A nurse educator is preparing an orientation on culture and the workplace. There is a need to address the many cultures that seek healthcare services and how to better understand the culture. This presentation will examine the role of the nurse as a culturally diverse practitioner.  

• Choose a culture that you feel less knowledgeable about: HISPANIC  OR MEXICAN
• Compare this culture with your own culture: ISLAND PACIFIC 
• Analyze the historical, socioeconomic, political, educational, and topographical aspects of this culture
• What are the appropriate interdisciplinary interventions for hereditary, genetic, and endemic diseases and high-risk health behaviors within this culture?
• What are the influences of their value systems on childbearing and bereavement practices
• What are their sources of strength, spirituality, and magicoreligious beliefs associated with health and health care?
• What are the health-care practices: acute versus preventive care; barriers to health care; the meaning of pain and the sick role; and traditional folk medicine practices?
• What are cultural issues related to learning styles, autonomy, and educational preparation of content for this culture?

This PowerPoint® (Microsoft Office) or Impress® (Open Office) presentation should be a minimum of 20 slides, including a title, introduction, conclusion and reference slide, with detailed speaker notes and recorded audio comments for all content slides. Use at least four scholarly sources and make certain to review the module’s Signature Assignment Rubric before starting your presentation. This presentation is worth 400 points for quality content and presentation.

Total Point Value of Signature Assignment: 400 points

Running head: THE PURNELL MODEL FOR CULTURAL COMPETENCE 1

THE PURNELL MODEL FOR CULTURAL COMPETENCE 2

The Purnell Model for Cultural Competence

Overview and Heritage

On our island, we lacked fresh fruits and vegetables, which makes eating healthy a challenge. This may be the contributing factor of high diabetes and hypertension rate on Guam. We mainly eat meat, rice and lots of diaries. I have a husband who is currently working and is contributing in addition to my salary. I can afford the essential needs to stay healthy. My job provides for health and dental insurance, which is crucial in my current stage of life. My current position can be stressful, but I find ways to try and avoid stress. My physical health is good, but I feel that it’s my mental health that I need to work on more to sustain myself in my current position.

My husband and I live alone. We have four grown children and six grandchildren. All but one lives out of state, my youngest, who is twenty-eight years old lives twenty miles away from me.

Communication

. My primary language is English, and my native language is called “Chamorro.” This is a blend of Spanish and Filipino words. I do speak Chamorro, but limited. When I was growing up, my mother did not speak our language to us. As a child, I remember when we had American teachers come to our island, and the students were all banned from speaking their native language. When I was a nurse, in 1989, I went to an island outside of Guam. Here, the people of the island spoke their language, “Chamorro,” and this is where I got to learn more about my language. I currently speak some Spanish, because it is close to my Chamorro language.

My family is very close. I am number five of eight children. I am a twin to an identical sister. I do not find it difficult to share anything with her. Sometimes, we can read each other’s minds, and this use to scare my younger sister. We have a uniquely close relationship. She lives in Guam, and I live in California. Although we don’t see or talk much, we tend to pick up where we left off. Sharing my thoughts with others can be difficult.

Family Roles and Organization

In our culture, it is the male who usually is the head of the household. Men would work, and the women would care for the children and household obligations. This is not the case anymore. Both parents are usually working. Family from the islands is pretty significant. The eldest is the one who cares for the younger siblings. I come from a family of eight, and I am number five child. I remember my brother caring for me, cooking for me while my parents were at work. We make decisions as a family. My husband and I work, so we share the duties at home and financial obligations. I have been married for thirty-one years. Our children are grown and are doing well. Being independent is what gives us family status. We have family from the island come to visit frequently, and we are delighted when they can come out here.

Pregnancy and Childbearing Practices

In the early 1900s on Guam, home birth was the standard practice. “Pattera,” which comes from the Spanish word “Partera” is a midwife that assists with home deliveries. Training of nurses and nurse-midwives on Guam began in 1907 when the U.S. Navy medical officers established a school for their instruction and licensing. Some of the nurse-midwives worked for the Division of Public Health and others for the hospital, but most worked independently in villages throughout the island. They traveled on foot or by bull cart and later by motorized vehicles to assist in home births. Patteras get paid by offering them food or livestock. This is a memory my aunt told me, when she assisted with a delivery, they would send her home with a branch of bananas.

Pattera served as the link between the Chamorro traditions surrounding childbirth and U.S. hospital-based birthing practices. Homebirths are not common anymore, although recently, there was a birth center built on the island, that is doing well. I have four children; all of the children were born in a hospital. The birth control method I use is a bilateral tubal ligation. My experience back home is that obstetricians did not talk too much about pregnancies. We do not eat or restrict foods during pregnancy. We usually go to cravings and fulfill them. I never had pica, an unusual craving, such as chalk or dirt when I was pregnant. Activities to avoid are strenuous activities when you are pregnant. When I delivered my babies, my twin sister was always there with me. I delivered them to a hospital, so I was in a lithotomy position. My husband and mother were the ones who cared for me after I delivered. There were no bathing restrictions, and I did not keep my placenta. Nothing was done specially for the umbilical cord, except to make it fall out spontaneously. We did not restrict baths because of the cord.

Spirituality

My religion is of the Christian faith. I grew up in a General Baptist Church and now attend a community church. I believe in God, the father, and his son, Jesus. I know that all my success are because of His mercy and grace. I would not consider myself deeply religious, but I try to hear the word of God daily. It is what motivates me. I pray daily, and, tell God how grateful I am for all his blessings. God’s word gives me strength in my life. Listening to Christian music daily improves my emotional and physical health.

Health Care Practices

My culture’s practice on Guam had witch doctors, called “Siruanu,” also known as healers of Guam. They were primarily herbalists. To be a healer, you would have to learn the plants, how to prepare them, and when to administer them. Some of our native Chamorros still use this practice. We all are responsible for healthy practices. My spouse and I remind each other that we need to take care of ourselves, as we are getting older. We use over the counter medications like Tylenol and Advil for our aches and pains. Mental illness is viewed as an illness but is not a stigma. Families are very supportive if a child has any physical or mental illness. My immediate family members all have health care services available. Although my family is healthy, healthcare benefits are considered a priority.

Conclusion

This self-assessment questionnaire has taught me more about my culture and cultural beliefs. As a provider, I do not practice some of the traditions. Religion is powerful in our culture, and I continue to learn and grow in my Christian faith. Culture is one of many categories of diversity, and it comprises belief systems, norms, and traditions, as well as language and religion. As I continue to learn the different cultures and understand their perceptions when in contact with each of them, I will be aware of my own biases, for this can lead to discrimination.