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Becoming Culturally Competent: 5 Tips for Nurses

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Question:

I'm a nurse in a small clinic in a big city. We see many patients from diverse cultural and ethnic groups. How can I learn more about working with people from different backgrounds?

Answer:

The very fact that you want to learn about various cultural groups as a means to improving your nursing care practice is an important step in becoming culturally competent. Culturally competent nurses are those who make every effort to provide nursing care that is appropriate and consistent with the cultural values of their patients.

According to the Census Bureau, by the year 2060, people identifying as minority racial or ethnic groups are estimated to make up 56 percent of the general population. Here are some tips for nursing care of these diverse population groups.

Be aware of your own culture and biases

Think about how you communicate best, how you like to spend your time, and how you view relationships. Americans tend to value independence and resourcefulness, while other cultures place high values on the welfare of the family or community group. Americans value innovation, yet others may see blending in with the larger society as a greater value. Your views of gender, religious beliefs, and time orientation (focused on the present as opposed to planning for the future) are likely to be different from many of your patients.

Be willing to listen and learn

Listening to patients is always important, more so when they are from diverse cultural groups. Be attuned to nonverbal indications of discomfort, listen carefully to what is said, and be sure to ask about how you can provide care in a way that is appropriate and comfortable. Use resources such as EthnoMed to get more information about cultural beliefs as they relate to health care of various ethnic groups.

Use the appropriate language

Assess which language is primary for the patient as well as their literacy level. Using family and community members as interpreters is fraught with problems, so it's important to use medically trained interpreters. Your clinic may have access to either a phone interpretation system or the ability to bring in trained and certified bilingual individuals.

Acknowledge differences but avoid stereotyping

As you become aware of and sensitive to other cultures, you are going from time to time run up against practices which you find difficult to accept. Perhaps the role of women is dramatically different, or personal care practices don't meet your hygiene standards. Be certain that the value differences do not prejudice your standard of care. Be sensitive to any tendency to devalue people with whom you may differ. Avoid making assumptions based on limited past experiences.

Share decision making

The use of alternative therapies, folk healing beliefs, differences in dietary patterns, and suspicion about the value of western medical advice may lead to misunderstanding. You are more likely to gain compliance with recommendations if the patient and family have a role in deciding how the plan of care is implemented, and if their values and practices are incorporated whenever possible.

If you are working toward a BSN or MSN degree, you can broaden your appreciation of culture and ethnicity by taking a course such as medical anthropology or sociology. Many communities also offer language courses, such as Spanish for health care workers. You will have the satisfaction of knowing that you are improving your cultural competence as you further your education.

Sources:

  • It's Official: The U.S. is Becoming a Minority-Majority Nation, Noor Wazwaz, U.S. News & World Report, July 6, 2015, http://www.usnews.com/news/articles/2015/07/06/its-official-the-us-is-becoming-a-minority-majority-nation
  • Projections of the Size and Composition of the U.S. Population: 2014 to 2060, U.S> Census Bureau, https://www.census.gov/content/dam/Census/library/publications/2015/demo/p25-1143.pdf

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