Cultural Competency & Public Health
Cultural Assessment & Care
- Cultural humility involves recognizing personal biases and approaching patients with openness to learn about their beliefs
- Health disparities often result from social determinants of health including income, education, and access to care
- Interpreters must be used for non-English speaking patients; family members should not translate medical information
Memory Aid - ETHNIC Framework:
E - Explanation (patient's perception)
T - Treatment (what patient has tried)
H - Healers (traditional/spiritual)
N - Negotiate (treatment plan)
I - Intervene (culturally appropriate)
C - Collaborate (with patient/family)
LGBTQIA+ Population Care
Inclusive Healthcare Practices
- Use chosen names and pronouns consistently and document preferred names in medical records
- Avoid assumptions about sexual orientation, gender identity, or family structures
- Understand that sexual orientation (who you're attracted to) differs from gender identity (internal sense of gender)
Clinical Scenario: A transgender male patient presents for routine care. The nurse should ask "What name would you like me to use?" and "What pronouns do you use?" while maintaining confidentiality and providing respectful, non-judgmental care.
Key Points
- Create inclusive environments with gender-neutral language and diverse educational materials
- Respect patient privacy regarding disclosure of LGBTQIA+ status
Foster Children, Abuse Victims & Elderly
Trauma-Informed Care
- Mandatory reporting requires healthcare providers to report suspected abuse, neglect, or exploitation to appropriate authorities
- Foster children may have complex medical histories and trauma-related behaviors requiring patience and consistency
- Elder abuse includes physical, emotional, financial, sexual abuse, and neglect
Clinical Scenario: An elderly patient presents with unexplained bruises and seems fearful when family members are present. The nurse should conduct a private assessment, document findings objectively, and follow facility protocols for reporting suspected abuse.
Memory Aid - Signs of Abuse (HELPS):
H - Hesitation to speak/fearfulness
E - Unexplained injuries
L - Lack of medical care
P - Poor hygiene/nutrition
S - Social isolation/withdrawal
Key Points
- Document objectively using direct quotes and body maps for injury documentation
- Safety is the priority - never confront suspected abusers directly
Common Pitfalls & Study Tips
Frequently Missed Concepts
Common Pitfalls:
- Assuming family members can serve as interpreters for medical information
- Making assumptions about patient preferences based on appearance or demographics
- Failing to recognize mandatory reporting requirements
- Overlooking the need for reasonable accommodations
Study Strategy: Remember that vulnerable populations require individualized, respectful, and non-judgmental care that addresses both immediate health needs and underlying social determinants of health.
Quick Check Questions
- ☐ Can you identify the five rights of delegation?
- ☐ Do you know when mandatory reporting is required?
- ☐ Can you describe trauma-informed care principles?
- ☐ Do you understand cultural humility vs. cultural competence?