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Importance of Cultural Competence in Nursing + 10 Examples of Culturally Competent Nursing Care


Written By: Darby Faubion BSN, RN

Are you a nurse who has faced situations in your nursing practice when your patients or peers were from a different culture and held different beliefs or values than you? Did those differences create problems or barriers to communication and effective work or patient care? In cases like this, understanding and implementing cultural competence is essential. Perhaps you are wondering, “What is cultural competence in nursing?” In this article, I will explain what cultural competence means and share my thoughts on the importance of cultural competence in nursing + 10 examples of how you can implement culturally sensitive and competent behaviors in your nursing practice.


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What Is Cultural Competence In Nursing?


Cultural competence refers to the ability of a person to understand and respect the attitudes, values, and beliefs of people with different cultural backgrounds. Cultural competence in nursing is the ability of nurses to provide nursing care to patients while demonstrating cultural awareness toward the patient and their loved ones.


How Is Cultural Competence Different From Cultural Humility?


Cultural humility is a process of inquiry and reflection involving one's awareness of cultural and personal biases. It includes demonstrating sensitivity and awareness of significant cultural issues affecting others, and offering opportunities for other people to share their own experiences, feelings, values, and beliefs without fear of judgment. Practicing cultural humility means a person can admit they do not know something and be willing to learn from others about their experiences while maintaining a firm belief in their own cultural standards.

On the other hand, cultural competence emphasizes the knowledge, attitudes, and skills nurses use to support care for people from different cultural backgrounds.


5 Reasons Why Cultural Competence Is So Important In Nursing


Cultural competence in nursing is no longer an option. Instead, it is vital for all nurses to develop culturally competent attitudes and behaviors. The following are a few reasons why cultural competence is so important in nursing.

1. Deeper Patient Relationships:

Cultural competence in nursing prepares nurses to relate to patients on a deeper level, making it easier for patients to respond to nurses and vice versa. These deeper nurse-patient relationships typically result in increased patient compliance and better health and organizational outcomes.

2. Greater Patient Satisfaction:

Cultural competency is known to improve the attitudes and knowledge of nursing staff, which makes patients feel more at ease, leading to greater patient satisfaction scores.

3. Less Risk of Healthcare Disparity:

Health disparity refers to the differences in the health status of different groups of people. Lack of knowledge about and respect for race, ethnicity, immigrant status, and sexual orientation are some factors that impact health disparities. When nurses practice cultural competence, they recognize that patients should be served with the same level of high-quality, safe nursing care, regardless of cultural differences.

4. Improved Patient Outcomes:

If there is a concern about the care plan, the patient is more likely to ask questions and work with the nurse to develop a culturally appropriate plan of care and be compliant, which increases overall health outcomes.

5. Better Patient Care:

Cultural competence promotes nurses' professional growth and development, making them more effective providers of patient care.


What Are The 5 Important Elements Of Cultural Competence In Nursing?


There are several elements and principles upon which culturally competent nursing practices are built. The following are five important elements necessary to practice cultural competence in nursing.

1. Cultural Awareness:

The first element of cultural competence in nursing is cultural awareness. This element involves examining yourself, your beliefs, and your values. Practicing cultural awareness means demonstrating a willingness to set aside prejudices against other cultures and developing an attitude of acceptance toward all patients and peers.

2. Cultural Desire:

A person's motivation to learn about other cultures is referred to as cultural desire. It is an openness toward other people and the ability to accept and understand cultures and learn from them.

3. Cultural Knowledge:

This element of cultural competence in nursing refers to acquiring information about the norms, beliefs, and values of others. Cultural knowledge is the aspect of cultural competence in nursing that involves actively searching for information about patients' beliefs, cultures, and values to help you understand and interact with them better, strengthening nurse-patient relationships.

4. Cultural Skills:

As you deepen your knowledge of diverse cultures, it then becomes possible to develop cultural skills. Cultural skills refer to a person's ability to collect and process relevant cultural data as it relates to the patient's presenting problem and perform a culturally sensitive and specific assessment. Cultural skills are useful in helping nurses engage patients, families, and peers with meaningful interaction, and be supportive of cross-cultural beliefs and values.

5. Cultural Encounter:

Each of the last four elements of culturally competent nursing leads to the cultural encounter. Cultural encounter occurs when nurses step out of their comfort zones and venture into new environments to interact with people from other ethnicities, cultures, and backgrounds.


5 Skills A Nurse Must Have To Provide Culturally Competent Care


It is essential for all nurses to demonstrate cultural competence in nursing. Both new nurses and experienced nurses can learn to implement skills that promote culturally competent nursing care. The following are a few essential skills to help provide culturally competent care.

1. Self-Awareness:

Becoming aware of and understanding your own cultural values, attitudes, judgments, and beliefs is vital when interacting with people from other cultures. Self-awareness is essential because our values, beliefs, and attitudes shape our perception of others and define how we see individuals and the world around us.

2. Effective Communication:

Effective, culturally respectful, and competent communication is vital in all aspects of nursing and healthcare. Effective communication can break down barriers, improve access to healthcare services, and promote positive health outcomes for clients.

3. Willingness to Learn:

Developing cultural competency involves a lifelong process of learning. Nurses must be willing to learn about themselves (self-awareness), develop behaviors and social skills relevant to diverse cultures and populations, and develop the ability to advocate for others.

4. Ability to Demonstrate Humility:

Humility is described as having a modest view of one's own importance. It is crucial for nurses to learn how to demonstrate humility when dealing with others, especially in the case of diverse cultures. Humility in cultural competence means avoiding judgment or biases about others' beliefs and accepting those beliefs, even if they contradict

5. Be Nonjudgmental:

Being culturally competent in nursing requires setting aside personal prejudices and biases that may lead to judgmental assumptions. Even the most well-intentioned among us can be judgmental at times. Practicing the art of acceptance and setting aside judgmental attitudes is a skill that demands lifelong perfecting.



HOW TO DEMONSTRATE CULTURAL COMPETENCE IN NURSING?


It is necessary for all nurses to find ways to strengthen cultural competence in their practices. There are many ways to demonstrate culturally competent nursing. The following are ten examples of cultural competence in nursing. In some examples, you will find a mock patient situation. Please note, that the names do not represent any patient's real name and is used for demonstration of the situation only.

EXAMPLE #1: Acceptance of the Patient’s Beliefs

Situation:

Mr. Jenkins has been a Christian minister for more than forty years. His primary nurse, Nurse Anna, does not associate with any religious preference, stating she does not believe in a spiritual deity or an afterlife. Mr. Jenkins fears her lack of Christian views may hinder her ability to provide the type of care he wants.

Culturally Competent Response:

Although there are an estimated ten thousand distinct religions worldwide, sixteen percent of the world's population do not affiliate with any religion, or are atheists or agnostics. In some cases, like the example above, a difference of religious opinions is cause for concern to the patient, nurse, or both.

The culturally competent response in this situation is for the nurse to be attentive to Mr. Jenkins' wants and needs without showing prejudice or bias because of her personal beliefs. If Mr. Jenkins approaches the topic of religion or Christianity with Nurse Anna, it is appropriate for Nurse Anna to listen to Mr. Jenkins without feeling the need to agree with him. In some cases, it may be necessary to set professional boundaries, including clarifying which topics are appropriate for discussion and those that are not. Cultural competence in nursing is best demonstrated in this scenario by the nurse being attentive, asking appropriate questions, and finding out to what extent Mr. Jenkins’ religious beliefs influence his decisions about healthcare.

Outcome of the Response:

When nurses show genuine interest in a patient's thoughts, values, and beliefs, it helps reduce stress and worry. It is essential to understand that showing interest does not mean changing your own beliefs to accommodate the patient. Instead, healthy conversations and appropriate sharing of relevant information can help nurses determine the best course of action in providing care while respecting the patient's beliefs and wishes.


EXAMPLE #2: Build Trust and Rapport with Patients and Team Members

Situation:

Effective nursing care requires building trust and rapport with patients and team members, regardless of racial or ethnic background. Treating patients or working with peers from diverse cultures often requires higher levels of trust to be established and maintained.

Mrs. Wilhite is an African American patient assigned to the care of Nurse Michael, a Caucasian male nurse. Mrs. Wilhite is guarded when Nurse Michael is in the room but appears more relaxed when Nurse Tammy, who is also African American, enters her room.

Culturally Competent Response:

Whether Mrs. Wilhite's apprehension is related to personal experiences related to racial differences or prejudices or the fear of such issues arising, Nurse Michael must acknowledge her feelings and work to help her feel at ease. While it could be pretty easy to request a reassignment, that does not promote cultural competence or help resolve the issues. The culturally competent response to this situation would be for Nurse Michael to get to know Mrs. Wilhite and allow her to get to know him. Simple acts such as spending a few extra minutes in the room to make sure Mrs. Wilhite is comfortable and asking about her family or hobbies show a genuine interest in Mrs. Wilhite and help build rapport and trust.

Outcome of the Response:

When patients feel a sense of rapport with and trust in their nurses, the likelihood of positive outcomes increases. Patient anxiety is reduced, participation in care increases, and open, therapeutic communication is more likely to occur. All of these contribute to improved patient outcomes and a better work environment.


EXAMPLE #3: Show an Interest in Learning About Other Cultures

Situation:

Nurse Emille works in an assisted living facility with a culturally diverse population. The facility residents are active, participating in group activities and outings. She can talk to clients from different backgrounds each day and wants to become a source of encouragement and help to anyone who needs her.

Healthcare reaches its full potential when nurses provide holistic care, including considering the patient, their family, their cultures, and day-to-day life and traditions. In this example, Nurse Emille is uniquely positioned to learn about different cultures, traditions, and beliefs and build strong nurse-client relationships.

Culturally Competent Response:

Nurse Emille can demonstrate a culturally competent response by getting to know patients on a level that is comfortable for them. Simple gestures, such as asking about her clients' families, work background, hobbies, likes, and dislikes are great ways to show interest. Allowing the clients to share their personal beliefs and stories about their cultural background and beliefs will give the nurse some insight into each client. She should show genuine interest in what each client says and, when appropriate, ask questions to gain a better understanding.

Outcome of the Response:

Showing interest in others and learning about what makes them different or unique is an excellent way to show cultural competence as a nurse. When nurses are open to hearing about their patients, families, and customs, it gives the patient a sense of belonging and strengthens the nurse-client relationship.


EXAMPLE #4: Educate Patients About Their Plan of Care

Situation:

It is crucial for each patient, regardless of their cultural background, to understand their care plan and consent to any medical procedures. If a patient is unfamiliar with a practice, the nurse is often the one who explains the procedure, why it is necessary, and how it benefits the patient.

For instance, Mr. Messina is accustomed to eating large meals that consist of heavy carbohydrate content, such as pasta and homemade breads. Unfortunately, Mr. Messina has been diagnosed with diabetes and must take insulin to control his blood sugar levels. He is frustrated, stating, "Don't you understand I'm Italian, and it's in my nature to eat pasta? I'd eat it at every meal if I could!"

Culturally Competent Response:

For many people, dietary habits are closely related to cultural traditions. Although it may be easy for some patients to give up a certain type of food, others may find it quite difficult. A culturally competent nurse should address Mr. Messina's concerns about his dietary changes with genuine concern.

The best response is to ask Mr. Messina if there are any foods he feels would be easier to give up or to enjoy in moderation. In this situation is appropriate to offer a dietary consultation with a dietician who recognizes the importance of cultural competence and is willing to help Mr. Messina develop a meal plan that makes him happy while meeting his health needs and restrictions.

Outcome of the Response:

In many cases, the fear of change is the biggest drawback for patients. When nurses make patients, like Mr. Messina, feel like their concerns or objections are valid and offer to help find solutions, the patients are less likely to be non-compliant.


EXAMPLE #5: Demonstrate Active Listening

Situation:

Mr. Wilson is an elderly patient being cared for by Sophia, a Hispanic nurse. Mr. Wilson is hard of hearing and appears anxious, especially when he does not understand what Nurse Sophia is saying, or he feels as though she does not understand what he says.

Culturally Competent Response:

Being hard of hearing can be frustrating for anyone. It becomes especially troublesome when the person who is talking feels like they are not understood. The culturally competent response to the situation would be for Nurse Sophia to calmly tell Mr. Wilson she understands he is frustrated but that she desires to listen to him and provide the best care possible. Then, the nurse should listen attentively to what the patient has to say without interrupting.

Outcome of the Response:

Practicing active listening is an excellent way to make patients feel what they say is essential. This is especially important when there are cultural barriers to communication. When a culturally competent nurse takes the time to listen to patients and puts forth the effort to understand the message the patient hopes to convey, it creates a more relaxed environment, which makes it easier to facilitate therapeutic communication and improve patient outcomes.


EXAMPLE #6: Overcome Language Barriers

Situation:

Ms. Sanchez arrived at the emergency department via ambulance with symptoms indicating a possible CVA. She speaks very little English, and her family has not yet arrived at the hospital. When Nurse Lee tries to communicate with Ms. Sanchez, the patient becomes increasingly anxious, causing the nurse to realize the need for assistance communicating with Ms. Sanchez.

Culturally Competent Response:

There are several culturally sensitive nursing care examples related to cultural competence. It is especially important to recognize examples related to barriers to care caused by language differences.

In the case of Ms. Sanchez, the culturally competent response should include a few actions by the nurse. The nurse's first action should be to speak calmly and slowly to the patient to try and ease her anxiety. If available, Nurse Lee should access the hospital's translator service at least until the patient's family arrives. In some cases, if the family is not yet present, but a phone number is available, the nurse may phone a family member and allow them to translate over the phone. Any important decisions that can be delayed without harm until an interpreter or family arrives should wait.

Outcome of the Response:

Patients requiring medical care are often anxious and scared. When there is a language barrier, it can worsen their fear and anxiety. In situations like the one described in this example, nurses can help calm patients by taking steps to facilitate effective communication. In this situation, whether the nurse utilizes a staff member, translator service, or a family member to communicate with Ms. Sanchez, the potential for a positive outcome increases.


EXAMPLE #7: Respect the Patient’s Religious and Cultural Beliefs, even if They Conflict with the Treatment Plan

Situation:

Mr. Ferrington had abdominal surgery two days ago. Although his recovery started without incident or concern, he now has bleeding, which has resulted in significant blood loss. His physician wants to do a blood transfusion. However, Mr. Ferrington is a Jehovah's Witness and does not believe in receiving blood transfusions. He states, "If Jehovah wants me to have more blood, He will stop the bleed. I choose to decline a transfusion."

Culturally Competent Response:

It is natural for nurses to want to encourage a patient's compliance with a recommended treatment regimen, especially if it is considered a life-saving measure, including a blood transfusion. In this situation, it is crucial for the nurse to set aside their own personal feelings or beliefs and respect the patient's decision. The nurse is responsible for educating the patient about the suggested treatment plan, answering any questions, and then allowing the patient to decide.

A culturally competent response in this situation would be making a statement like the following: “Mr. Ferrington, after talking with the doctor about your healthcare options, it is my understanding that you do not wish to proceed with having a blood transfusion. Do you have any concerns or questions I can address with you, or is there anyone you would like to consult with?”

Outcome of the Response:

One of the most challenging situations nurses face is knowing what could benefit a patient and increase their chances for improved outcomes but having to face the fact that the patient has a right to accept or decline treatment. When a culturally competent nurse addresses a situation like the one in this example with a sense of understanding and acceptance, it gives the patient a sense of control and helps build trust within the nurse-patient relationship. This is important because, although Mr. Ferrington may choose not to have a blood transfusion, other treatment options may be available. If he feels he can trust his nurse to listen and respect his wishes, he is more likely to be open about his wants and needs.


EXAMPLE #8: Honor Traditions for End-of-Life Care

Situation:

Knowing how to conduct oneself in the face of a patient’s death is another example of culturally sensitive nursing care. Dying is a personal process. The values, goals, and experiences of individuals impact how that person views death and dying. It is important for nurses to be aware of any cultural or religious traditions their patients have regarding end-of-life and post-mortem care.

For example: Mr. Aronowitz is an Orthodox Jewish patient receiving care in the hospice ward of a long-term care facility. Mr. Aronowitz and his family have expressed their desire to have their Jewish beliefs honored and traditions upheld, including proper post-mortem procedures.

Culturally Competent Response:

Nurses who wish to provide culturally competent nursing care must be willing to learn about their patient's beliefs and desires for care. In this example, the nurse should talk with the patient and his family and ask about their traditions and beliefs so that end-of-life and post-mortem care is respectful of those beliefs. For instance, Orthodox Jews typically will not bury a person on Saturday, or Shabbat, or on a Jewish holiday. True Orthodox Jews may not answer the phone on those days, which could make notifying next of kin difficult. The nurse should verify who should be contacted in the event of the client's death or another emergency. Additionally, many Jewish families use a funeral home and a Chevra Kadisha, which is a Jewish burial society. It is important to know the family's intentions for using a Chevra Kadisha because, if used, they will wash the body according to Jewish law.

Outcome of the Response:

Individuals who follow a specific religious belief find relief in knowing their nurses and other healthcare providers are willing to honor their beliefs. By acknowledging the patient’s beliefs and following their religious preference, it creates a stronger nurse-patient bond, making the delivery of healthcare easier, even in the most difficult times.


EXAMPLE #9: Avoid Making Assumptions

Situation:

Nurse Kimberly is a new nurse working on the Med-Surg floor. She has been assigned to care for Mr. Collins who is rumored to be a member of a white supremacist group. Nurse Kimberly has no personal prejudices against any race and is concerned that Mr. Collins may be offended by or retaliate against her.

Culturally Competent Response:

One of the most important rules nurses can live by is to avoid rumors which can lead to inappropriate or misplaced assumptions. Whether Mr. Collins is a member of any group, organization, or culture should not impact the quality-of-care Nurse Kimberly provides or her attitude toward him. The culturally competent nursing response is for Nurse Kimberly to provide high-quality nursing care, within her scope of practice to Mr. Collins. If issues arise that make Nurse Kimberly feel uncomfortable or fearful, she should discuss those issues with her immediate supervisor, not other staff members.

Outcome of the Response:

It is necessary to acknowledge that just because someone tells you something that does not always make it true. In this example, if Nurse Kimberly treated Mr. Collins differently because of the rumor she heard, his quality of care could have been compromised, resulting in a poor outcome. However, demonstrating culturally competent nursing and being respectful of Mr. Collins as a patient and healthcare client helps to build rapport and a trusting nurse-patient relationship and improve the chances of a positive health outcome for him.


EXAMPLE #10: Advocate for a Culturally Diverse Nursing Workforce

Situation:

There is a challenge in healthcare caused by the increased healthcare needs of diverse ethnic and racial populations, each having its own cultural traditions. Additionally, only approximately nineteen percent of the registered nurse workforce in the United States is comprised of nurses from minority backgrounds.

Culturally Competent Response:

Advocating for opportunities for a more culturally diverse nursing workforce is another one of the examples of cultural competence in nursing. Nurses who realize the need for cultural diversity among the nursing team and bring those needs to the attention of employers are instrumental in creating a culturally diverse work environment capable of catering to patients from many different backgrounds.

Outcome of the Response:

As the nursing workforce becomes more culturally diverse, it is possible for healthcare organizations and facilities to offer culturally competent and sensitive care to clients. The diversity in nurses creates a welcoming and accepting atmosphere where patients feel more comfortable, increasing patient retention and compliance and improving patient outcomes.



HOW TO BECOME A MORE CULTURALLY COMPETENT NURSE?


Practicing cultural competence in nursing benefits everyone involved in patient care, including the patient, nurse, healthcare team, and the healthcare organization. There are several things you can do to implement measures to increase your level of cultural competence. Learning cultural competence does not have to be centered around nursing only. You can learn to become more culturally competent and demonstrate those skills in your personal and professional life. Once you learn and implement these skills, you can use them to demonstrate culturally competent nursing care. The following are 10 tips to help you become a more culturally competent nurse and individual.

1. Practice Self-Awareness:

You can begin practicing self-awareness by exploring your own cultural history, values, and beliefs. A few ways to practice self-awareness are to ask trusted friends or family members to describe you, take personality tests, and ask for feedback from supervisors and peers.

2. Learn About Different Cultures:

There are several ways to learn about different cultures. Seek insight into diverse cultures by reading academic books, journals, and articles focused on people from other cultures.

3. Interact with People from Diverse Cultural Groups:

Developing cultural competence takes deliberate action. A few things you can do to promote cultural competence include getting involved with culturally diverse opportunities. For example, attend events sponsored by professionals from other cultural backgrounds or participate in campus-wide or organizational events that cater to issues of inclusion and social change.

4. Share Things About Your Culture with Others:

Cultural competence is not only learning about others. It also involves an element of sharing things about your culture, values, and beliefs with others. When you share information about the things you value, others tend to feel more at ease doing the same, which improves cultural competence for everyone involved.

5. Seek Positions in a Culturally Diverse Setting:

Most people have heard the old phrase, "sink or swim." It is a saying that uses swimming as a way of describing how you either fail for lack of trying or swim because you give it all you got. In other words, if you don't try, you sink, but you can succeed if you kick your feet and paddle your arms until you are swimming. The same principle applies when learning cultural competence in nursing. Seek positions in settings that are culturally diverse. Then, put forth your best effort to learn from and about others and allow them to learn about you.

6. Seek Cross-Cultural Interactions with Peers:

One of the easiest ways to increase cultural competence in nursing is for nurses to intentionally engage with peers from other cultural backgrounds. It is possible to share thoughts and ideas, learn about other cultures from your peers and help strengthen one another's cultural competence.

7. Consider Volunteer Opportunities:

Volunteering is an excellent way to get involved with and learn about different cultural practices and beliefs of people from diverse populations. Many nurses volunteer in community health clinics, especially in underserved areas where diversity of populations is more common.

8. Be Mindful of Your Perspective on Cultural Diversity:

Cultural competence is a lifelong process that involves increasing your self-awareness and developing social behaviors and skills that promote acceptance of diverse cultures. Learning to be a culturally competent nurse means having an open mind and a willingness to learn about and accept that cultural diversity is the norm for society. Be aware of your personal biases, opinions, and any prejudices. Ask yourself questions about what made you form those opinions and discover ways to overcome any negative feelings about different cultures.

9. Attend Conferences and Events Focused on Cultural Diversity and Competence:

One of the best ways to learn about cultural competence is to learn from others who have high levels of cultural competence. Professional conferences, such as those offered by nursing associations, healthcare organizations, or professional development coaches, are excellent places to learn from experienced people. One of the great things about attending conferences or events is the opportunity to meet people from culturally diverse backgrounds in person.

10. Consider Learning a New Language:

Although your job may not require it, learning a new language can benefit you, your patients, and your organization. Learning a new language is an excellent way to build rapport with patients who speak little or no English and helps foster trusting relationships with patients and their families for whom there is a language barrier in healthcare.



5 Consequences Of Lack Of Cultural Competence In Nursing


1. Poor Patient Outcomes:

Lack of cultural competence in nursing often results in lower-quality care, which can negatively impact patient health outcomes.

2. Stress Within the Interdisciplinary Team:

Nurses who work within culturally diverse teams but lack cultural competence experience higher stress levels on the job. High stress leads to decreased quality of care and higher employee turnover rates.

3. Decreased Patient Compliance:

Nurses are responsible for providing high-quality patient care, including educating patients about the care plans and anticipated outcomes. When there is a lack of cultural competence, nurses may fail to convey messages about care or explain treatments effectively, which can result in decreased patient compliance.

4. Increased Healthcare Costs:

The culturally competent nurse understands the impact cultural competence has on patient care and healthcare costs. When there is a lack of cultural competence, the chances of nursing errors increase. When errors occur, it can lead to legal ramifications, which often results in increased healthcare costs.

5. Decreased Patient Satisfaction Scores:

When patients feel their cultural traditions or beliefs are not valued, they may develop a negative outlook toward the nursing and healthcare staff. Whether their feelings are justified or the result of a misunderstanding, the lack of cultural competence the patient believes they experienced can result in decreased patient satisfaction scores.


Useful Resources To Learn More About Cultural Competence In Nursing


Even the busiest nurses can access information with a quick click of a mouse or swipe on a smart device. If you want to learn more about culturally competent nursing and how to improve cultural competence, a few ways you can accomplish this is to read books, watch videos, and listen to lectures or podcasts. The following are examples of some blogs, websites, YouTube videos, podcasts, and books about culturally competent nursing.

Blogs/Websites

Diversity Nursing:

This website offers resources to bring nurses, nurse educators, and healthcare employers together, focusing on diversity and inclusion in nursing. Nurses can post resumes and search for jobs on the site. Healthcare employers may create profiles and post job openings to the site, as well. Diversity Nursing also features a blog with helpful information on various topics, including cultural competency in nursing.

YouTube Videos

Becoming a Culturally Competent Nurse:

This sixteen-minute YouTube video is presented by Jana Lauderdale, RN, FAAN, Ph.D., Associate Professor, Assistant Dean at the Office of Diversity and Inclusion at Vanderbilt University. Ms. Lauderdale shares innovative ways for nurses on the front lines of healthcare to provide life-changing patient care and improve health outcomes for patients and families.

Cultural Competence for Healthcare Providers:

Presented by the Jefferson Center for Interprofessional Education, this video offers cultural competence training for healthcare providers. The video includes perspectives from patients and providers.

Cultural Competence and Diversity in Healthcare:

Dr. David (DrRegisteredNurse) shares her views on the importance of cultural competence in nursing and the impact of diversity in healthcare. This fifteen-minute video includes Dr. David’s perspective on overcoming the challenges of becoming culturally competent and how to implement culturally competent nursing practices.

Podcasts

The Nurse Keith Show:

Featured on the Health Podcast Network, the Nurse Keith Show offers several episodes filled with information essential to nurses and the many roles we fill. Episode 145, Diversity, Embracing Cultural competence, and Your Nursing Career, discusses embracing cultural diversity and developing cultural competence as a key aspect of all 21st century nursing roles.

Audible:

Audible is an online platform offered through Amazon featuring podcasts and other professional resources. One example is the podcast Cultural Competence is Not a Destination with Dr. Karlita Warren. In this episode, Dr. Warren discusses the meaning of cultural competence and its implications for patients and nurses alike.

Books

Cultural Competencies for Nurses- Impact on Health and Illness:

This text offers information about health beliefs and the impact of culture on both health and illness. It contains an overview of the most common cultural competency theories for nursing, information about the health beliefs of some minority groups, the impact of diversity on health disparities, and case studies.

A Treatment Improvement Protocol- Improving Cultural Competence:

In A treatment Improvement Protocol, learn about measures to improve cultural competence in nursing and impact patient outcomes.


BONUS! 5 Barriers To Cultural Competence In Nursing And What You Can Do To Overcome Them


It is every nurse’s responsibility to recognize barriers to cultural competence in nursing and find ways to address and overcome them. The following are five examples of barriers that impact cultural competence in nursing and suggestions for ways to address and overcome them.

BARRIER #1: The Patient’s Lack of Health Literacy

What is it:

Health literacy refers to the degree to which a person has the capacity to obtain, understand, and process basic health information. It is essential for individuals to have a degree of health literacy so they can make smart decisions about healthcare and improve their communication with nurses, physicians, and other healthcare members. Health literacy equips individuals with the ability to advocate for themselves. Unfortunately, according to the National Assessment of Adult Literacy, only twelve percent of Americans have competent health literacy skills, reflecting the need for education among the general population.

How to Overcome:

The United States Centers for Disease Control and Prevention suggests when people understand the basic concepts of health and wellness, including bodily functions, causes of illness, and methods of care and treatment, their health literacy skills increase. Therefore, one way to demonstrate cultural competence in nursing is to help patients overcome a lack of health literacy. Using printed information such as diagrams and pamphlets is a great way to relay important information to patients. Also, ask your patients questions, and encourage them to ask you questions to ensure understanding.


BARRIER #2: The Nurse’s Lack of Understanding of the Patient’s Cultural Traditions

What is it:

Lack of understanding can create barriers in every aspect of a person's life. When nurses lack an understanding of their patient's culture and traditions, it can hinder communication, reduce patient compliance, and create risks to patient safety.

How to Overcome:

Seeking an understanding of a patient's culture and the traditions or values they hold is an excellent way to promote therapeutic communication, increase patient compliance and help improve patient outcomes. Nurses should know that understanding a patient's cultural traditions does not mean they have to change their personal views. Instead, understanding allows nurses to approach patient care with the patient's interests, wants, and desires in mind.


BARRIER #3: Lack of Training

What is it:

Unfortunately, one of the most significant barriers to cultural competence in nursing is a lack of training. Lack of cultural competence is more common in small, rural, or underserved populations where it may be difficult to staff healthcare facilities.

How to Overcome:

While many nurses rely on employers to offer training about important issues, such as cultural competence, it is within the nurse's right to learn about these issues independently. Nurses can overcome the barrier of lack of training by attending conferences on cultural diversity, joining culturally diverse nursing associations, and reading about culturally competent nursing practice.


BARRIER #4: Lack of Diversity in Nursing Leadership

What is it:

Although the United States population includes a diversity of cultures, minority groups account for less than forty percent of the population. Approximately ninety percent of all nursing and other healthcare leaders are white (non-Hispanic or Latino). The lack of cultural diversity in healthcare leadership is sometimes considered a barrier to cultural competence in nursing. Nursing teams comprised of diverse cultures may feel as though they could be better served by more diverse leadership. Patients may be less likely to communicate openly with nurses and nursing supervisors from different cultures. Keep in mind, many of these issues are unrelated to prejudices or biases but are more likely to occur because of a lack of understanding.

How to Overcome:

With less than forty percent of the population comprised of individuals from minority groups, it is understandable that the percentage of people from minority groups in leadership positions may also be less. It is possible to overcome this barrier to cultural competence in nursing. Healthcare organizations and employers can address this lack of diversity in leadership by offering positions to qualified applicants from diverse cultural backgrounds. When no applicants from minority groups meet hiring criteria, employers should implement measures to educate leaders about the importance of cultural competence.


BARRIER #5: Poor Cross-Cultural Communication Between Patients and Nurses

What is it:

Despite growing numbers of culturally diverse populations, one of the most significant barriers to culturally competent nursing care is poor communication, usually the result of language barriers. Challenges to effective communication can make it difficult to educate patients about their medical status, care plans, and treatment options. When a patient does not understand his condition or cannot ask questions about care and treatment options because of impaired communication, it makes the issue of informed consent difficult, which can lead to both legal and ethical dilemmas.

How to Overcome:

Under Title III of the Americans with Disabilities Act, healthcare providers and facilities must provide an interpreter to any patient with a language barrier. Many healthcare facilities choose to hire bilingual employees. Others use staffing services or 23-hour translation lines to accommodate situations when cross-cultural communication is an issue. Nurses can help overcome the barrier of poor cross-cultural communication by learning a second language. Also, if an interpreter is not a member of the staff or a translator is not readily available, nurses should encourage employers to contract with a translation service.


My Final Thoughts


Throughout this article, we have discussed the answer to the questions, "What is cultural competence in nursing?” We have also talked about the importance of cultural competence in nursing + 10 examples. Culturally competent nursing care does not require you to change your personal view or perspective. Instead, it means you demonstrate a willingness to accept what others believe and adapt your behavior to show support of their cultures and values. As a culturally competent nurse, you can offer high-quality nursing services to patients from diverse backgrounds, with different beliefs and values, while promoting positive patient outcomes and supporting the profession.


FREQUENTLY ASKED QUESTIONS ANSWERED BY OUR EXPERT


1. How Does Self-Awareness Affect Cultural Competence In Nursing?

Self-awareness is the ability of an individual to focus on their own thoughts and emotions and examine how they do or do not align with their personal standards. Nurses who have a strong sense of self-awareness usually find it easier to appreciate others' viewpoints, which helps create an atmosphere of respect and cultural sensitivity.


2. Will Lack Of Cultural Competence Impact A Nurse’s Career?

Cultural competence in nursing is instrumental in helping nurses offer the best services and care to each patient. Without cultural competence, it is difficult to establish trusting nurse-patient relationships, which can negatively impact patient outcomes. Additionally, lack of cultural competence may lead to difficulty within the nursing and healthcare team, making it difficult to be an effective member of the interdisciplinary team. Each of these are examples of how a lack of cultural competence can impact a nurse's career.


3. Are All Types Of Nurses Required To Be Culturally Competent?

Culturally competent nurses play a vital role in providing high-quality patient care to people from diverse cultural backgrounds and working effectively with multi-cultural teams. Therefore, all nurses should strive to become culturally competent.


4. Are Culturally Competent Nurses Happier?

Many studies indicate culturally competent nurses report having a better outlook on life and greater job satisfaction. The belief is that cultural competence allows nurses to be themselves while accepting others, and vice versa, which helps improve relationships between patients, nurses, healthcare teams, and employers, reduces stress, and creates an overall sense of happiness and well-being.


5. How Do You Assess Cultural Competency In Nursing?

It is possible to assess culturally competent nursing care by observing nursing behavior. For example, when assessing cultural competency in nursing, the person assessing should ask these questions:

• Does the nurse use terms and language the patient understands?
• Are the patient’s religious and cultural beliefs respected, even if they conflict with the treatment plan?
• Does the nursing staff represent diverse populations such as health professionals from diverse, underserved, and/or LGBTQ communities?



6. How Do Nursing Schools Teach Cultural Competence?

While students learn basic information about culturally competent nursing care in lectures and classroom instruction, nurse educators use other methods to enforce cultural competence. A few ways nursing schools teach about cultural competence include creating culturally diverse student/study groups, role-playing case studies to present issues of access to care and health disparities in diverse patient populations. Nurse educators also anticipate controversy and plan for discussions about sensitive topics such as stereotyping, racial prejudice, health disparities among culturally diverse populations, and biases.


7. Is There A Curriculum For Cultural Competence In Nursing?

There is not a set curriculum for cultural competence in nursing. However, all nursing schools teach the importance of cultural competence and provide learning opportunities to strengthen cultural competence. Nurse educators ensure topics are relevant to nursing and provide activities to engage in multicultural activities and role-play.


8. What Organizations Promote Cultural Competence In Nursing?

Typically, all nursing organizations promote cultural competence in nursing. The American Nurses Association, American Geriatrics Society Ethnogeriatrics Committee, and the American Hospital Association are a few examples of healthcare organizations that promote the importance of culturally competent nursing care.


9. How Is Cultural Competence Important In Nursing Research?

When there is a lack of cultural competence, nurse researchers risk imposing the values, beliefs and behaviors upon those from other cultures. Cultural competence in nursing research is vital as it helps researchers understand the needs and views of diverse groups. It is a critical part of nursing research, as it helps reduce health disparities and improve access to high-quality healthcare, care that is aware, respectful of, and responsive to the needs of other cultures.


Darby Faubion BSN, RN
Darby Faubion is a nurse and Allied Health educator with over twenty years of experience. She has assisted in developing curriculum for nursing programs and has instructed students at both community college and university levels. Because of her love of nursing education, Darby became a test-taking strategist and NCLEX prep coach and assists nursing graduates across the United States who are preparing to take the National Council Licensure Examination (NCLEX).