Profiles in Nursing
Josepha Campinha-Bacote and Culturally Competant Care
Taking a common sense, practical approach tp culturally competent care
Have you heard of CLAS? Not likely, but this wouldn’t surprise Josepha Campinha-Bacote, Ph.D., MAR, APRN-BC, CNS, CTN, FAAN.
A third-generation Cape Verdean, she has spent most of her professional career immersed in the issue of culturally competent care, and she is well aware of how much progress has been made, but also how many shortcomings persist.
Her interest comes naturally, the result of the untimely death of her grandfather, who received medication instruction that did not take into account his background and cultural mores. Since then, she has “used healthcare as the medium to look at treating everyone equally.”
Campinha–Bacote is a graduate of University of Rhode Island (1974) and Texas Women’s University (1980). She earned her Ph.D. in 1986 from the University of Virginia. Now a clinical specialist in adult psychiatric and mental health nursing, she has been a member of the American Academy of Nurses since 1998.
At present, Campinha-Bacote works primarily through Transcultural C.A.R.E. Associates, the company she founded in 1990. She also holds an appointment at Case Western Reserve University School of Nursing as a clinical assistant professor. She has developed several assessment tools for health professionals and offers presentations, training institutes and clinical education to these groups all over the country.
"A practitioner, not a theorist,” her goal is to have a model of cultural competence; her current work offers several well-developed constructs, but she is quick to say it will change if it can’t be applied. A prolific author, her book, The Process of Cultural Competence in the Delivery Healthcare Services, is in its fifth edition. She spends much of her time consulting for the Department of Health and Human Services on HRSA grants, working with universities to make sure concepts such as ethnopharmacology are integrated into the curricula.
So what is CLAS? These are the federal standards for culturally and linguistically appropriate services in healthcare that have been advocated since 2000. Campinha-Bacote is one of only two nurses who participated in their formulation. Since only a few parts of the standard are mandatory, recognition and implementation has lagged.
Focusing primarily on language interpretation, most hospitals have improved their compliance with this aspect of the standards. But many still have not instituted the broader requirements such as ongoing assessment of culturally sensitive care, recruitment that acknowledges the cultural composition of the service area, and appropriate grievance resolution. Campinha-Bacote sees workforce issues, the sort of “horizontal aggression” of nurses among themselves, to be one of the most challenging issues facing nursing.
One striking aspect of her work is her very clear enunciation of Biblical values, especially as they translate into moral and intellectual virtues. This is an uncommon approach for nursing academics, many of whom would not consider the Bible as a textbook, but often enough turn to icons of popular culture, the movie Crash for instance, as a resource.
How does she do it all, this heavy professional commitment including a new theology degree and a full family life with three children? She sets priorities: God, family, work, in that order. Perhaps as significantly, awards do not turn her head. The list of honors is quite long but Campinha-Bacote is not resting on her laurels.
Elizabeth Hanink RN, BSN, PHN, is a freelance writer with extensive hospital and community-based nursing experience.