Cultural Competence in Nursing: Overcoming Healthcare Controversy

The term “culture” is chosen for a reason, as it represents the complex structure of human behavior, while the term “competence” refers to the capacity to behave effectively.

Thus, among the components of cultural competence nursing are awareness of the norms and values of cultures and taking into account their perceptions, knowledge of beliefs and practices, which involves understanding the social and emotional needs of people from different social groups, and skills that demonstrate culturally appropriate behaviors.

There are five pivotal elements that contribute to the enhancement of cultural competence within a system, institution, or agency:

• Acceptance of diversity.
• Ability to introspectively evaluate culture.
• Recognition of the dynamics inherent in cultural interaction.
• Institutionalization of cultural knowledge.
• Developing adaptable service delivery methods that reflect an understanding of cultural diversity.

What Is the Importance of Cultural Competence in Nursing Practice?

Due to rapid migration, the United States has experienced dramatic changes in its population. There are now many ethnic minorities living in the country, which means that people with different cultural backgrounds must learn to interact and live happily within one country.

Nursing and cultural competence are two interrelated things. Here is why it’s vital:

• Better Patient Care: It allows nurses to tailor care to a patient’s cultural background, leading to improved outcomes.
• Self-Awareness: To provide nondiscriminatory care, nursing specialists must understand their own biases and prejudices.
• Effective Communication: Competence helps bridge language gaps, and fosters trust between patients and nurses.
• Reducing Disparities: It contributes to reducing healthcare disparities among different cultural groups.
• Respect for Beliefs: Nursing care providers can respect diverse beliefs and practices, avoiding misunderstandings.
• Legal and Ethical Obligations: It’s a professional and legal obligation to provide culturally sensitive care.
• Patient Satisfaction: Patients are more satisfied when their cultural needs are acknowledged.
• Enhanced Teamwork: It improves collaboration among nursing and healthcare professionals from diverse backgrounds.
• Effective Health Education: Nurses who know how to adjust their teaching methods to match a patient’s preferences are likely to be able to convey important health information more effectively.

All in all, cultural competence enhances the quality of nursing care, reduces disparities, and fosters effective communication and teamwork, benefiting both patients and healthcare providers.

Examples of Cultural Competence in Nursing: Impact on Patient Care

Cultural competence positively impacts patient care by improving their outcomes, reducing barriers and disparities in health care, and promoting patient satisfaction because their needs and preferences are recognized and respected.

Among good examples of cultural competence in nursing are established communication, providing a comprehensive evaluation to collect information about patients’ beliefs, values, and practices that may affect their medical treatment, respecting their traditions (e.g., offering a special diet), effective care planning tailored to specific needs, exploring norms, taboos, and expectations of health care common to different groups, understanding the religious practices and beliefs as well as an appropriate environment for each person individually.

EXAMPLE: Respecting Dietary Preferences

Situation: The Muslim patient has halal dietary restrictions, which means she only eats food cooked and processed according to Islamic dietary laws.
Culturally Competent Response: In this situation, a nurse should ensure that the patient’s dietary needs are met (e.g., ask about some preferences, then ask the hospital’s dietary staff to ensure that the food is cooked according to the patient’s needs).
Outcome of the Response: The Muslim patient enjoys culturally competent care. She feels comfortable and trusts the nurse, so she responds more responsibly to treatment measures and gains better health outcomes quickly.

Cultural Competence in Nursing Scholarly Articles on Common Problems

According to statistics mentioned in the article about Cultural Competence in Health Care from Georgetown University researchers, people from diverse backgrounds often face challenges related to:

Language Barriers:

• Approximately 18 million adults in the U.S. who speak a language other than English report speaking English less than “very well.”
• Among non-English speakers needing an interpreter during healthcare visits, only 48 percent reported always or usually having access to one.
• According to the Healthgrades survey, 31% of people claimed that language is the main reason for individual traits.

Low Literacy:

• An estimated 40 to 44 million Americans lack the necessary literacy skills for daily functioning.
• The elderly, racial/ethnic minorities and people with low literacy skills face challenges understanding prescription instructions, health education materials, and insurance forms.

Healthcare Disparities:

• Spanish-speaking Latinos visit physicians and mental health providers or receive less often preventive care like mammography exams or influenza vaccinations than Whites.

Discrimination and Bias.

Teaching Cultural Competence Nursing Education

These are some tips on how nursing students and qualified nurses can enhance their skills and knowledge:

• Self-reflection and self-assessment: Analyze your biases, values, and beliefs.
• Self-education: Read thematic books, cultural competence in nursing scholarly articles, and research studies to expand your horizons.
• Participate in cross-cultural experiences: Seek to interact with people from different cultures. This could be volunteering in different communities, traveling, or participating in traditional events.
• Build trusting relationships: Take the time to actively and empathetically listen to their concerns and demonstrate respect for their values and beliefs.
• Take competence training: Many healthcare providers offer competency training programs or workshops. You can gain valuable knowledge, tools, and strategies to improve your nursing cultural competence at these.
• Utilize competent language services: Ensure language barriers do not interfere with effective communication. Use professional interpreters or translators to achieve accurate understanding between you and your wards.
• Respect personal preferences: All people are individuals, and their preferences and beliefs may differ from common norms. Always respect their choices and wishes, as this is a key to improving cultural competence in nursing practice.
• Involve patients in decision-making: Invite patients to participate in developing treatment plans and treatment decisions. This will enable them to make choices in accordance with their cultural and personal values.

Why Is Cultural Competence Important in Nursing?

Competent care is what makes it possible to achieve equal access to medical treatment and improve health outcomes for all people. Still, there are some strategies that may improve the quality of nurses’ work. For example, cultural competence should be part of policy goals to improve the quality of care. The first priority should be collecting and analyzing demographic data. Next, cultural competency in nursing training should become a job requirement, and performance evaluations of nurses should be implemented to ensure that all measures are met. Hospitals should provide translation and interpretation services to overcome language barriers.

All in all, the importance of cultural competence in nursing is huge. When working with a patient, the nurse should maintain confidentiality and inform clients about the risks, advantages, and treatment alternatives. Ethical values such as human dignity, privacy, fairness, autonomy in decision-making, accuracy and precision in care, commitment, human relations, empathy, honesty, and individual and professional competence should also be kept in mind.

As healthcare disparities still persist across the United States, we recommend you check the practical guide to implementing the National CLAS Standards.

Conclusion

We hope now it’s clear what is cultural competence in nursing. To provide fair and patient-centered care and to understand the unique cultural attributes of patients, nurses must be culturally competent. More attention must be paid to this aspect of health care, and we should not turn a blind eye to the situations that occur with many people aligned to other traditions.

Olivia Reynolds

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Yale University

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