Cultural competence is not new to nursing—nor is it new to other fields. The idea that people with different cultural inclinations/backgrounds bring new challenges to nursing has always been around. What has changed, however, is the level and intensity of cultural diversity and exposure. Like it or not, the western world is being swallowed by globalization.
What is “Cultural Competence?”
The Department of Health and Human Services defines cultural competence as “a set of behaviors, attitudes, and skills that enable nurses to work effectively in cross-cultural situations.” Of course, this definition, although accurate, does not delve into all the complexities of the term.
Some people, for example, think only of nationality, race and ethnicity when it comes to cultural competence in nursing practice. There are several problems with this perception. First of all, cultural differences extend to other areas, such as biological differences, socioeconomic distinctions, geographic-specific preferences (not necessarily in reference to foreigners), religious inclinations, and sexual orientation.
Secondly, many false assumptions, biases, and myths continue to hamper or interfere with the efficient/effective delivery of healthcare. The area of “culture” is replete with these possibly dangerous (leading to miscommunication or wrong diagnoses/treatments) false beliefs or practices.
Through ethnocentrism, for example, healthcare providers operate under the idea that how they view things is the right way and everyone must conform to that. Such healthcare providers may have trouble understanding why the Middle Eastern husband of a female patient doesn’t want a male doctor to examine his wife or why Asian patients often avoid eye contact.
Cultural competence in nursing practice is more than just about having the right information, though. It’s about establishing professional relationships with every patient, regardless of how weird or unusual their expectations may appear. It’s about providing optimum care at all times, even when patients pose special, unexpected challenges.
How Does One Develop Cultural Competence?
Although most programs now include cultural-sensitivity training, this has unfortunately not been the case in the past. Consequently, most nurses may need training in this important field. To that end, training programs are being instituted through private agencies and government initiatives.
Examples are the Culturally Competent Nursing Modules (CCNMs) and the Culturally and Linguistically Appropriate Services (CLAS) Standards. Using these, participants watch videos, listen to and read presentations, and take tests (leading to certificates and credit units) that help them improve their understanding of and show more respect for people from different cultures.
Of course, before teaching the intricacies of cultural competence in nursing practice, nurses must first understand the importance of and agree to implement this type of training. It’s not just about making patients feel accepted and comfortable; rather, it’s about improving communication, avoiding costly mistakes (which increase the cost of healthcare and sometimes lead to expensive lawsuits), and, most importantly, leading to accurate diagnosis/treatment and improving outcomes.
What Are Some Other Important Cultural Competence Facts to Keep in Mind?
Although there are no one-size-fits-all secrets to impart to nurses, the following caveats and reminders may help them become better-attuned to cultural competence in nursing practice:
•Some patients will prefer home remedies over what is being prescribed, for example, some Asians preferring the use of acupuncture and herbal remedies. These treatments should be assumed to be “useless.”
•Barriers to cultural sensitivity include stereotyping, prejudice, discrimination, and racism.
•Cultural competence in nursing practice does not require accepting/agreeing with patient’s perceptions/expectations—it just requires that respect be shown.
•Obtaining medically-qualified translators and interpreters can greatly enhance communication with non-English or language-challenged (mute, deaf, blind, autistic, etc.) patients.
•Ethnopharmacology teaches that different ethnic groups may respond differently to popular drugs/treatments—an important fact to consider in assessing progress or identifying shortcomings.
Culturally Competent Nurses Are Better Prepared for the Future!
Both clinical and academic experts agree that healthcare settings will have to become better-suited for people far more diversified than they have ever been before. Cultural competence is one way nurses will stay in touch with the special demands now being felt everywhere. Not only does cultural competence make nurses better prepared to do their job, it also enables them to enjoy better job security, connect better with patients, and bring about optimum healthcare.
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