Nurse speaking with a patient of a different nationality

Cultural Competence: Respect and Understanding

Do you have the skills you need to be a culturally competent caregiver? To truly answer this question, you might need to first perform a self-evaluation. If you do not know what your beliefs are and how you deal with others with differences, you will not be able to obtain cultural competence.

The National Institutes of Health (NIH) define cultural competence as:
…the combination of a body of knowledge, a body of belief and a body of behavior. It involves a number of elements, including personal identification, language, thoughts, communications, actions, customs, beliefs, values, and institutions that are often specific to ethnic, racial, religious, geographic, or social groups. For the provider of health information or health care, these elements influence beliefs and belief systems surrounding health, healing, wellness, illness, disease, and delivery of health services. The concept of cultural competency has a positive effect on patient care delivery by enabling providers to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients (NIH, 2015).

In a profession that is 90% female and 81% white, Caucasian it is important that we understand and respect the differences in our friends, staff, family, and patients (Paternotte, Scheele, Seeleman, Bank, Scherpbier, A.J, and van Dulmen, (2016).

Did you know that in the United States 21% of Americans do not have the skills to complete tasks that require comparing information, paraphrasing, or making low-level inferences (language literacy) and that even those who are literate, may not be able to obtain, process, and understand basic health information and services to make appropriate health decisions (health literacy) (Office of Disease Prevention and Health Promotion: Health Communication Activities, 2019; National Center for Education Statistics (NCES, 2019).

One of the biggest tools in your competency toolkit is communication skills. By recognizing the way you communicate, including body language cues, you can detect the differences in the patient’s communication style. If you don’t know why the patient is communicating in a manner that you are not comfortable with, find resources to help you understand the cultural differences. Above all, do not react with judgment. For example, if the patient or family does not make or maintain eye contact, they are not being rude or dismissing what you are saying; their culture may not encourage direct eye contact.

Healthcare professionals must participate in building cultural competence skills. Understanding and respecting the differences among our population will enhance the experience for all involved. Need a reminder of what cultural competence is? Try this acronym EAR:

  • Expect differences
  • Accept differences
  • Respect differences

For more information about providing culturally competent care, refer to the course Practicing Cultural Competence.

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National Institute of Healthcare (NIH). (2019). Cultural respect.  Paternotte, E., Scheele, F., Seeleman, C.M., Bank, L., Scherpbier, A.J. and van Dulmen, S. (2016). Intercultural doctor-patient communication in daily outpatient care: Relevant communication skills. Perspectives on Medical Education. 2016; 5: 268–275. < The National Center for Education Statistics (NCES). (2019). Adult literacy in the United States