While there is no typical day in the life of a nurse, there is one constant: the focus on patient care. An essential aspect of providing safe, quality care is cultural competence.
The U.S. is expected to become “minority white,” with Hispanics, blacks, Asians and multiracial populations accounting for more than 50% of the nation’s population by 2045. The trend signals a corresponding shift in the racial makeup of patient populations, and improving cultural competence can help RNs meet the needs of each of their patients.
What Is Cultural Competence?
Cultural competency applies to any workplace. Diversity Resources defines cultural competence as “the ability to interact effectively with people from different cultures,” calling it “the most important skill for diversity in the workplace training.”
The Agency for Healthcare Research and Quality defines cultural competence in healthcare as “care that respects diversity in the patient population and cultural factors that can affect health and health care, such as language, communication styles, beliefs, attitudes, and behaviors.”
How Does Cultural Competence Improve Patient Outcomes?
It can be challenging enough for native English speakers to understand health information. Imagine the difficulties for patients whose preferred language is not English.
Even plain language is not enough to ensure that patients with limited English proficiency (LEP) will understand. Medical interpreters can bridge the language gap. Unfortunately, they are not always available.
The lack of a competent interpreter was found to be a significant factor in the death of a 9-year-old from a drug reaction. The hospital relied on the patient and her brother to translate because the parents only spoke Vietnamese.
Failing to understand cultural differences can also harm patients in other ways as well. The Center for Substance Abuse Treatment shares the story of a Japanese patient with alcohol dependence. The program expected clients to notify family members about their treatment. Despite the patient’s reluctance to do so, he was persuaded to comply. His parents disowned him for disclosing his “problem” and “shaming” his family.
While cultural sensitivity is vital in caregiving professions, it is also important to avoid stereotyping patients based on their backgrounds.
As both cases demonstrate, culturally competent care can protect patients from physical and emotional harm. Still, a Health and Human Services report shows that racial and ethnic minority groups in the U.S. are at greater risk for “worse health outcomes from preventable and treatable conditions.”
The authors of Impact of Language Barriers on Patient Safety discuss the link between communication and patient outcomes:
- Nearly 60% of all serious adverse events reported to the Joint Commission were caused by communication errors.
- Nearly 50% of LEP patients who experienced adverse events were physically harmed. This statistic drops to about 30% with English-speaking patients.
- Rates of medication errors were higher for patients with a language barrier, putting them at higher risk for complications.
- LEP patients may not understand a diagnosis and risk factors. As a result, they may be unable to make informed decisions about their health. In some cases, this could be life-threatening.
How Do Healthcare Organizations Benefit From Cultural Competence?
Cultural competence for hospitals and other healthcare organizations begins with understanding the local community and patient population. Organizations can them plan training and education accordingly.
Healthcare organizations benefit from reducing variations in care. According to the Institute for Diversity and Health Equity, these benefits include:
- Increased respect and understanding between the organization and patients
- Increased community participation and involvement in health issues
- Improved legal and regulatory compliance
- Improved efficiencies in care services
- Fewer medical errors and increased cost savings
- Fewer missed medical visits
- Increased market share for the organization
How Can Nurses Develop Cultural Competence?
Becoming a culturally competent nurse begins with realizing that it is an ongoing process.
A self-assessment is a good place to begin. In a Wolters Kluwer Health article, Linda Smith, PhD, MS, RN, CLNC, explains that self-assessment involves evaluating one’s own abilities to be “culturally competent and empathetic toward patients, peers, faculty, and administrators.”
One question to ask, she suggests, is “How do I respond and behave when witnessing cultural incompetence, incivility, and bullying in educational and clinical settings?” Training in assertive communication can help RNs feel more confident in addressing culturally incompetent care they observe.
Minority Nurse recommends engaging in cross-cultural interactions with patients. Take time to learn about their beliefs, values and needs. For example, does a patient have healing traditions? Work to improve communication across cultures.
Earning a bachelor’s degree can also boost cultural competency. Associate degree programs emphasize general nursing skills, and BSN programs go beyond the basics to prepare RNs with a broader base of skills and knowledge.
Students in the online RN to BSN program at Lamar University, for example, build on assessment skills to identify health promotion, risk assessment and disease prevention behaviors, including cultural considerations. Students also examine cultural influences on community health.
RNs spend more time with patients than other healthcare providers. A hospital shift, for example, may involve performing assessments, providing emotional support, evaluating symptoms, drawing blood, starting IVs, administering medications, preparing patients for discharge and more. Through it all, there are many technologies to support RNs as they provide quality care. But as it turns out, one of the best tools is the ability to deliver culturally competent care.
Learn more about Lamar University’s online RN to BSN program.
