clothing, or shelter). I also identify with being the middle-class adult that I am today. I often encounter patients that are in poverty and I never have forgotten where I came from. I think I most identify with the family and personal parts of this theory.

This theory helps to meet CLAS standards to advance health equity in many ways. It helps the nurse practitioner to be able to provide the patient with respect and quality care that aligns with the patient’s specific culture. It stresses the importance of providing continuing education to nurse practitioners in order to help them better understand cultural differences. It teaches the nurse practitioner about the importance of self-awareness but also teaches that no one specific culture is right. It provides language assistive services through translators to help the patient and practitioner to better understand one another. It helps to provide written instructions in the patient’s language in order to help promote more positive outcomes. It encourages a partnership within the community to implement and evaluate policies to better provide for the patient (Office of Minority Health, n.d.).

References

 

Butts, J. B., & Rich, K. L. (2017). Philosophies and theories for advanced nursing practice (3rd ed.). Jones & Bartlett Learning.

Dian Ellina, A., Nursalam, N., Yunitasari, E., Putra, M., & Adiutama, N. (2022). Culturally based caring model in nursing services. Kontakt, 24(3), 212–218. https://doi.org/10.32725/kont.2022.027Links to an external site.

Think cultural health. (n.d.). U.S. department of health and human services. https://www.thinkculturalhealth.hhs.gov/clas/what-is-clasLinks to an external site.

NR 501NP Week 6: Culture and Caring Theories (Orig Post Due Wednesday, Responses Due Sunday)

NR 501NP Week 6: Culture and Caring Theories (Orig Post Due Wednesday, Responses Due Sunday)

A Sample Answer For the Assignment: NR 501NP Week 6: Culture and Caring Theories

Title: NR 501NP Week 6: Culture and Caring Theories

Purpose  

The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.  

Activity Learning Outcomes  

Through this discussion, the student will demonstrate the ability to: 

• Demonstrate logical and creative thinking in the analysis and application of a theory to nursing practice. (PO 2 and 5) Weeks 2, 6 
• Examine broad theoretical concepts as foundational to advanced nursing practice roles. (PO 1 and 2) Weeks 1, 2, 4 

• Analyze theories from nursing and relevant fields with respect to the components, relationship among the components, and application to advanced nursing practice. (PO 1) Weeks 4, 6 

Due Date: Sunday, 11:59pm MT  

 A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.  

Total Points Possible:  75 

Requirements:  

Discussion Criteria   

1.  Application of Course Knowledge: The student post contributes unique perspectives or insights gleaned from personal experience or examples from the healthcare field. The student must accurately and fully discuss the topic for the week in addition to providing personal or professional examples. The student must completely answer the entire initial question.  

1.  Engagement in Meaningful Dialogue: The student responds to a student peer and course faculty to further dialogue. 

• Peer Response: The student responds substantively to at least one topic-related post by a student peer. A substantive post adds content or insights or asks a question that will add to the learning experience and/or generate discussion.   

• A post of “I agree” with a repeat of the other student’s post does not count as a substantive post. A collection of shallow posts does not equal a substantive post.  

• The peer response must occur on a separate day from the initial posting.    
• The peer response must occur before Sunday, 11:59 p.m. MT.    

• Faculty Response: The student responds substantively to at least one question by course faculty. The faculty question may be directed to the student, to another student, or to the entire class.     

•  
• A post of “I agree” with a repeat of the faculty’s post does not count as a substantive post. A collection of shallow posts does not equal a substantive post.  

• The faculty response must occur on a separate day from the initial posting.   
  

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1. Integration of Evidence: The student post provides support from a minimum of one scholarly in-text citation with a matching reference and assigned readings or online lessons, per discussion topic per week. 

• What is a scholarly resource? A scholarly resource is one that comes from a professional, peer-reviewed publication (e.g., journals and government reports such as those from the FDA or CDC).  

• Contains references for sources cited  
• Written by a professional or scholar in the field and indicates credentials of the author(s)  

• Is no more than 5 years old for clinical or research articles  

• What is not considered a scholarly resource?   

• Newspaper articles and layperson literature (e.g., Readers Digest, Healthy Life Magazine, Food, and Fitness)  
• Information from Wikipedia  or any wiki  
• Textbooks  

• Website homepages  
• The weekly lesson  
• Articles in healthcare and nursing-oriented trade magazines, such as Nursing Made Incredibly Easy and RNMagazine (Source: What is a scholarly article.docx; Created 06/09 CK/CL  Revised: 02/17/11,  09/02/11  nlh/clm)  

• Can the lesson for the week be used as a scholarly source?  

• Information from the weekly lesson can be cited in a posting; however, it is not to be the sole source used in the post.  

• Are resources provided from CU acceptable sources (e.g., the readings for the week)?  

• Not as a sole source within the post. The textbook and/or assigned (required) articles for the week can be used, but another outside source must be cited for full credit. Textbooks are not considered scholarly sources for the purpose of discussions.  

• Are websites acceptable as scholarly resources for discussions?  

• Yes, if they are documents or data cited from credible websites. Credible websites usually end in .gov or .edu; however, some .org sites that belong to professional associations (e.g., American Heart Association, National League for Nursing, American Diabetes Association) are also considered credible websites. Websites ending with .com are not to be used as scholarly resources.

  

1. Professionalism in Communication: The post presents information in logical, meaningful, and understandable sequence, and is clearly relevant to the discussion topic. Grammar, spelling, and/or punctuation are accurate. 

1. Wednesday Participation Requirement: The student provides a substantive response to the graded discussion question(s) or topic(s), posted by the course faculty (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. 

1. Total Participation Requirement: The student provides at least three substantive posts (one to the initial question or topic, one to a student peer, and one to a faculty question) on two different days during the week.  ISCUSSION CONTENT  
   

   DISCUSSION CONTENT
   Category	Points	%	Description
   Application of Course Knowledge:	20	27	Answers the initial discussion question(s)/topic(s), demonstrating knowledge and understanding of the concepts for the week.
   Engagement in Meaningful Dialogue With Peers and Faculty	20	27	Responds to a student peer and course faculty furthering the dialogue by providing more information and clarification, adding depth to the conversation
   Integration of Evidence	20	27	Assigned readings or online lesson and at least one outside scholarly source are included. The scholarly source is:  1) evidence-based, 2) scholarly in nature, 3) published within the last 5 years
   			Total CONTENT Points= [60 pts]
   DISCUSSION FORMAT
   Category	Points	%	Description
   Grammar and Communication	8	10	Presents information using clear and concise language in an organized manner
   Reference Citation	7	9	References have complete information as required by APA   In-text citations included for all references  and references included for all in-text citation
   			Total FORMAT Points= [15 pts]
   			DISCUSSION TOTAL= 75 points

   Preparing the Assignment 

   Which of the culture and caring theories most resonates with you for your practice as an NP? How does the theory integrate the nursing paradigm?  What parts of the theory do you identify with? How does the theory help to meet CLAS standards to advance health equity? 

     

   **To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric. 

Purnell Model for Cultural Competence  

  

     The cultural nursing theory that most resonates with my practice as a future NP is The Purnell Model for Cultural Competence. Similar to other nursing theories, The Purnell Model places focus on the importance of provider understanding of cultural practices and preferences of the patient for optimal treatment outcomes. The Purnell Model is composed of 12 domains which provide an organized framework for the model and include, overview or heritage, communication, family roles and organization, workforce issues, bio-cultural ecology, high-risk behaviors, nutrition, pregnancy, death rituals, spirituality, healthcare practices, and healthcare professionals (Purnell, 2019).

By analyzing common health disparities of groups and considering these 12 domains, providers can better understand health care practices, beliefs, cultural norms, and preferences of our patients. According to Purnell (2018), the model provides guidance that urges nurse practitioners to consider their personal and cultural beliefs and values in relation to those we are caring for. By assessing our own attitudes toward cultural practices, we are better able to care for patients, families, communities, and society as a whole. By considering and managing our own thoughts and beliefs, NPs are better able to provide respectful, dignified, care that helps patients to feel comfortable, confident, and recognized in their healthcare.  

     A nursing paradigm is a fundamental idea that guides development of the practice. According to Deliktas et al. (2019), paradigms that shape the education, research, and practice aspects of a discipline are defined as metaparadigms. Metaparadigms are composed of core issues of a discipline. Jacqueline Fawcettt defined person, health, and environment in nursing as the four main concepts that need to be explored (Nikfarid et al., 2018). The Purnell model is a theory that can be generalized and utilized in all areas of health practice.

The Purnell Model of Cultural Competence is significant in the nursing paradigm because it enhances patient care by considering the person as a human being by reflecting on their cultural preferences as a core aspect of the provision of care. The theory has the metaparadigm concepts of global society, community, family, and person; and can be generalized for use in other professions (Purnell, 2019).  

     I believe I can identify with the Purnell Model because I understand the importance of providing fair, respectful, and dignified health care. I have traveled to many countries and have been fortunate enough to live in and learn about the various cultural beliefs and norms that guide health decision making in those areas. As an example, I lived in Nicaragua where there were high rates of adolescent pregnancies. Through learning about the country’s health disparities and norms, I found that the reason for this was the Machismo culture, beliefs against birth control, and overall, lack of sex education.

A primary community effort through the use of international volunteers was sex education and prenatal care. It is crucial that as health care providers, we utilize the Purnell Model to consider communities we treat, their group’s health disparities, and beliefs surrounding health care. I feel that this mutual respect, and knowledge that I have gained has helped me to become a better, more culturally competent and sensitive provider. I also work in an ER that is culturally diverse. By enhancing my knowledge of varying cultures, I can provide better care that best serves the individual.  

     National Standards for Culturally and Linguistically Appropriate Services (CLAS) were developed in 2000 by the US Department for Health & Human Services Office of Minority Health (OMH) to create systems of care that acknowledge the need to address culture and cross-cultural relationships among individuals, health care providers, and communities (Gomez et al., 2016). The theory focuses directly on improving health care, patient-provider communication, health equity, and cultural competence.

When healthcare providers aim to meet CLAS standards, and utilize theory-based practices such as Purnell’s Model, providers are able to implement better healthcare that acknowledges and respects the culture of a patient, and reaches mutual decisions that validates and includes the preferences of the individual. When culturally competent care is provided, patient-provider relations are enhanced, compliance to care plans is met, and health care goals are achieved. As a future NP, I plan to continue to increase my cultural competence through continued education to better serve my patients and their families.  

 References 

     Deliktas, A., Korukcu, O., Aydin, R., & Kabukcuoglu, K. (2019). Nursing students’ perceptions of nursing metaparadigms: A phenomenological study. Journal of Nursing Research, 27(5). https://doi.org/10.1097/jnr.0000000000000311 Links to an external site. 

     Gómez, M. , Charnigo, R. , Harris, T. , Williams, J. & Pfeifle, W. (2016). Assessment of National CLAS Standards in Rural and Urban Local Health Departments in Kentucky. Journal of Public Health Management and Practice, 22 (6), 576-585. doi: 10.1097/PHH.0000000000000410. 

     Nikfarid, L., Hekmat, N., Vedad, A., & Rajabi, A. (2018). The main nursing metaparadigm concepts in human caring theory and Persian mysticism: a comparative study. Journal of medical ethics and history of medicine, 11, 6. 

     Purnell, L. (2018). Models and theories focused on culture. In J. B. Butts & K. L. Rich, Philosophies and theories for advanced nursing practice, 3rd ed. (pp. 565-599). Jones & Bartlett 

Purnell, L. (2019). Update. Journal of Transcultural Nursing, 30 (2), 98-105. doi: 10.1177/1043659618817587. 

This is a great conversation to have. I believe as health care providers we all should be very aware of the role our subconscious mind plays in everything that we do. The National Healthcare Quality and Disparities Report indicated healthcare outcomes are worse for non-white patients than for their white counterparts (Narayan, 2019).  At first glance, most people would probably determine that this is due to systemic racism, however, I believe implicit bias may play more of a role.

Although there may be some providers that subscribe to the racist point of view, I have witnessed implicit bias in providers that did not realize different treatment was provided to different groups of people. In the psychiatric realm, implicit bias is very prevalent and seems to be applied more to patients with a lower socioeconomic status. Patients that have insurance that is willing to pay for extended inpatient psychiatric hospitalizations receive better treatment and more time with the provider (NP or MD).  On the other hand, those with no insurance or considered low-income receive minimal care and rapid discharge even if at times that they are not stable. As a PMHNP, I plan to continue to examine .my beliefs, thoughts, and actions, therefore, understand the implicit biases that I have and work to change them.  

  

References 

Narayan, M. (2019). Addressing Implicit Bias in Nursing: A Review. The American Journal of Nursing, 119(7), 36–. https://doi.org/10.1097/01.NAJ.0000569340.27659.5a.