Guide to Cultural Sensitivity in Nursing
March 12, 2020 | Category: Nursing
The United States is becoming increasingly culturally diverse. According to data from the U.S. Census Bureau, Asian and mixed-race people represent the fastest-growing segments in the country. Non-Hispanic whites, on the other hand, have a higher death rate than birth rate. In response to these population changes, the healthcare industry – specifically nurses – will need to adapt to the unique needs and cultural backgrounds of patients.
To learn more, check out the infographic below created by Advent Health University’s Master of Science in Nursing.
Cultural Diversity in the U.S.
The U.S. population is nearing 400 million. Within a few decades, minority groups will become the majority. The healthcare industry has made some efforts to adjust to the needs and demands of culturally diverse patients, but more significant changes are still necessary.
U.S. Population, 2019
There were nearly 330 million people in the U.S. in 2019, making it the third-largest country in the world. The average life expectancy was 78.9 years, with women’s life expectancy roughly five years more than men.
In 2015-16, non-Hispanic whites made up 198 million of the population, followed by Hispanic (57.5 million) and African American (46.8 million). While English was the most spoken language, 60 million Americans spoke a language other than English at home. In terms of religious beliefs, 48.9% of Americans identified as Protestant Christian, followed by Catholic (23%) and agnostic/atheist (22.8%).
Between 2014 and 2016, the non-Hispanic white population grew 18.6%. Hispanics grew by 11.2%, and Asians grew by 3.9%.
How Healthcare is Adjusting
Healthcare organizations are reacting to growing diversity by implementing strategies that acknowledge shifts. For instance, 70% of hospitals nationwide offer translation services. Additionally, 15 states pay for interpreters needed by Medicaid patients. 21 states have also adopted health equity standards to guide physician training. Other industry efforts to improve cultural competence include gearing programs to recruit and retain diverse staff members, providing cultural competency training for healthcare providers, and offering culture-specific healthcare settings.
Medical schools are also making efforts to erase the equality gap. These efforts include recruiting and training more minority students and training all students to examine their own biases.
Obstacles to Cultural Sensitivity in Nursing
Nurses play a key role in patient care and often face challenges when working with culturally diverse patients. Patients’ beliefs, values, and health-related practices impact nearly every step of the healthcare process. Understanding these cultural factors is the key to providing effective care.
Defining Key Terms
According to an article published in Families in Society: The Journal of Contemporary Social Services, “Culture is an organized group of learned responses, a system of ready-made solutions to the problems people face that is learned through interactions with others in society.”
According to an article published Health & Social Work, cultural sensitivity can be defined as being “sensitive to the ways in which community members’ values and perceptions about healthcare differ from his or her own.”
According to an article published in Arthritis Care and Research, cultural competent healthcare requires being “sensitive to the differences between groups, to the differences in outward behavior, and also to the attitudes and meanings attached to emotional events such as depression, pain, and disability.”
Challenges to Culturally Competent Healthcare
While delivering culturally competent care is an important goal, there are several challenges to keep in mind when providing culturally competent care. Some of these challenges include bureaucratic constraints, healthcare professionals’ bias potentially leading to misdiagnosis, and culture’s influence on patients’ values and beliefs.
Additionally, there is an increased layer of complexity due to language, culture, and resource barriers. These barriers may impact key components of caregiving such as practitioner-patient communication, information provision and instruction, diagnosis, and engagement in intervention/therapy.
Challenging Situations with Divers Patients
Cultural traditions and philosophies may also make it difficult to provide optimal healthcare for all patients. For instance, Japanese patients may feel shy and anxious when trying to express themselves in English, because Japanese culture holds that being too expressive is impolite and conveys too much nonconformity. Another example may be of a Mexican migrant who suffered an injury and appears uninterested in recovering because they believe they won’t recover without traditional Mexican healing practices.
Tips for Providing Culturally Sensitive Care
Developing cultural competence is an ongoing process, and nurses should be committed to educating themselves about diverse patients’ beliefs, values, and perspectives.
The Building Blocks of Culturally Sensitive Care
In The Case Manager, Josepha Campinha-Bacote and Cora Munoz propose a five-component model for developing cultural competence. The five components are cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire. These components can help healthcare professionals strive to become knowledgeable in the complexities of patient culture.
There are also tips for providing culturally competent care as a nurse. These include ensuring the patient and their family clearly understand the situation, identifying verbal and non-verbal language barriers, addressing culture-specific dietary considerations, and avoiding stereotyping a patient into a cultural or ethnic group based on appearance, race, county of origin, or stated religious preference.
All patients are different, yet each one is equally important. To ensure each patient receives culturally competent care, nurses must be aware of their own prejudices and biases and take steps to educate themselves about the beliefs, practices, and perspectives of diverse patients.