Culture and the values learned within a cultural group are critical to how people perceive health, health care, and nursing care providers (Maurer, Smith, 2013). A community health nurse be educated in the cultural values, beliefs, views and their accepted way of life in order to provide care in a manner that the patient population will accept and understand.

Whether community/public health nurses focus on an individual, group, or community as the unit of care, these concepts must be understood to provide the best possible nursing care (Maurer, Smith, 2013) 

The deliberate act of keeping cultural heritage from the present for the future is known as preservation (Maurer, Smith, 2013) . These are practices that have been past down through multiple generations and provide a sense of pride to that culture. The Chinese culture of acupuncture to relive pain is a cultural preservation practice (americannursetoday.com, 2017). This has been shown to proven to control pain and can be used as part of the care plan for pain control. They risk infections, organ damage and bleeding if not preformed correctly(mayoclinic.org , 2017). The nurse may not believe in the practice and try to encourage medication only.

 Cultural accommodation is respecting a practice of a culture that has not been proven to work but does not cause harm to the patient (Maurer, Smith, 2013) . The Mexican culture places a metal object on the navel of a sick newborn because it is believed assist in healing (americannursetoday.com, 2017). . This has no evidenced based research proving any type of healing nor places the new born in danger. The nurse will incorporate this practice in the care plan of the new born showing respect for the cultural practice. May prevent the parents from seeking medical interventions in a timely manner resulting in a very ill newborn when seeking care. The care giver may not fully understand this practice and perceived the parents as neglectful and possible case for protective services. 

 Cultural repatterning is changing a practice that may interact in medical treatment (Maurer, Smith, 2013) . The African American Culture believes in prayers and folk medicines for healing. This may prevent the patient from compliance with their treatment plan that has a proven positive outcome. A cancer diagnosis brings increased prayers, home made medicine that has been past down from previous generations and refusal of medical treatment. My culture believes that air causes cancer to spread and will refuse recommended proven medical intervention. Having little to no understand, faith or trust  medical practice because Jesus heals the sick. No matter how much information is given or who presents it the cultural practice of prayer over rules all.

 Culture brokering gives professionals the tools to assess cultural factors so they can work more productively with clients from diverse backgrounds (Jezewski, 1990) . If a patient does not speak or understand English a culture broker will translate the information between the care giver and patient. . As the medical professional explains a cardiac cauterization to a patient, the broker can use a brochure with pictures of the procedure as a visual tool. Translating each step in correlation with the doctor, pictures, terms the patient understands being mindful of cultural implication of medical care by strangers. The patient may not have trust in the broker if no prior relationship existed and refuse treatment.

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