In a larger sense, practicing culturally competent nursing means more than understanding and acknowledging specific cultural differences. It also calls for seeing patients through a lens of cultural understanding, always striving to recognize and respond to each patient’s differing language, customs, and beliefs.
To prepare to practice with cultural competence, a nurse can become familiar with the elements of culturally competent healthcare and strive to apply them with compassion and respect to every patient they encounter.
Know the Elements of Culturally Competent Nursing
Learning to deliver culturally competent nursing care takes effort, but the reward of bridging the cultural divide to give better care is well worth it. The following are five components to know and practice.
1. Cultural Awareness
Culturally competent nursing begins with awareness — an in-depth reflection on a nurse’s own cultural beliefs and practices related to healthcare. Consider questions such as these:
- Does your culture postpone doctor appointments in favor of trying home remedies?
- Does your culture practice dietary restrictions or customs related to meals and nutrition?
- Does your culture talk about illness? Who makes the decisions about care?
- Does your culture have important birthing or end-of-life customs?
Quizzing yourself about your own cultural background and how it affects your healthcare choices is a key first step in understanding others’ views. Various cultural assessment tools can also help you explore your awareness of your cultural attitudes toward healthcare.
2. Cultural Knowledge
Learning as much as possible about other cultures is an important step in understanding people and providing them with culturally competent care. Explore websites, journal articles, books, college courses, and workshops for in-depth discussions of the cultures of groups you may serve, as well as other groups.
3. Cultural Skill
According to Diversity Nursing, cultural skill is a measure of a nurse’s ability to “collect relevant cultural data regarding the patient’s presenting problem and accurately perform a culturally specific assessment.” Nurses who develop cultural skill can better gauge and respond to their patients’ health issues. They can customize their approach to caregiving based on what they know about each patient’s culture.
Specific models for best practices that support developing cultural skill include the Giger and Davidhizar Model of Transcultural Assessment. This model—designed to help student nurses tailor and deliver culturally competent care—assesses cultural differences in six areas: communication, time, space, social organization, environment, and biological variations.
4. Cultural Encounter
Developing cultural competence in nursing is an ongoing process. The way to continually grow as a culturally competent nurse is simple: Interact often with patients from all cultures. Cross-cultural interactions deepen understanding.
5. Cultural Desire
A motivated culturally competent nurse wants to engage with other cultures and learn from them. Willingness to be open to other cultures generates the understanding and respect that result in culturally competent nursing — to the benefit of patients and caregivers alike.
Overcome Common Communication Barriers
Often, people of different cultures speak different languages, which can cause confusion for patients and caregivers who don’t speak the same language. Miscommunication in healthcare can have serious repercussions. For example, communication barriers can affect patients’ willingness to accept treatment and their ability to understand explanations about their own health needs.
At minimum, culturally competent nurses should:
- Listen carefully to patients
- Avoid interrupting
- Ask follow-up questions
- Be sensitive to nonverbal cues
Nurses should also think about word choice when speaking with patients. Avoid phrases that might offend. For example, don’t label a patient’s culture by using terms they don’t use to refer to themselves, such as categorizing a Spanish-language speaker from the Dominican Republic as “Spanish.” Referring to U.S. citizens as “American” can be off-putting as well, because Central and South Americans, for instance, are also American.
When nurses and caregivers don’t share a common language, using translators and interpreters is critical. A colleague might serve in this role, or the patient might bring a family member who can assist. Either way, be sure to allow enough time for full communication to take place.
Examples of Culturally Influenced Miscommunications
Culture affects communication in unexpected ways. For instance, non-English-speaking patients getting mammograms or other technical procedures might hesitate to say they don’t understand the technician’s medical jargon. In another situation, a patient might misinterpret the term “Medicaid” as the name of an illness.
Furthermore, in some cultures, only designated family members, often the eldest man, make important decisions about a person’s healthcare. This can cause communication breakdowns in the examining room. For instance, a female patient who seems reluctant to accept treatment might be deferring the decision to a husband or son who isn’t present, a circumstance a nurse might misunderstand.
Finally, good communicators don’t stereotype. Avoid assuming that an individual’s way of expressing themself, or the opinions they share, reflect a cultural stereotype [“all members of this group are this way”]. In addition to respecting cultural differences, culturally competent nurses respect each patient’s uniqueness.