One charted phrase, noncompliant with diabetic diet, is taken apart with Tervalon and Murray-Garcia's account of cultural humility in NU434's reflection for Unit 6. Searches like "nu 434 unit 6 assignment example", "nu434 unit 6 sample" and "nu434 unit 6 example" land here.
"Noncompliant With Diabetic Diet": A Cultural Humility Reflection on a Chart Entry Written Before a Single Question
[Student Name]
Purdue University Global
NU434: Holistic Nursing
Unit 6 Assignment
[Instructor Name]
[Date]
Composite patient and family written as a model document. The reflection concerns the writer's lens, not the patient's background.
What Happened
A composite 64-year-old man was admitted with a foot infection and high blood glucose. Each evening his wife arrived with containers of home cooking. On my second shift I charted: "Noncompliant with diabetic diet, family bringing outside food." I had not asked either of them anything.
Two days later the dietitian's weight record showed he had lost 4 kilograms in five days. His trays were going back almost untouched. When I finally sat down with the couple, he told me the hospital food made him nauseated, and his wife's meals were the only ones he could finish. She had been bringing them so he would eat at all.
Self-Critique
Tervalon and Murray-García describe cultural humility as a lifelong commitment to self-evaluation and self-critique, to redressing power imbalances, and to building partnerships (Tervalon & Murray-García, 1998). Their first commitment asks me to look at my own assumptions before anyone else's.
The assumption underneath my phrase was that the tray is the treatment and anything else is defiance. I did not learn that from this patient; I learned it in training and on units where "outside food" is a problem to be managed. I wrote a judgment about him that was really a description of my own habit.
Power
A nursing note carries authority into every later shift. Nurses who read "noncompliant" before meeting him would approach him expecting resistance. Research on medical records has shown that stigmatizing language in a chart can shift how later clinicians view a patient and even the treatment they choose (Goddu et al., 2018). My phrase did not stay on my shift; it traveled with him to every nurse who came after me.
Partnership
The third commitment is partnership. Once I asked, the dietitian met with the couple, and together they adjusted his wife's recipes: portions, rice, the amount of oil. Her meals became part of the plan rather than a violation of it, and he started eating again. His glucose improved over the next four days, and his weight stopped falling.
What I Missed and Why
I missed it because the phrase was ready-made. "Noncompliant" is a word I had seen charted hundreds of times, and it let me describe a problem without understanding it. It also placed the problem in him rather than in the food, the plan or my questions. If I had asked one open question, "Tell me about the food your wife brings," the chart entry would have been different on the first day, and he might not have lost 4 kilograms.
I also notice that I assumed the family was the obstacle. In fact his wife was the only person on the team, in those first days, making sure he ate. The holistic nursing standards describe the patient and family as partners in care (American Holistic Nurses Association & American Nurses Association, 2019), and she was acting as one long before I recognized it.
What Humility Is Not
It would be easy to turn this reflection into a lesson about his culture, a list of foods or customs I should have known. That would miss the point. Tervalon and Murray-García contrast humility with competence understood as mastery of facts about other groups (Tervalon & Murray-García, 1998). I did not fail because I lacked facts about his background; I failed because I did not ask him anything and wrote as if I knew. Learning more facts would not have prevented that. Asking would have.
Humility also does not mean abandoning the plan. His glucose needed controlling, and the diet mattered. What changed was that the plan was built with him and his wife rather than imposed on them, and it worked better because it fit how he actually ate.
What I Do Now
Before I chart any patient as noncompliant, I ask one open question about the behavior and record the answer instead of the label. If I still need to document a gap between the plan and what is happening, I describe the gap in plain terms, for example, "eating home-cooked meals; hospital trays returned untouched; dietitian consulted," and leave out words that judge the person. I have also started reading back through my own notes at the end of a shift, looking for any word that tells the next nurse what to think of a patient before she has met him, and replacing it with what I saw and what the patient said.
References
American Holistic Nurses Association & American Nurses Association. (2019). Holistic nursing: Scope and standards of practice (3rd ed.). American Nurses Association.
Goddu, A. P., O'Conor, K. J., Lanzkron, S., Saheed, M. O., Saha, S., Peek, M. E., Haywood, C., & Beach, M. C. (2018). Do words matter? Stigmatizing language and the transmission of bias in the medical record. Journal of General Internal Medicine, 33(5), 685-691. https://doi.org/10.1007/s11606-017-4289-2
Tervalon, M., & Murray-García, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117-125. https://doi.org/10.1353/hpu.2010.0233
How this NU434 Unit 6 example is structured
Three commitments set out by Tervalon and Murray-Garcia organize the reflection, each applied to the same chart entry. Self-critique comes first: the writer identifies the assumption underneath the phrase, that the tray is the treatment and anything else is defiance, and traces it to training rather than to anything the patient did. Power follows: a nursing note carries authority into every later shift, so a word like noncompliant shapes how others approach him before they meet him. Partnership comes third, describing how the dietitian and the couple adjusted the wife's recipes together, portions and all, so home food became part of the plan. No paragraph offers the patient's background as an explanation, because the reflection is about the writer's lens. A final paragraph commits to one change in charting practice.
Get an NU434 Unit 6 example written to your instructions
Reflection prompts vary: some want one incident, some a pattern across a career. Share the Unit 6 wording, the incident you plan to use with identifiers removed, and the rubric. The model reflection keeps its lens on the writer and ends on a visible change. It arrives within 24-48h; the first one is free and drafted to your instructions. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU434 Unit 6 questions, answered
Does the reflection need to be about a patient from another culture?
Not necessarily, and the strongest reflections often are not. Cultural humility concerns any assumption a nurse brings into a room, including assumptions about age, class, body size or religion. The sample's assumption concerns food and adherence, and it never explains the patient through his background. Choose the moment where your own habit was most visible.
How personal should the writing be?
Personal enough to name what you assumed and why, but not confessional. The reader needs the assumption, its source and what changed, not an account of your feelings about it. First person is normal here. Keep patient details composite or stripped of identifiers, since the reflection is about your practice, not about the person you cared for.
Is cultural humility the same as cultural competence?
They are related but not the same, and conflating them costs precision. Competence frameworks describe knowledge and skills a nurse acquires; humility, as Tervalon and Murray-Garcia framed it, stresses ongoing self-critique, attention to power and partnership, with no point at which learning ends. If your prompt uses one term, use it accurately and mention the other only to draw the contrast.