Cultural Competence in Nursing
The five essential constructs of culture according to Campinha-Bacote (2001) are cultural knowledge, cultural awareness, cultural encounters, cultural skill and cultural desires. Acquiring cultural competence is important in nursing because nurses must be able to understand each patients needs; especially those from different cultural backgrounds. The following essay analyzes each of the five essential constructs of culture, and the components and barriers of each.
Cultural awareness is the “self-awareness and critique” (para.4.) of an individuals cultural awareness. This is a lifelong process that a nurse goes through in order to become “respectful, appreciative, and sensitive to the values, beliefs, lifeways, practices and problem-solving strategies of a client’s culture” (para.4). This is an important process in nursing; many cultural diverse patients may have different cultural interpretations of their illness, degree of pain and other important factors which must be understood and addressed by the nurse.
Ethnocentrism and Ethnorelativism. Nurses demonstrating ethnocentrism could be a potential danger to their patients. Such nurses feel that their values and beliefs are the only right ones which matter. These nurses can impose their own beliefs on their patients causing the patients cultural needs to be unmet. An ethnocentric nurse will apply the same rehabilitation strategies to all patients, ignoring the patients’ cultural background. It is important for these nurses to learn the proper ways of caring for patients of different cultures through individual study and participating in classes on diversity. Learning and experiencing different cultural backgrounds will result in ethnorelativism; the nurse will then appreciate the needs of patients of different cultures. This self-awareness will allow the nurse to adjust his or her practices to the needs of the patient.
Cultural skill is need for the physical assessment of culturally diverse patients. Patients’ vary in their physical, biological and physiological needs. During the process of cultural competence, a nurse must learn the proper techniques needed to assess patients. Once a nurse is comfortable in their cultural skills, a nurse can adjust their physical assessment strategies accordingly.
According to the author, cultural knowledge in the most important construct of cultural competence; it is critical to the accurate understanding of a patient’s worldview. Of the four stages of cultural knowledge, unconscious competence, conscious incompetence, conscious competence and unconscious competence, the last stage, unconscious competence is what a nurse should strive to achieve. It is a comfort level, in which one isn’t concerned with political correctness, but rather unconsciously knows how to adjust the nursing strategy to one in which is appropriate for a patient’s cultural background.
Nurse encounters with diverse cultures vary, and because the people of one culture are different within themselves, it is important to make sure one encounters many different types of people from a distinct culture. Otherwise, one may stereotype a certain culture. To avoid stereotyping, the author suggests interacting with many people from the same culture in order to better understand their needs.
Cultural desire is an important concept in cultural competence, it is the desire to learn and be confident in the diverse cultures of patients. This drive to “engage in the process of cultural competence” (para.20) is necessary for all nurses in order to appropriately assess and care for patients based on the patients cultural background. Those nurses that don’t have cultural desires will not address the patients’ needs and therefore be unsuccessful in helping them.
Achieving cultural competence is a necessary process in order to provide appropriate and successful care to each individual patient. Remembering the mnemonic ASKED will provide nurses with a guide for achieving cultural competence and patient satisfaction.
Campinha-Bacote, J. (2001). Rehabilitation Nursing. (vol.26, iss.1).