Crossing the cultural divide: A new model for nursing case management

There is an ongoing discussion about the best way to deliver culturally competent healthcare. The negative impact that cultural and linguistic barriers have on patients' understanding of illness, treatment, compliance, clinical outcomes, and quality of life, particularly among vulnerable populations, is widely recognized. As healthcare providers, we must recognize its importance as well as our own limitations in achieving it. It is clear that achieving cultural competency is a lifelong learning process and one skill that may we may never truly master.

This presentation describes a nursing model utilizing a team approach in an effort to maximize the delivery of cultural competent healthcare. Implemented in a public health program serving low-income, uninsured men with prostate cancer, this model partners a trained public health nurse with a bilingual Spanish-speaking coordinator, who possesses knowledge of Latino culture, social service information and referrals. All care is provided telephonically by the nurses. Training for both nurses and coordinators uses a curriculum emphasizing cultural competency and communication, while delineating areas of responsibility, scope of practice, strengths and limitations of each discipline, and strategies for creative problem solving. Nurses and coordinators work together to effectively break down barriers that impede access or adherence to treatment.

While much work remains to successfully develop and document evidence-based nursing strategies to eliminate health inequities in vulnerable populations, this collaborative model offers nurses greater insight into how to optimize health outcomes within the context of each patient's life situation; thereby, helping to bridge the cultural divide between provider and patient.