Nurses encounter patients from all different walks of life and backgrounds during their time in health care. As cultural knowledge expands, nursing training programs are placing more emphasis on culturally competent care in nursing—but what does this mean? How do you become culturally competent, and why does it matter for patient outcomes?

Let’s break down cultural competence in nursing and provide strategies for developing the right nursing skills while addressing common challenges in the clinical setting. We’ll also explore why it’s so important for healthcare providers to pursue cultural competency throughout their careers.

Start Your Nursing Journey

What is Cultural Competence in Nursing? 

In the words of the Centers for Disease Control and Prevention, “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.”¹

In other words, culturally competent nurses provide care while acknowledging (and making efforts to accommodate) patients’ culturally diverse backgrounds.

Let’s break that CDC definition down further:

• Attitudes, behaviors, and policies – Your hospital system or practice’s philosophy, the behaviors it encourages, and the policies it implements indicate its approach to cultural competence. Not all employers prioritize cultural competence.
• Enables effective work – Effective work in nursing is providing the care that helps patients reach their goals. Acknowledging and accommodating (when possible) cultural nuances can help patients reach their goals.
• Cross-cultural situations – Even if you don’t share a cultural background with a patient, that shouldn’t stop you from providing the best possible nursing care. And, in many cases, the best possible care is compatible with a patient’s cultural background.

Key Components of Culturally Competent Care 

What does culturally competent care in nursing look like? Let’s review a few of the hallmarks of a culturally competent care approach.

Awareness

To acknowledge a patient’s cultural background competently, you need to be aware that their cultural nuances exist in the first place. In today’s healthcare training landscape, all levels of nursing are encouraged to increase their cultural awareness by:²

1. Learning about other cultures – In the digital age, information about other cultures is widely available. Additionally, nurses may have opportunities to enroll in cultural diversity training courses that increase their cultural knowledge.
2. Talking to patients – Asking your patients (or their families) about their cultural beliefs at appropriate times can help you learn more about their values, healthcare goals, and background.

By increasing awareness, nurses can deliver care that helps patients meet their goals within the context of their culture.

Knowledge

Knowledge and awareness go hand-in-hand in the cultural competency conversation. To identify a patient’s cultural background, you need a baseline knowledge of the various cultures represented in your patient population.

Nurses can increase their overall cultural knowledge by enrolling in training programs and talking to their patients. But what should nurses make a point to learn about? In a healthcare context, nurses may need to know about culture-specific:

• Cuisine and dietary preferences
• Practices related to birth and death
• Approaches to medicine
• Titles, honorifics, and naming conventions

Building knowledge about a patient’s cultural background can help nurses connect with them—and connection can ease the treatment process.

Skills

Armed with cultural knowledge and awareness, what should nurses do with this information? Cultural information translates to culturally competent skills like:

• Routine-building – Creating a schedule for medication dosing and vital checks is key to critical care. Nurses should accommodate any culture-specific scheduling nuances into a patient’s routine when possible.
• Dietary planning – When recommending meals and nutrition for patients, nurses should do their best to follow their patients’ cultural guidelines.
• Managing birth and death – When babies are born, or patients die, nurses with cultural knowledge should help patients and their families incorporate rituals when appropriate.

These are just a few examples. Culturally competent skill-building is a key focus of many nursing education programs today.

Encounters

In a clinical context, a culturally competent encounter with a patient might look like:

• Using their preferred name, title, or honorific
• Asking about any rituals they completed throughout the day
• Bringing up potential ways their culture could impact their treatment plan
• Discussing how at-home rituals will impact their health once they’re released

If a patient chooses not to follow portions of their treatment plan because they conflict with their cultural practices, they may not reach their health goals. Nurses can help set patients up for success by doing their best to accommodate these practices while talking to patients about their care plans.

Desire

Simply put, nurses have to want to learn about, acknowledge, and accommodate patients’ cultural beliefs—even if they don’t have to.³

When nurses take an interest in their patients’ lives, patients take notice. This has the potential to strengthen the patient-provider relationship, which can support a smooth treatment plan.

If you're not enthusiastic about learning more about potential cultural differences in your patient population, consider how you might feel in the patient’s shoes: feeling unwell in a clinical environment where nurses don’t understand your culture, language, or even your name.

If a nurse made an effort to accommodate your cultural differences, you'd likely be grateful—especially if they considered your rituals and needs while planning your treatment.

Strategies for Developing Cultural Competence 

With all of the above in mind, how can nurses build cultural competence? We touched on some possible routes above, but let's elaborate to help you make a plan.

Education

One of the best ways to keep your skills sharp, learn about new technologies in medicine and increase your overall confidence as a nurse is to participate in continuing education opportunities. The same is true when it comes to building cultural competence.

Luckily, today's top nursing education programs cover cultural competency in-depth. If you're planning on enrolling in a nursing program soon, expect to cover topics like:

• Which cultures are represented in the US
• How different cultures approach medicine and personal patient care
• Ways in which nurses can respectfully ask questions about their patients’ different cultural backgrounds

Training Programs

Like degree programs, training programs can connect nurses with the information and tactics they need to provide culturally competent care.

Not sure where to look for training programs? Explore opportunities with:

• Your employer – Your hospital system or practice may offer a professional development course or vouchers to participate in third-party training programs.
• A local nursing organization – Local chapters of nursing groups like the American Nurses Association (or other healthcare organizations) can connect professionals to continuing education opportunities.⁴
• A college or university – Many colleges and universities offer certificate programs in addition to degree programs—and many of these are available in a convenient online format.

Immersive Experiences in Diverse Communities

Perhaps the best way to learn more about other cultures is to immerse yourself in them. This is especially true if you can spend time engaging with people outside of your cultural group in a place where your culture isn’t represented in the majority.

If you’re looking for an informative immersion experience, research opportunities like:

• Volunteer efforts like community immunization events
• Travel nursing 
• Humanitarian aid and disaster response abroad

Your employer or a local nursing organization could also help you discover immersion opportunities.

Start Your Nursing Journey

Challenges in Culturally Competent Nursing 

As you make efforts to expand your cultural competency as a nurse, you’ll likely run into some roadblocks. Let’s explore a few common challenges and offer tips for overcoming them.

Language Barriers

Whether other languages are widely represented in your patient population or you seek out an immersion experience, you’re likely to encounter at least one patient who doesn’t share your language in your cultural competence training.

What can nurses do to provide exceptional care when they don’t speak a patient’s language?

• Use tech tools – Instant voice translation and voice-to-text translation are just two common features of today’s smartphones.
• Ask for a professional interpreter – If you’re working in your home hospital system or practice, consider asking to use your system’s translation services. If these are unavailable, this is something to bring up to your supervisor.
• Find an impromptu interpreter – If your professional interpreter resources are limited, consider asking another nurse on your unit or a member of the patient’s family to translate. While these aren’t ideal solutions, consider these options in critical situations.

Preconceived Notions

Developing preconceived notions about cultures outside of your own is a perfectly normal experience—even if you consider yourself open-minded. How can you keep preconceived notions from informing your culturally competent care practices?

• Leave assumptions at the door. If you didn’t learn about a cultural nuance from a member of that culture or a qualified educator, don’t assume that it’s true.
• Ask questions when you’re not sure. Admitting your lack of knowledge is a safer choice than making a conjecture.
• Engage with a more diverse population. Every time you learn something about a culture that’s new to you, you have the opportunity to use that cultural diversity to dispel preconceived notions.

The same can be said for systemic biases. Like preconceived notions, these biases are rooted in every facet of our everyday lives, and they have the potential to significantly impact patients of minority cultural groups in clinical settings. Turn to experts, ask questions instead of conjecturing, and make efforts to engage with people affected by these systemic biases.

Why Does Cultural Competence Matter in Nursing?

According to healthcare researchers and experts, culturally competent care produces better patient outcomes—it’s just that simple.⁵

Cultural differences have the potential to impact everything from the legal system to individual hospital policies. In many cases, these differences lead to real-world health disparities for patients across the race, class, age, and gender spectra.

When nurses acknowledge and (when possible) accommodate these differences, they prevent these disparities from growing wider. And, as a result, diverse patients from all cultural backgrounds receive more equitable care.

Discover Professional Development Opportunities in Nursing

Cultural competence in nursing has been a widely discussed topic in healthcare for decades, and today’s nurses have ample opportunities to develop this competence for the future of nursing—especially when they enroll in high-quality education programs.

At Alliant International University, our expert nursing educators provide the highest standard of instruction, facilitate hands-on learning, and prepare the next generation of nurses. Whether you’re looking to become a nurse or advance to a leadership position in healthcare, we have a program that can help.

Learn more about our nursing education opportunities and apply now.

---

Sources: 

1. “Cultural Competence In Health And Human Services.” US Centers for Disease Control and Prevention. February 23, 2024. https://npin.cdc.gov/pages/cultural-competence-health-and-human-services. Accessed March 22, 2024.
2. Červený, Martin, et al. “Methods of increasing cultural competence in nurses working in clinical practice: A scoping review of literature 2011–2021.” Frontiers in Psychology. August 24, 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9449514/. Accessed March 22, 2024. 
3. Campinha-Bacote, Josepha. “Cultural Competemility: A Paradigm Shift in the Cultural Competence versus Cultural Humility Debate – Part I.” Online Journal of Issues in Nursing. December 4, 2018. https://ojin.nursingworld.org/table-of-contents/volume-24-2019/number-1…. Accessed March 22, 2024.
4. Find Your State Association.” American Nurses Association. https://www.nursingworld.org/membership/find-my-state/. Accessed March 22, 2024.
5. Nair, Lakshmi and Adetayo, Oluwaseun A. “Cultural Competence and Ethnic Diversity in Healthcare.” Journal of the American Society of Plastic Surgeons. May 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571328/. Accessed March 22, 2024.