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Culturally Competent
Vixony Vixamar
St. Thomas University
Prof. Kathleen Price
NUR 417
October 28, 2021
Culturally Competent
The COVID-19 has affected over 45 million in the United States
and has led to over seven hundred and forty thousand deaths
across the United States. The pandemic has increasingly
affected all individuals and has led to various economic as well
as social changes. However, there have been some health
disparities identified with people of color being among the most
affected individuals (Reyes, 2020). Nurses are at the frontline
of providing health care services to individuals that have been
infected by the virus. Therefore, as a nurse, I have come across
various COVID-19 cases where the patient needed to be
observed or there was a need to manage the condition.
One case was that of a middle-aged pregnant woman that had
contracted the virus. The symptoms started as headaches and
feeling tired. She stated that she initially assumed these
symptoms as normal pregnancy symptoms as she had earlier on
in the week engaged in some intensive exercises as she went
shopping with some family members. However, one evening she
had some challenges breathing and her family members rushed
her to the hospital. She had to be put on oxygen as she needed
support breathing. She was given a PCR test that turned out to

be negative. However, the fact that she needed to be on oxygen
necessitated another test which also read negative. At this point,
it was crucial that a chest scan be done to help with the
diagnosis. Upon the scan, the physician diagnosed the patient
with COVID-19. Her condition quickly deteriorated and she had
to be put in intensive care. It was especially challenging caring
for her given that she was seven months pregnant at the time. At
one point, the family had contemplated terminating the
pregnancy to increase her chances of surviving given that fetal
movements had subsided for a while. However, after a few
weeks in the intensive care unit, she made a full recovery and
was able to deliver her baby full-term. She remained on oxygen
and under observation until her due date.
The patient was a patient of color, with a university education
and is from a middle-income family. Her family, the mother,
and three sisters, played an important role as they helped with
the health care decision making. The patient’s health literacy
was high and, therefore, she would ensure that she had
information on all possible alternatives before making a
decision relating to her health. The education level of
individuals is highly linked to their health literacy with
individuals with higher education being perceived as being
health literate (Bayati, et al., 2018). As a person of color, it was
important to provide culturally competent care to meet her
needs. A quick self-assessment was important to ensure that I
do not hold any subtle biases that might affect the delivery of
care. It was especially important to recognize that a majority of
Black Americans do not trust the health care system due to past
historical injustices. Therefore, creating a conducive therapeutic
environment was important for helping build a mutually trusting
relationship. The relationship was especially crucial in
educating the patient and family about the importance of getting
vaccinated. According to Kricorian & Turner (2021), the
acceptance of the COVID-19 vaccine is low among Black
Americans. Therefore, it was important to address all their
concerns about the vaccine and understand the impact of culture

on the same. The efforts made were not in vain as the family
was fully vaccinated with the patient receiving the vaccine a
few months after giving birth.
References
Bayati, T., Dehghan, A., Bonyadi, F., & Bazrafkan, L. (2018).
Investigating the effect of education on health literacy and its
relation to health-promoting behaviors in health center. Journal
of Education and Health Promotion, 7, 127. doi:
10.4103/jehp.jehp_65_18
Kricorian, K., & Turner, K. (2021). COVID-19 Vaccine
Acceptance and Beliefs among Black and Hispanic
Americans. PloS One, 16(8), e0256122.
https://doi.org/10.1371/journal.pone.0256122
Reyes, M. V. (2020). The disproportional impact of COVID-19
on African Americans. Health and Human Rights, 22(2), 299.
PMID: 33390715

Providing Culturally Competent Care
Andrea Lyn-Bell
St Thomas University
NUR 421: Nursing Practice in a Multicultural Society
Professor Price
October 28, 2021
Providing Culturally Competent Care
I have been involved in the care of many people in the
Emergency setting since the beginning of the COVID-19
pandemic from early 2020 until now. This pandemic has been
challenging for all. The fear of contracting the virus and the
havoc it can wreak inside ones body, the social isolation in an
effort to contain the spread, the financial challenges as many
people’s livelihood has been affected and not knowing how long
our lives will be altered by this new normal has affected
everyone in various ways, most of which are negative. Mental
health crises are at an all-time high as people struggle to
navigate this difficult period. A Kaiser Foundation health
tracking poll from July 2020 found many adults reporting sleep
disturbances, increases in alcohol consumption or substance
abuse, and worsening chronic conditions due to stress or worry (
Panchal et al, 2021).
I remember having a patient earlier on in the pandemic who had
a difficult time accepting that she had contracted the virus and
providing care for her became quite an ordeal. She was an older
Caucasian woman who appeared to be very affluent and knew
many people who donated generously to various local healthcare
organizations. She presented to the emergency department
experiencing fever, cough, chest discomfort and loss of taste
and smell. After being examined by the emergency room
Physician she was informed that as a part of her work up she
would be tested for COVID-19. She made is clear that it was not
necessary as she was tested three days prior and had a negative
result. It was explained to her that she is now presenting to the

hospital with worsening symptoms and she would more than
likely need to be admitted as she was now requiring oxygen to
address her low oxygen saturation readings. The patient
continued to get upset and after speaking with her husband she
agreed to be tested again. Upon receipt of her positive result
and her chest x-ray showing ground glass opacities consistent
with viral pneumonia that patient became even more
disgruntled. The patient let us know that she did not believe the
results and we were not carrying out the testing properly. It was
explained to the patient that she is in droplet isolation and
should not leave her room especially to use shared facilities.
The patient disregarded all the isolation precautions and
continued to walk around the unit. It was explained to her that
she was putting other patients and staff at risk and security
would be called if she continued to disregard the protocols. The
patient started to drop names of the influential people that she
knew and stated that she would be contacting various board
members to tell them how horribly she was treated by the staff.
As her nurse I explained to her that we are trying to provide her
with the best care possible and that I understood that due to the
fear surrounding the pandemic this diagnosis may be hard to
accept. With her permission I went head and contacted her
family and explained the details of what happened since their
loved one came into the hospital. Her husband and children
were afraid but did not approve of the way in which the patient
had handled the situation. After much discussion, they
convinced her to stay for treatment and monitoring.
It is our responsibility to do what is best for our patients and
sometimes we are faced with challenging situations that we
must navigate as healthcare providers. I tried my best to provide
care for this patient is the most respectful way possible while
advocating for the safety of the other patients and staff on the
unit. I realized that getting her family involved was best and
collaborated with them to de-escalate the situation and get the
patient admitted to the hospital. According The Chicago School,
cultural competence prepares Nurses to empathize and attend to

patients needs on a deeper level through bridging gaps and
personalizing care (2021).
References
Panchal, N., Kamal, R., Cox, C., & Garfield, R. (2021, July 20).
The implications of COVID-19 for mental health and substance
use. KFF. Retrieved from https://www.kff.org/coronavirus-
covid-19/issue-brief/the-implications-of-covid-19-for-mental-
health-and-substance-use/ (Links to an external site.).
The importance of cultural competence in nursing. Insight
Digital Magazine. (2021, August 13). Retrieved from
https://www.thechicagoschool.edu/insight/health-care/the-
importance-of-cultural-competence-in-nursing/.
Edited by Lyn-Bell, Andrea on Oct 29 at 1:52am
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