How can community health nurses apply the strategies of cultural competence to their practice? Provide at least one example from each of four strategies: cultural preservation, cultural accommodation, cultural repatterning, and cultural brokering. What is a possible barrier to applying the strategy/example chosen? Use an example that is different than the postings of other students. As an OB nurse, I care for many Hispanic women having babies. One of the culturally challenging barriers I have come across is that the women believe they should wait until their milk comes in before they start breast feeding. In the meanwhile they wish to feed their newborns formula from a bottle. Evidence-based practice supports breastfeeding from within one hour of birth until the child is one year old or older. In our institution we attempt cultural repatterning, that is working with the patient “to help… her change cultural practices that are harmful” (Huber, 2009, p. 14). We try to encourage the women to attend free breast feeding classes prior to delivery and we have a bilingual lactation consultant who provides them with verbal and written information regarding the benefits of colostrum (comes in before the milk) and the benefits of early breastfeeding (bonding, improved milk supply, earlier effective breastfeeding by newborn). If they continue to insist on formula feeding, they are asked to sign a consent/waiver stating they understand the risks and still desire to bottle feed.
Prior to the presentation of evidence-based info showing the risks of formula feeding and the benefits of breastfeeding, nurses believed that bottle-feeding the first few days was not harmful and therefore just a cultural variation that could be supported. Allowing the mothers to formula-feed under this assumption is called cultural accommodation which “supports and facilitates the use of cultural practices that have not been proven harmful” (Huber, 2009, p. 14).
In years past, formula was...
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