Amy Stewart, RN, RAC-MT, DNS-CT

What is cultural competence and how can I assess for it in my nursing staff?

At its core, cultural competence is the awareness of one’s own behaviors, beliefs, and biases.  According to the State Operations Manual, cultural competence is crucial to the care practiced in nursing facilities because it allows clinicians to better communicate with “individuals of various cultural backgrounds” and to “plan for and provide care that is appropriate to the culture and to the individual.”

Culture influences the thoughts, actions, beliefs and values of all residents, including how they view health-related choices. Residents with cultural or language differences often have misunderstandings with culturally insensitive caregivers, which can lead to insufficient care plans, lack of compliance with treatment, and challenging resident behaviors. For example, residents with certain cultural backgrounds may feel uncomfortable when staff help with personal care or hygiene activities such as bathing. This issue can be mitigated by asking the resident about his or her preferences and engaging the resident’s family in care planning.

Before assessing staff, train on cultural competency generally and also use the facility-wide assessment to target culture-specific education. If your facility is home to a significant number of Japanese-American residents, for example, educate staff on how age is viewed in Japanese culture and leave room for discussion to help staff process specific challenges that they might be having. To assess staff, ask them to consider how culture may be at play in specific scenarios. 

Culturally competent staff will be able to better understand and communicate with residents, leading to better care plans and resident outcomes. 

Please send your nursing-related questions to Amy Stewart at [email protected]