By Shantelle Coe RN BSN - Diversity and Inclusion Consultant

Creating an environment that embraces diversity and equality not only attracts the most qualified nursing candidates, but an inclusive environment also helps to assure that the standards of nursing care include “cultural competency.”  Cultural differences can affect patient assessment, teaching and patient outcomes, as well as overall patient compliance.

Lack of cultural competence is oftentimes a barrier to effective communication amongst interdisciplinary teams, which can often trickle down to patients and their families.

With the increase in global mobility of people, the patient population has become more ethnically diverse, while the nursing forces remain virtually unchanged.  Nursing staff work with patients from different cultural backgrounds.  Consequently, one of the challenges facing nurses is the provision of care to culturally diverse patients.  Hospitals and healthcare agencies must accommodate these needs by initiating diversity management and leadership practices.

According to Cross, T., Bazron, B., Dennis, K., and Isaacs, M. (1989); these are the 5 essential elements that contribute to an institutions ability to become more culturally competent:

• Valuing diversity

• Having the capacity for cultural self-assessment.

• Being conscious of the dynamics inherent when cultures interact.

• Having institutionalized cultural knowledge.

• Having developed adaptations of service delivery reflecting an understanding of  cultural diversity. 

A culturally competent organization incorporates these elements in the structures, policies and services it provides, and should be a part of its overall vision.

From all levels, the nursing workforce should reflect the diversity of the population that it serves.  A more diverse workforce will push for better care of underserved groups.  It’s important to note that that diversity, inclusion, and cultural awareness isn't just about race or ethnicity.  We must always keep in mind socioeconomic status, gender, and disability in our awareness.

Becoming more inclusive is a shared responsibility between nurses and healthcare agencies.  Becoming an “agent of change” within your facility can inspire awareness and affect attitudes and perceptions amongst your peers. 

Nurses and healthcare workers must not rely fully on the hospital and healthcare systems to institute an environment of cultural awareness.   

Nurses can increase their own cultural competencies by following a few guidelines:                                   

• Recognizing cultural differences and the diversity in our population.

• Building your own self-awareness and examining your own belief systems.

• Describing and making assessments based on facts and direct observation.

• Soliciting the advice of team members with experience in diverse backgrounds.

• Sharing your experiences honestly with other team members or staff to keep communication lines open.  Acknowledging any discomfort, hesitation, or concern.

• Practicing politically correct communication at all times –  avoid making assumptions or stereotypical remarks.

• Creating a universal rule to give your time and attention when communicating.

• Refraining from making a judgment based on a personal experience or limited interaction.

• Signing up for diversity and inclusions seminars.

• Becoming involved in your agencies diversity programs – find out what your resources are - most institutions have something in place.

By incorporating a few of these steps into your daily nursing practice, you are taking steps towards becoming culturally competent.

Inclusive nurses demonstrate that we are not only clinically proficient and culturally competent, but are the essence and spirit of the patients that we care for.