The Role of Cultural Competence in Nursing

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Two nurses consult with a patient in a hospital bed.


In the next few decades, the U.S. is projected to grow even more diverse, with minority groups expected to make up more than half the population by 2050, according to the U.S. Census Bureau. As the diversity grows, cultural awareness and sensitivity will be essential skills in virtually every profession. For nurses and those pursuing a nursing degree, cultural competence is especially vital.

Numerous case studies have shown that minority groups are often at a disadvantage both in terms of their access to health care and the level of care they receive. Consequently, cultural competence in nursing is a critical component in reducing health disparities and achieving equity in quality of care among all populations.
Research has shown that minority patients are more comfortable in settings where their providers share or understand their cultures and are more likely to adhere to treatment guidelines, thereby reducing the risk of adverse events when providers adapt care to address patients’ unique social, cultural and language needs.
Individuals interested in exploring cultural competence in nursing should consider the benefits of an online Bachelor of Science in Nursing degree.

What Is Cultural Competence in Nursing?

Cultural competence in health care is defined as “the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including the tailoring of health care delivery to meet patients’ social, cultural and linguistic needs,” according to the American Hospital Association. As the first point of contact for many patients, nurses are uniquely positioned to practice cultural competence at the earliest stages of care, setting the tone for a patient’s entire health care experience.

Culture influences personal health care decisions at every level, including how patients perceive their illness, whether, where and how they seek help, and how they respond to treatment. Far from being merely an exercise in politeness, cultural competence can have a direct impact on quality of care and eventual health outcomes.
For example, recognizing how different groups communicate and divide roles in families can alleviate potential miscommunications related to consent and treatment. As part of a cultural assessment, nurses should also ask patients about spiritual or religious practices and other customs that may be relevant to a patient’s clinical situation.

Additionally, nurses should be aware that while cultural competence has traditionally referred to racial and ethnic minority groups, it’s increasingly being used to include other groups, such as people with disabilities and members of the LGBTQ community.

Nurses should also possess an understanding of ethnopharmacology: the study of substances that different ethnic and cultural groups use medicinally and how those groups respond to different forms of medication. Patients from certain cultures may be more likely to take traditional medicines, such as herbal remedies, which can have harmful interactions with physician-prescribed medications.

Positive Impacts of Cultural Competence

As the nation becomes more diverse, the risk increases that cultural differences between patients and providers will lead to negative outcomes. Evidence suggests, however, that when providers make cultural sensitivity a hallmark of care, the likelihood increases that their patients will be more satisfied and, ultimately, healthier.
Studies have consistently shown that health care professionals who practice cultural competence have better relationships with their patients, enjoying increased patient trust and engagement. A U.S. Department of Health and Human Services study found that minorities placed greater importance on whether their providers shared or understood their cultures; if their providers did, then minorities were more likely to report having a positive relationship and more prone to follow health recommendations, which can lead to overall better health outcomes.

Disregarding the role of culture and language in health care can result in adverse effects for patients, including diagnostic errors, missed screenings and unexpected negative responses to medication. Conversely, studies have shown that a care plan that incorporates cultural competence can increase patient engagement, use of preventive services, treatment adherence and overall health status.

By exercising cultural competence, nurses and other health professionals can overcome language barriers, differing cultural beliefs and practices, unconscious and conscious medical bias, and low health literacy, thereby sidestepping the many racial and ethnic disparities that are prevalent in health care.

Developing Essential Skills for Nursing

Cultural competence in nursing is rooted in empathy. Nurses who understand and respect their patients’ cultural backgrounds are more likely to have success providing care to a diverse patient population.
For nurses, the cultural competence path begins with awareness. Recognizing their own cultural attitudes and biases, both conscious and unconscious, and working to eliminate them is essential. It’s human nature for people to approach situations from their own beliefs and value systems, but in a clinical setting, this may be harmful. Everyone knows the Golden Rule: Treat others as you want to be treated. According to Becker’s Hospital Review, nurses must learn to apply the “Platinum Rule”: Treat others as they want to be treated.
Simple steps such as communicating with patients in layperson’s terms — using clear, descriptive words that align with the communication practices of a patient’s culture — are critical elements of a culturally competent care plan.

While nurses aren’t expected to become experts on every culture, they should seek to gain an understanding of the cultures in the communities in which they work. They can accomplish this by researching a community’s demographic information and reaching out to different cultural groups in the community. Possessing at least a general knowledge of the cultures they may engage will help nurses understand the attitudes and beliefs of their patients and their families.

Nurses should also strive to adhere to the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (the National CLAS Standards). The National CLAS Standards are designed to “advance health equity, improve quality and help eliminate health care disparities by providing a blueprint for health care professionals to implement culturally and linguistically appropriate services,” according to the Health Department.

Pursue a Bachelor of Science in Nursing

The need for cultural competence in nursing has never been greater. In an increasingly diverse society, patients want to feel that their culture is understood and respected when seeking medical care. By practicing cultural competence, nurses can help reduce health disparities and contribute to providing equitable care for all.
If you’re interested in exploring cultural competence in nursing, consider pursuing Rider University’s online Bachelor of Science in Nursing degree, which offers a course, Cultural Diversity in a Global Society, that puts nursing students on the path to becoming culturally competent. Learn more about how Rider can help you pursue your professional nursing goals.

Recommended Readings:
The Qualities of a Good Nurse in Action
Why Is Communication Important in Nursing?
Nurse Management Roles in Healthcare

Agency for Healthcare Research and Quality, Cultural Competence and Patient Safety
Becker’s Hospital Review, “Platinum rule trumps the golden one for best patient experience”, “A Guide to Culturally Competent Nursing Care”
MAS Medical Staffing, How to Strengthen Cultural Competence in Nursing Practice
MedCity News, “The Need for Cultural Competence in Healthcare”
National Institutes of Health, Cultural Respect
Quality Interactions, “Cultural Awareness in Healthcare: A Checklist”
U.S. Census Bureau, “Demographic Turning Points for the United States: Population Projections for 2020 to 2060”
U.S. Centers for Disease Control and Prevention, “Reported Importance and Access to Health Care Providers Who Understand or Share Cultural Characteristics With Their Patients Among Adults, by Race and Ethnicity”