I have been given the Purnell Model for Cultural Competency to discuss. The Purnell Model was created by Larry D. Purnell. The model was established when Purnell learned of the need for both students and staff to have a way to learn about their cultures and the cultures of others. Dr. Larry Purnell made this discovery when he was teaching undergraduate students (Purnell, 2005). The framework for this theory was organized in 1991 (Purnell, 2005). Early in 1998, his model was confirmed as a grand theory and not a framework, by three well-known nurse theorists (Purnell, 2005). Purnell’s Model has been used to develop cultural competence in many different fields, and also stimulates the want for further investigation into cultural backgrounds, not only of one’s self but of others as well, despite the debate about grand theories versus conceptual framework (Purnell, 2005).
Components Domains are not intended to stand alone, rather, they affect one another (Purnell, 2005). There are twelve domains to the Purnell Model (Purnell, 2005). The twelve domains are overview, inhabited localities, and topography, communication, family roles and organization, workforce issues, biocultural ecology, high-risk behaviors, nutrition, pregnancy and childbearing practices, death rituals, spirituality, health-care practices, health-care practitioners (Paulanka & Purnell, 2008). Purnell’s Model provides a framework for many people of different disciplines to study concepts of culture, learn circumstances that affect culture, and offer suggestions that relate to most central relationships of culture (Paulanka & Purnell, 2008).
ApplicationWhen I was in nursing school to get my associates degree, I took care of a patient during my mother baby rotation, that was of Mexican descent. This model was helpful for me to learn some things about how to communicate with the patient and her family. Upon my arrival in the unit that day, the charge nurse gave me an article to read about things that the Mexican culture believe to be true and helpful during childbirth. One thing I learned that day was that they are very open during childbirth and want as much of their family present for the actual birth as possible. When the lady gave birth that afternoon, there were eleven family members present in the room when the child was born. It was a very full room, to say the least, and was unlike anything I was used to.
This theory is applicable to my current work due to the diversity of not only the patients but also the diversity of the staff I work with. It is important to be conscious of not only your patients but also co-worker’s beliefs as well. When working with people from other cultures it is important to make sure you know what they consider disrespectful, as well as how they like to communicate. Some people do not mind a simple touch on the arm, while others may find that offensive. Another important thing to be aware of is death rituals. In the healthcare field when a death occurs it is a stressful situation and things need to go as smoothly as possible so knowing what your patient, or their family needs, or wants is a way to show respect and gain trust.
Influences This theory can be used across healthcare to integrate transcultural competence, not only in practice but in educational realms as well (Purnell, 2005).
As noted by Albougami, Pounds, and Alotaibi undergraduates often use this theory in communications and programs for health assessment (2016). Flexibility is one of the strongest features of the Purnell model, enhancing its applicability in various healthcare contexts (Albougami, Pounds, & Alotaibi, 2016). The model allows nurses to learn different characteristics and concepts of diversity and interlinks historical elements and their influence on a person’s international cultural perspective and elaborates on the chief relationships of culture, thus allowing culturally competent care (Albougami, Pounds, & Alotaibi, 2016). The model’s framework encourages nurses to consider and reflect on the unique characteristics of every patient, including their views of illness, motivation, healthcare and facilitates the analysis of cultural data, allowing nurses to cater to families, groups, and individuals in terms of their respective cultural uniqueness using various communication strategies (Albougami, Pounds, & Alotaibi, 2016).
Cultural Care on the ForefrontCultural background plays a large part in how people like to be treated. Effective healthcare revolves around communication and understanding the client’s cultural beliefs will help with the ease of those interactions. All caregivers need similar culturally specific data, the way the data is used may differ significantly based on the discipline, distinct practices, and exact conditions of interacting with the client. As nurses’ assurance in their ability to deliver culturally competent care increases, so does their desire to experience newer and more challenging multicultural patient care encounters (Kersey-Matusiak, 2013). Nurses who reach this level of confidence as culturally competent nurses will help reduce the disparities that exist between groups and serve as role models and mentors for other nurses (Kersey-Matusiak, 2013).
The major assumptions of the Purnell model for cultural competence and their associated framework involve drawing on a broader perspective, which makes them applicable to all healthcare environments and practice disciplines. Each discipline has its own unique knowledge base to support its ways of knowing its clients as well as techniques, roles, norms, values, ideologies, attitudes, and beliefs, which interlock to make a reinforced and supportive system within its defined practice. An understanding of ethnocultural diversity improves the effectiveness of all healthcare providers (Purnell, 2005).