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Josie is a public health nursing student completing her final clinical hours before graduating. She and a classmate have been volunteering in a school-based clinic. The school nurse has invited Josie to join her on a home visit to check up on a student who has just given birth. Josie uses the GPS on her smartphone to find the apartment; it is located in a part of the city she normally avoids. She carefully locks her car and joins the school nurse in the apartment lobby. The client answers the buzzer, and they are invited upstairs to the apartment. The unfamiliar hallway lighting and smells cause Josie to proceed cautiously. She hopes to focus on what the school nurse accomplishes rather than on her own feelings of discomfort.
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JOSIE'S NOTEBOOK Competency #10 Demonstrates Nonjudgmental and Unconditional Acceptance of People Different From Self
Listens to others in an unbiased, respectful manner
Promotes the expression of diverse opinions and perspectives
Identifies the role of diverse factors when selecting or designing public health interventions tailored to specific individuals, families, communities, or systems
Interacts respectfully, sensitively, and effectively with individuals, families, and communities
Source: Henry Street Consortium, 2022
USEFUL DEFINITIONS Acceptance: “To consider their patients’ culture and incorporate it in care” (Cioffi, 2003, p. 305) and the “respect of another's individual person and self-defined reality” (Porr, 2005, p. 189).
Cultural Competence:
“[A] set of congruent behaviors, attitudes and policies that come together in a system or agency or among professionals that enable effective interactions in a cross-cultural framework” (Cross et al., 1989, p. 4).
“[T]he ability to work effectively across differences” (Azzopardi & McNeill, 2016, p. 287).
Note that it is broadly accepted today that it is not possible to achieve cultural competence through acquiring knowledge and skills and that this term has been replaced by other terms, including cultural consciousness and humility.
Cultural Consciousness:
“[A]s an ongoing and dynamic developmental process with no endpoint—one that requires active, critical, and purposeful engagement on the part of the social worker entering the helping relationship” (Azzopardi & McNeill, 2016, p. 287).
“is conceptualized not only at the level of the individual social worker, but also at the broader level of the organization, recognizing that systemic support is crucial to delivering culturally responsive services” (Azzopardi & McNeill, 2016, pp. 287–288).
Cultural Humility: “incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances … and to developing mutually beneficial and non-paternalistic clinical and advocacy partnership with communities on behalf of individuals and defined populations” (Tervalon & Murray-Garcia, 1998, p. 117).
Unconditional: “A form of respect that involves profoundness of feeling, treasuring, warm regard, [and] solicitous concern” (Dillon, 1992, p. 120).
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Activity
Consider the following questions about Josie's situation: