Despite the increase in ethnic and racial diversity in the United States, evidence of disparities still exist. Promoting cultural competency is one way of addressing these gaps, especially in the healthcare system (Cai, 2016). Nurses have a pivotal position in providing culturally competent care that helps to improve the patients’ outcome since they are patient advocates. Cultural competence refers to the multicultural knowledge base that nurses should possess along with the ability to apply the knowledge in nursing practice (Henderson et al., 2016). Nurses are entitled to use the culture care competency framework, which acts as a guide that enlightens them on their own and other’s culture. The framework helps the nurses understand how the knowledge of culture influences their solution and perception of a problem. The culture care competency framework has several elements, including cultural sensitivity, cultural knowledge, and cultural resources, which are fundamentals to the nursing practice.
Cultural competence in nursing practice incorporates attitudes and skills that support the provision of care to patients across different cultures and languages. Not only does culture influence healthcare practices, but it also weighs how patients and health professionals perceive illnesses (Young & Guo, 2016). Nurses need to be aware of their patients' since the manifestation of diseases, epidemiology, and medications effects vary from one ethnic group to another. Furthermore, being aware of how culture influences the behaviors of patients allows nurses to integrate the best care plans for their patients (Cai, 2016). Cultural competence also involves learning different ways of communicating and interacting with patients. Thus, nurses can develop a set of skills that can help increase their cultural competence.
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Importance of Culturally Competent Care to Nursing Practice
Culturally competent care is fundamental in nursing practice to reduce the healthcare disparities and increase the access to quality care for all patients. Cultural competency establishes a better rapport between nurses and their patients (Henderson et al., 2018). With multiculturalism being on the rise, healthcare providers have a responsibility of providing culturally competent care in their practice and workplace accordingly. Young & Guo (2016) allude that there is a need for improved levels of communication for nurses to assess the needs of patients and develop an effective treatment for diseases. Moreover, nurses should have a clear understanding of patients' cultural backgrounds to offer culturally competent care.
Employing culturally sensitive practices is beneficial to nurses and healthcare organizations. Cultural competence has social benefits including increased trust, promotion of respect, patient healthcare empowerment, and patient responsibility promotion (Young & Guo, 2016). When there is an understanding between, patients become more involved in their preventive health care and doctors’ appointments. This helps in reducing related legal costs for healthcare facilities and medical errors. It also promotes the improvement of patients’ health outcomes. Ultimately, culturally competent care is making the patients’, values, beliefs, and emotions feel respected and understood.
Providing a culturally competent care safeguards the healthcare organization against malpractice claims and potential liability and improves the effectiveness of patient treatments. One of the most common reasons for lawsuits and malpractice claims is miscommunication between the patients and nurses (Cai, 2016). Thus, healthcare organizations need to evaluate their linguistic competence, vet their enlisted translation services, and address any existing gaps. Nurses have to be more curious about every patient, no matter their cultural orientation. By establishing an open dialogue between patients and nurses, cultural barriers can be transcended, leading to the provision of culturally competent care.
Relationship between Cultural Competency, Diversity, and Patient-and Family-Centered Care.
Cultural competence and diversity are closely connected concerning the delivery of quality healthcare. To serve a diverse patient population, nurses and other healthcare providers have to enhance their cultural competency skills (Young & Guo, 2016). Valuing diversity is an essential principle of maintaining cultural competency within any healthcare organization. This means that nurses have to respect and accept the differences within and between cultures. Understanding different cultural orientations can lead to a better understanding of the complexity of diversity (Cai, 2016). Besides a culturally competent healthcare organization is guided by the diverse behaviors, values, practices, attitudes, structures, and policies that establish cross-cultural communication. Therefore, when healthcare providers recognize value and respect every culture, the needs of diverse groups can be met, making it a culturally competent organization.
Cultural competence is also tied to the patient and family-centered care. In the most recent years, the two have been promoted as integral factors for improving quality healthcare (Clay & Parsh, 2016). The main aim of a patient and family-centered care is the provision of individualized care and restoration of a personal relationship between family members. Nurses are responsible for elevating quality care for all patients. Alternatively, cultural competence aims at reducing disparities and increasing health equity by concentrating on people from different cultural and ethnic backgrounds (Henderson et al., 2018). Nurses have know the diversity of patients to deliver individualized care. Thus, patient-centered care should be culturally competent to ensure that care is delivered universally. Since cultural competence improves the nurses’ abilities and healthcare systems in addressing the goals and preferences of individual patients, care ought to be more patient and family-centered (Clay & Parsh, 2016). A patient and family-centered approach should be considered, especially when proposing the methods of interactions between nurses and patients to enhance cultural competency. Additionally, the basic characteristics of patient-centered care, which include values, building relationships, patient values, and finding common standpoint can be endorsed as elements of cultural competence.
From my nursing experience, I had to care of a Muslim woman who was in labor and about to go for a postpartum care. The patient's family was there to support her throughout the experience, including her husband and in-laws. In Muslim culture, women should cover their heads and wear the 'hijab’ in front of any male. I noticed that the patient was wearing the 'hijab’ even when she was breastfeeding. I decided to ask her if wearing the whole 'hijab’ was mandatory. I felt that it was physically inconvenient, but the patient insisted that it was part of her culture. She explained to me the extent of their restricted cultural values and the possible punishments of not following the cultural practices. By interacting and being patient-centered, I was able to understand that different cultures have different practices and require different nursing care. Therefore, I could not neglect the cultural practices of the patient but to show her some respect and provide the care that she needed.
Barriers to the Provision of Culturally Competent Care
Providing of culturally competent care to a diverse population can be challenging. The language barrier is a major threat that hinders effective communication between patients and nurses (Hendson, Reis, & Nicholas, 2015). Language barrier results from lack of linguistic competence which may cause miscommunication or lack of communication with diverse populations including people with disabilities, low literacy skills, limited to English Proficient (LEP) and individuals with any degree of hearing loss. Research indicates that about 26 million individuals in the United States are limited to English Proficiency, which accounts for approximately 9% of the country’s population (Young & Guo, 2016). With healthcare organizations frequently admitting LEP individuals, effective communication can be very hard to achieve between nurses and patients.
The healthcare environment is another barrier to the provision of culturally competent care. This includes a lack of diversity in leadership and healthcare workforce, non-supportive staff, and rigid procedures and policies. The healthcare environment is vital for the provision of competent health care. There is likely to be an increase in ethnic and racial disparities among healthcare providers with such barriers. Poorly designed hospital systems are also a barrier to the effective delivery of culturally competent care since the systems might fail to meet the requirements of patient from different cultural backgrounds. Other barriers include nurses' attitude, professional experience, and lack of sensitivity towards the patients. Simple actions towards the patients can sometimes intentionally hurt them or show some form of disrespect.
Recommendations
Several ways can be used to provide health promotion activities in a multicultural patient community. Through communication, public awareness of healthy behaviors can be raised. To improve communication with patients, healthcare organizations should have professionally trained interpreters who can communicate with LEP patients (Hendson, Reis, & Nicholas, 2015). This will help promote quality care and satisfaction among patients from different cultural orientations. Other communication strategies that can in health promotion include mass media, public service announcements, and health campaigns (Cai, 2016). Education is another health promotion activity that can help empower actions and behavior change in a multicultural patient community. The health education strategies can be accomplished through support groups, courses, and training. There is also a need to make systematic changes in healthcare systems through improved policies, systems, social and physical environment (Henderson et al., 2016). This will provide diverse health choices among patients from different cultures.
Conclusion
The increase in diverse cultural and ethnic groups in the United States has led to more demand for culturally competent care in healthcare settings. Cultural competence has proved to be advantageous in delivering quality care in nursing practice. It has led to an increase in trust, reduction of medical errors, effective treatment of diseases, and promotion of patient health care. Cultural competence is closely related to diversity, and nurses have to understand patients' cultural orientation to promote effective care. Patent and family-centered are also linked to cultural competency through different methods of delivering care to patients as well as their values. Despite the importance of cultural competence in healthcare, there are several barriers which can be a hindrance to the provision of quality care. The barriers include; language barriers, poor hospital systems, non-supportive staff, poor leadership, and lack of experience. Different ways can be used to provide health promotion activities in a multicultural patient community. This can be achieved through communication, education, and systematic hospital changes.
References
Cai, D. Y. (2016). A concept analysis of cultural competence. International Journal of Nursing Sciences , 3 (3), 268-273.
Clay, A. M., & Parsh, B. (2016). Patient-and family-centered care: It is not just for pediatrics anymore. AMA journal of ethics , 18 (1), 40-44.
Henderson, S., Horne, M., Hills, R., & Kendall, E. (2018). Cultural competence in healthcare in the community: a concept analysis. Health & social care in the community , 26 (4), 590-603.
Hendson, L., Reis, M. D., & Nicholas, D. B. (2015). Health care providers' perspectives on providing culturally competent care in the NICU. Journal of Obstetric, Gynecologic & Neonatal Nursing , 44 (1), 17-27.
Young, S., & Guo, K. L. (2016). Cultural diversity training: the necessity of cultural competence for health care providers and in nursing practice. The health care manager , 35 (2), 94-102.
