Demonstrate and Improve Cultural Competence in Nursing

As the U.S. continues to diversify, so do patient populations. By demonstrating and increasing your cultural competence, you can enhance care quality, patient outcomes, and patient-staff relationships.

According to the U.S. Census Bureau, the 2020 Census indicated the U.S. is now more racially and ethnically diverse than in 2010. And in a 2021 Gallup poll, more individuals identified as a part of the LGBTQ+ community than in 2012.

As we strive for inclusive practices, we should consider the attributes, identities, and affiliations of patients, colleagues, and nurse leaders. Differences and similarities may involve anything from a person’s religious practices to their dietary restrictions. Cultural competence in nursing is the practice of understanding these types of differences and using them to inform how we build relationships and provide care — with awareness, empathy, and skill.

“The act of cultural competence in nursing represents a genuine understanding of another [person’s] cultural and religious beliefs, race, ethnicity, values, and more. Taking this approach supports a comprehensive individualized plan of care using your patient’s perspective as your guide,” said Trish Richardson, MSN, BSBA, RN, NE-BC, CMSRN, Director of Post-Acute Care Solutions at Relias.

Cultural Awareness

Demonstrating cultural competence in nursing starts with awareness. With awareness, you’re identifying the diversity that exists among your patients and then using that information to provide care that is informed and free from bias.

Trish Richardson, RN

Richardson explained that awareness is considering all elements of a patient’s situation and using those elements to adapt your care, so the person feels understood and comfortable.

“For example, you may be caring for someone who is recently diagnosed with heart failure and will now need to take a daily medication and routinely monitor their weight,” explained Richardson. Is English their primary language or will you need to bring in medical translation support? How do their cultural beliefs influence whether they will be compliant with medications and discharge instructions? Do they have insurance, or would they benefit from a prescription discount card (if one is available)? Do they have a scale at home and internet access to transmit their weight logs to the doctor?”

Posing thoughtful questions like these will help you find ways to communicate with your patients so they can clearly understand you while maintaining their comfort.

A 2018 study showed that language barriers between patients and nurses is common. Most participants in this study used interpreters to clearly communicate with their patients, reporting improved care quality in work environments with these services.

By exemplifying awareness, you’re not only improving your nurse-patient relationship — you’re also improving the quality of your care.


Empathy is an essential part of the patient-staff relationship. By exhibiting empathy, you acknowledge an understanding of another individual’s feelings or perspectives through unbiased communication and listening.

Alisha Cornell, DNP, RN, and Senior Clinical Implementation Consultant at Relias, mentioned one example of empathy used in concert with cultural competence.

“If a patient’s culture doesn’t allow care provided by the opposite sex, make sure the nurse covering the patient during the shift is appropriate …read more

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