| Course | NUR 391 Professional Nursing Theory |
|---|---|
| Module | Module 4 |
| Paper type | Discussion post with peer reply |
| Length | About 520 words |
| Format | Discussion post with APA 7 citations |
| School | Arizona State University |
| Program | RN to BSN |
| Updated | October 2026 |
Free sample paper for NUR 391 Module 4
Discussion: Cultural Advocacy
Speaking in a Good Way: Advocating for How a Diné Patient Receives Risk Information Before Access Surgery
Initial Post
My cultural advocacy example comes from our dialysis clinic. Mr. B. is a composite of several patients I have cared for: a Diné man in his sixties who moved to Phoenix from the Navajo Nation to be closer to dialysis. Kidney failure is far more common among Navajo adults than among U.S. adults overall (Hochman et al., 2007), so many of our patients share his background. His catheter had to be replaced with a fistula, and the surgeon's office sent a consent form listing risks such as infection, clotting and loss of the limb. When a staff member began reading the risks to him, saying "you could lose your hand," he stopped her, said he would not sign, and missed his next treatment.
I learned that for some traditional Diné people, speaking about bad outcomes is believed to make them more likely to happen. In an ethnography on the Navajo reservation, informants explained that patients and clinicians should think and speak in a positive way, and most of those asked considered advance care planning a dangerous violation of traditional values (Carrese & Rhodes, 1995). The concept behind this is hózhó, which joins beauty, harmony, goodness and order. Not every Diné patient holds these beliefs, so the first step is to ask rather than assume.
I asked Mr. B. how he would like to hear information about the surgery. He said he wanted to know what the doctors would do and what he should watch for, but he did not want anyone to say bad things would happen to him. I spoke with the surgeon's nurse and our charge nurse, and we agreed to present risks in the third person and in terms of what the team does to keep patients well, for example, "Some people get an infection, so the team checks the site at every visit." His nephew attended the next conversation, and Mr. B. signed the consent the following week.
Leininger's culture care theory, which pairs cultural diversity with universality, fits this situation because it asks nurses to preserve, accommodate or repattern care according to the patient's culture (Friberg & Saewert, 2023). Here we accommodated how information was delivered while keeping the content needed for informed consent. That is the difference between advocacy and avoidance: the patient still received the information, but in a form consistent with his values.
Reply to a Classmate
Dana, your example of a Muslim patient who requested a female nurse during Ramadan raised a staffing question I had not considered: what happens when the accommodation is hard to provide on a given shift? In my example, the change was in our words, which cost nothing. In yours, it depended on who was working. I like that you documented the preference in the care plan so the next shift could plan for it. I wonder whether your unit has a standing way to record cultural preferences, because ours relies on whoever happens to know the patient best, and that knowledge leaves when a nurse transfers.
References
Carrese, J. A., & Rhodes, L. A. (1995). Western bioethics on the Navajo reservation: Benefit or harm? JAMA, 274(10), 826-829. https://doi.org/10.1001/jama.1995.03530100066036
Friberg, E. E., & Saewert, K. J. (Eds.). (2023). Conceptual foundations: The bridge to professional nursing practice (8th ed.). Elsevier.
Hochman, M. E., Watt, J. P., Reid, R., & O'Brien, K. L. (2007). The prevalence and incidence of end-stage renal disease in Native American adults on the Navajo reservation. Kidney International, 71(9), 931-937. https://doi.org/10.1038/sj.ki.5002100
What the NUR 391 Module 4 instructions ask for
The current NUR 391 syllabus pairs this 5-point discussion with Module 4's reading on nursing theories related to professional practice and a short theory quiz. The cultural advocacy prompt generally has you recount a time a patient's culture shaped care, explain how a nurse advocated, or could have advocated, for that patient, and connect the situation to a nursing theory or professional standard from the readings. As with other boards in the course, you write an initial post and respond to classmates during the week. Check Canvas for whether a specific theory is required, the number of sources, and the reply count, since some instructors ask for two replies.
How the NUR 391 Module 4 example is put together
The sample starts with a concrete encounter at a dialysis clinic, a consent conversation that went wrong, and gives enough detail to show why it mattered. It then explains the cultural belief behind the patient's reaction with a cited ethnography and adds a caution against assuming every Diné patient shares it. The advocacy is described as actions, asking the patient, talking with the surgeon's nurse, and changing the framing of the risks, with the result stated. A paragraph names Leininger's culture care theory and uses its own terms to explain why this was accommodation rather than withholding. The reply builds on a classmate's example with a practical question. The three sources appear in an APA reference list under the post.
Where the marks sit in the NUR 391 Module 4 rubric
Discussions in NUR 391 are usually graded on whether the post answers every part of the prompt, applies the module's reading accurately, uses scholarly support and meets the reply requirements. For this board, graders look for a clear example of advocacy, a named theory applied correctly, and respect for the culture described, without stereotyping. Citations in APA format are expected on posts. Replies earn points when they extend the classmate's thinking with a question, a contrast or a source. Late posts tend to lose points quickly because each board is worth only five. A post that shows the patient's own voice, what he said and what he asked for, usually reads as stronger advocacy than one that only reports what staff decided.
NUR 391 Module 4 help: mistakes that cost marks
A common problem is describing a culture as a list of traits, which can read as stereotyping; describe one patient's preferences and note that individuals vary. Another is presenting advocacy as simply doing what the family asks, which can conflict with the patient's own wishes or with informed consent. Name the theory and use its concepts, not just its title. Keep identifiers out of the post, and do not name the facility. If the prompt asks for a theory other than Leininger's, apply that one. If you would like a draft built on your own example, send the board prompt and a short description. Also make clear that the patient received the full information, since advocacy never means withholding what consent requires.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More NUR 391 and RN to BSN sample papers
- NUR 391 Module 1: Introductions and Social Forces Discussion
- NUR 391 Module 2: Socialization in Nursing Paper
- NUR 391 Module 3: Ethics Essay on Dialysis Withdrawal
- NUR 391 Module 5: Quality and Patient Safety Discussion
- NUR 391 Module 7: EBP in the Workplace and Group Communication
- NUR 460 Module 3: Image of Nursing Presentation
- NUR 318 Module 6: Evidence Evaluation Table and Appraisal
- NUR 444 Module 5: Informatics Competencies Assessment and Plan
- NUR 392 Module 5: We Are Family Meeting Presentation
NUR 391 Module 4 questions, answered
Where can I find a free NUR 391 Module 4 sample paper?
The complete cultural advocacy discussion is here: an initial post about framing surgical risks for a Diné dialysis patient, tied to Leininger's culture care theory, and a reply to a classmate, with references.
Which nursing theory works for the NUR 391 cultural advocacy discussion?
Leininger's culture care diversity and universality theory is the most direct fit, though Purnell's model or the Campinha-Bacote model also work if your readings include them.
How do I avoid stereotyping in a NUR 391 cultural post?
Describe one patient's stated preferences, cite research about the culture carefully, and say that individuals differ. Show that you asked the patient rather than assumed.
What counts as advocacy in the NUR 391 discussion?
Actions a nurse takes to protect a patient's rights, safety or preferences, such as asking about preferences, involving the team, arranging an interpreter, or changing how care is delivered.
Can I use an example from clinical rotation in NUR 391?
You can, provided nothing in the post could identify the patient or the site. Many RN to BSN students use an example from their current job.