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How can community health nurses apply the strategies of cultural competence to their practice? Provide at least one example from each of the following 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.

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 regarding the benefits of colostrum and the benefits of early breastfeeding .
In the past 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).Formula was believed to be the gold standard for infant feeding. At that time, cultural preservation was practiced, that is nurses supported formula-feeding assuming it was a “scientifically sound cultural” (Huber, p. 14) practice. In this instance, the outcome is the same, that is, the mothers are allowed to bottle feed their infant until their milk comes in. Preservation assumes the practice is correct and beneficial, whereas accommodation

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