Elizabeth Fitzgerald

Significant literature exists that focuses on cultural competence at the individual level, while cultural competence at the organizational level is rarely addressed. In addition, there is extensive literature separating and distinguishing cultural competence from cultural humility. The lack of intersectionality between individuals and organizations and the perceived division between cultural competence and cultural humility impedes the delivery of quality and equitable services. Part II of this two-part series on cultural competemility applies an intersectionality approach to the process of cultural competemility and offer strategies for nurses to actively challenge and address inequalities in their journey towards cultural competemility. In Part II the authors discuss the problem of silo thinking, after which they present an intersectionality perspective of cultural competemility, offer practice, educational, and administrative, and research applications, and conclude that a lens of intersectionality allows healthcare providers to consider new ways to overcome the division between individuals and organizations so as to promote delivery of quality and equitable healthcare services.

Background: There is a need to identify objective measures for growth in the development of intercultural competence for students who engage in education abroad programs of study. The Intercultural Development Inventory (R) (IDI) identifies the participant's orientation on the Intercultural Development Continuum T (IDC). Method: Students completed the IDI 4 weeks prior to departure and 8 weeks upon completion of an education abroad program. Students were debriefed by an IDI-qualified administrator. Results: Group results suggest that students perceived they were further along in the IDC than their actual developmental orientation score revealed. Conclusion: The IDI has promise as a way to measure intercultural development. The IDI enhances preparation of students for participation in an education abroad program.

Nurses face many dilemmas when providing healthcare to immigrants, a vulnerable population. Racist, rancorous dialogue can create a hostile care environment that may place patients at risk for substandard care. This article presents a two part case study about a Hispanic patient to illustrate both examples of inappropriate dialogue (Part I) and potential nursing actions (Part 2). The authors review myths versus facts about Hispanic immigrants and introduce activist Thomas Merton’s concept of the guilty bystander, the nursing professional code of ethics, and Professor Joseph Badaracco’s concepts of quiet leadership as practical tools and approaches that nurses can use to advocate for safe, quality, ethical care of immigrant populations.

The purpose of this phenomenological study was to seek a better understanding of needs and access issues among pregnant, low-income Hispanic women. Hispanic women who attended a community prenatal education program participated in follow-up focus groups to explore their experiences regarding prenatal education, pregnancy resources, access to, and satisfaction with, the care available to them. Focus groups were facilitated by a leader, bilingual in English and Spanish, with knowledge of the Hispanic culture. Sessions were audiotaped, then translated into English for transcription. Data were analyzed according to guidelines by Colaizzi and three themes emerged: pregnant Hispanic women experienced a sense of anguish (la angustia) from questions and unknowns rampant during pregnancy, leading to a yearning (el anhelo) to learn and understand more, but with a desire to do so without sacrificing native identity (la identidad). Implications of these themes for improving prenatal care for this population are explored.