Cultural competence in nursing refers to the understanding of cultural differences and the incorporation of behaviors and attitudes into nursing care to promote effective cross-cultural interactions. Culturally competent nursing care can help reduce healthcare disparities and promote trust in healthcare professionals.
A career in nursing can be meaningful and fulfilling for those looking for opportunities to serve their communities. As a nurse, you’ll work with diverse coworkers and serve diverse patients. The diversity within the nursing field underscores the importance of cultural competence in nursing.
With an esteemed history of educating diverse student populations, Northeastern University instills in nursing students the importance of cultural competence and provides the tools for nurses to provide culturally sensitive care.
Our Accelerated Bachelor of Science in Nursing (ABSN) program is an extension of our commitment to educating the next generation of compassionate, culturally competent nurses. By leveraging students’ academic history, our ABSN students receive a comprehensive nursing education, allowing them to earn their Bachelor of Science in Nursing (BSN) in as few as 16 months.
But what exactly does cultural competence mean, and which cultural considerations in nursing should you be aware of as a student? In this blog, we will explore this concept and how you can promote it in the workplace.
What Is Cultural Competence in Nursing?
Culturally competent nursing care is more than awareness and acceptance of cultural differences. It also encompasses integrating these cultural differences directly into patient care and interactions with others.
According to the Centers for Disease Control and Prevention (CDC), “Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.”
The CDC goes on to note that organizations (and, by extension, nurses) must assess their own level of cultural competence, understand the value of diversity, manage cultural differences and adapt to cultural contexts present within the patient populations they serve.
Key Elements of Cultural Competence
Four main elements of cultural competence are applicable to the nursing field. They are as follows:
Awareness
Self-awareness is a necessary precursor for personal growth and learning. Cultural competence starts with becoming aware of one’s beliefs and values, as well as one’s implicit biases.
Attitude
As you work on developing greater cultural awareness in nursing, the next step is to acknowledge that your implicit biases affect your response to others. It’s important to actively cultivate an open mindset and attitude of acceptance.
Knowledge
Nurses should strive to continually learn new things about both clinical care and the values, beliefs, and practices of the diverse people whom they work with and care for.
Ability
By developing greater self-awareness, knowledge, and an open mindset, nurses can continue to practice greater cultural competence until it is an ingrained habit in their daily interactions.
What does it take to be a nurse? Explore these top 10 nursing characteristics.
Benefits of Cultural Awareness in Nursing
Cultural competence in nursing allows nurses to become more effective and compassionate clinicians, as well as more professional coworkers. Below is a sample of the many benefits of incorporating cultural competence into nursing practice.
Enhanced Trust in Healthcare
Being mindful and respectful of cultural differences in a clinical setting is an effective way to develop stronger rapport with patients. In turn, this can allow trusting relationships to flourish, increasing patients’ comfort with the healthcare system. This trust can encourage patients to form productive relationships with their healthcare team and seek care again when needed.
Patient Satisfaction and Engagement
When patients feel they can trust their providers, they are more likely to be satisfied with the care they receive. This can also encourage patients to adhere to treatment recommendations and to become active participants in their own care during their stay and after discharge.
Reduced Healthcare Disparities
Healthcare disparities are all too common, particularly among diverse and underserved communities. Some individuals from historically marginalized groups harbor sustained mistrust toward healthcare professionals due to past injustices.
The 2021 study, “Discrimination and Medical Mistrust in a Racially and Ethnically Diverse Sample of California Adults,” revealed that 11% of the surveyed Hispanic adults and 30% of non-Hispanic Black adults have felt providers have judged or treated them differently due to their race or ethnicity. In comparison, only 3% of the non-Hispanic White adults in the survey group reported the same feeling.
Historical context is important to understanding why some marginalized communities are more likely to mistrust the healthcare system.
One notable example is the U.S. Public Health Service Untreated Syphilis Study at Tuskegee. From 1932 to 1972, this study tracked the progression of syphilis in Black male patients; however, the study required participants to not receive treatment, despite its availability, and researchers did not require informed consent from participants.
An ad hoc advisory panel recommended ending the study in 1972, and the National Research Act was signed to enact regulations that ensure future studies meet high ethical standards.
As a result, the study contributed to long-lasting mistrust of health professionals among the Black community, which can influence how future generations view healthcare. Approaching cultural competence with an understanding of the historical context helps nurses make informed patient care decisions that encourage patient trust in their healthcare team.
Cultivating cultural competence is a way to demonstrate respect toward one’s patients. This, in turn, can encourage underserved communities to access the healthcare services they need.
Common Cultural Barriers
Although the importance of culturally competent nursing care is undeniable, there are still many common barriers. Nurses should be aware of the following challenges:
Language Barriers
Language barriers in healthcare can be challenging. Even when the patient speaks English, they may not have a native speaker’s understanding of the nuances of the language. Certain figures of speech and expressions may be misinterpreted.
In the U.S., every healthcare facility (and insurance company) that receives federal assistance is legally obligated to provide patients with limited English proficiency with access to a qualified medical interpreter.
Lack of Cultural Awareness
One major issue with a lack of cultural awareness in nursing is the adage, “You don’t know what you don’t know.” It’s difficult to provide care to a patient when you lack awareness of their culture and values, creating a disconnect. Some cultural values and beliefs may affect whether a person is willing to ask for help or even acknowledge that they are in pain.
Other cultural differences can create a social divide, such as the way people use tone and volume of speech, facial expressions, directness, and eye contact. For example, an American-born nurse might prioritize making eye contact with their patients as a means of connecting with them and demonstrating attention. However, other cultures, such as some Asian cultures, find eye contact to be rude and disrespectful, and patients may decide to leave without receiving care.
Lack of Diversity Among Healthcare Professionals
Although healthcare professionals are from all cultural, racial, and ethnic backgrounds, the nursing field isn’t yet as diverse as it could be. According to the 2022 National Nursing Workforce Survey, from 2017 to 2022, the nursing workforce comprised 80% White/Caucasian, 7.4% Asian, 6.3% Black/African American and 2.5% multiracial nurses.
Cultivating diversity among healthcare professionals is important. Representation matters, as it fosters trust and reduces healthcare disparities. A diverse nursing staff allows other nurses to learn about cultural differences, helping the organization as a whole deliver informed, culturally compassionate care.
Learn about the importance of diversity in nursing and prepare to become a champion for social justice.
How to Promote Culturally Competent Nursing Care
Nurses have a professional duty to serve as advocates for their patients and communities. This means that all nurses must explore the many cultural considerations in nursing and work toward becoming more culturally competent.
There are many approaches to promoting greater cultural competence in the nursing field, including the following:
Continued Training and Education
Professional development can involve either formal or informal initiatives. A combination is often best. Nurses should take advantage of any formal cultural competence training offered by their healthcare employer or by professional nursing associations. If their employer doesn’t offer cultural awareness training, nurses can band together to advocate for it.
Individual nurses can also work toward improving their own understanding and acceptance of cultural differences, such as by learning from their diverse coworkers and patients. Nurses might even take foreign language courses so they can connect on a more personal level with patients who speak English as a second language.
Medical interpreting should only be provided by qualified medical interpreters, but learning common phrases like, “Hi, it’s nice to meet you,” can help establish rapport.
Diverse Community Engagement
Nurses and healthcare organizations should strive to nurture authentic, collaborative engagement with the diverse communities they serve. This can include developing a greater understanding of the area’s diverse and underserved communities, working toward greater health equity, and creating inclusivity as a means of overcoming historic inequities and marginalization.
For example, nurses may encourage their health systems to develop public and community health outreach programs designed specifically for underserved populations.
Show Empathy and Develop Trusting Relationships
Above all, nurses should always strive to demonstrate empathy and compassion as the basis for forging trusting relationships. No nurse can be expected to know everything about the many cultures represented in healthcare settings, but the right mindset can conquer ignorance. Nurses who stay open-minded and eager to learn from other cultures are an asset to their healthcare organization.
Become a Culturally Competent Nurse at Northeastern
At Northeastern University, we are committed to promoting diversity among our students and faculty, and to prioritizing cultural competence in nursing education. Our diversity, equity and inclusion (DEI) pillars at Bouvé College of Health Sciences include building a diverse and inclusive community, promoting an inclusive culture, and establishing a proactive, anti-racist curriculum that effectively prepares healthcare professionals to be champions of social justice.
We aim to increase engagement and mentorship for students from historically underrepresented groups, provide scholarship opportunities for BIPOC students and work toward community outreach by connecting underserved communities with pro bono healthcare services. Are you interested in joining us?
Northeastern’s ABSN program allows you to earn your nursing degree in as few as 16 months by leveraging your prior non-nursing college credits. Contact an admissions counselor today and take the next step toward advocating for underserved patients in your community.
