Cultural competence in health care is understanding the ethnocultural diversity amongst patients and having a unique knowledge base for supporting their ideologies, beliefs, attitudes, norms, and values (Purnell, 2005). The Purnell Model provides a framework for providers to learn concepts and characteristics of culture, which define a persons worldview (Purnell, 2005). The macro aspects of this model include global society, community, family, and person (Purnell, 2002). On a micro level, this model consists of 12 domains which are interconnected and common to all cultures, subcultures, and ethnic groups (Purnell, 2002). These domains include heritage, communication, family roles and organization, workforce issues, biocultural ecology, high risk behaviors, nutrition, pregnancy and childbearing practices, death rituals, spirituality, health care practice, and health care practitioner (Purnell, 2002). This model can be used to help assess, plan, and individualize interventions (Purnell, 2005). For example, Orthodox Jewish law prohibits any active intervention that would hasten the death of a terminal patient (Jewish Visiting, n.d.). This includes not moving a dying patient as this may hasten death (Jewish Visiting, n.d.). Also, it is essential to clarify with family their specific intentions and limitations to the DNR order since Jewish law places great importance in preservation of life (Jewish Visiting, n.d.). In addition, a dying patient may wish to see a Rabbi to say prayers and possible arrangements should be made for the patients own Rabbi to attend (Jewish Visiting, n.d.). Communication may also differ across cultures. For example, the Chinese rely heavily on indirect communication, relying less on words and are more attentive to posture, expression, and tone of voice to draw meaning (Scroope & Evason, 2017). This may often make their speech ambiguous, as their purpose is to maintain harmony (Scroope & Evason, 2017). It is seldom for them to say no or disagree with you as they want to be polite and respectful (Scroope & Evason, 2017). It may be necessary to clarify several times, focus on hints of hesitation, and use a translator to clearly communicate with the patient (Scroope & Evason, 2017). In the hospital, it is also useful to call their family members, who speak English. Their family members are very helpful because they can clearly communicate the patients needs and relay the information back to the patient. Patients also tend to be more comfortable talking with their relatives and voicing their concerns to them than to a translator, who are strangers to them. It is important to recognize their needs by helping them feel comfortable communicating clearly and assisting them by using an interpreter or calling their caregiver. References Jewish Visiting. (n.d.). Caring for a jewish patient A guide for medical professionals. https://www.jvisit.org.uk/caring-for-a-jewish-patient-a-guide-for-medical-professionals/ Scroope, C., & Evason, N. (2017). Chinese culture. Cultural Atlas. https://culturalatlas.sbs.com.au/chinese-culture/chinese-culture-communication Purnell, L. (2002). The purnell model for culturally competence. Journal of Transcultural Nursing, 13(3), 193-196. Purnell, L. (2005). The purnell model for culturally competence. The Journal of Multicultural Nursing and Health, 11(2), 7-15.