As a student in my final year of nursing school, I've been exposed to various teaching methodologies involving culturally appropriate care, especially for underserved communities. The patient population in the US is only growing more diverse; therefore, the need to shift our care ideologies from cultural competence to cultural humility is paramount in providing culturally sensitive patient- and family-centered care. Let's explore the differences between these two concepts.
Cultural competence means having the skills and attitudes necessary to knowledgably care for patients of diverse cultures and backgrounds. Nurses who practice cultural competence attend to patients' needs appropriately, understand cultural behaviors, and reduce health disparities. This entails addressing specific concerns for underrepresented groups, such as higher rates of diabetes and hypertension. However, cultural competence suggests that there is a "stopping point" to providing the most culturally appropriate care when, in fact, it's impossible for nurses to learn about all aspects of every culture. Further, cultural competence implies that definitive knowledge can be gained, which may lead to biases and stereotypes. For instance, in Chinese culture, it's believed that women have open pores after giving birth; therefore, many mothers don't wash their hair. Nurses practicing cultural competence may fail to offer basic hygiene care because they assume every Chinese mother follows this belief. Instead, nurses can ask what practices the patient would like to incorporate into their care plan, which is the essence of cultural humility.
The implementation of cultural humility in the clinical setting, instead of cultural competence, is crucial. Cultural humility is ongoing, dynamic learning accompanied by acknowledging our biases and practicing self-reflection. This lifelong learning framework advocates for continuous curiosity instead of a stopping point and acknowledges that there may be individual differences in cultural practices. For example, each time I care for patients, even if we are of the same background, I always ask the patient if they have any cultural preferences that they would like me to implement into their plan of care. I don't rely on stereotypes to guide my care or assume that I already fully understand their preferences. Instead, I work to recognize the complexity of cultural practices and involve the patient in their care process. This means that the patient can advocate for their needs and demonstrate to me how to best incorporate their cultural preferences into their hospital stay. This has allowed me to provide individualized care for a wide range of communities.
As our patient populations become increasingly diverse, nurses must shift toward cultural humility, rather than cultural competence. As one of the newest board members for Nursing Made Incredibly Easy, I believe this message is made clear in this issue focusing on underserved communities. This Nurse's Month, I invite you to look through the lens of cultural humility as the journal unpacks key issues related to caring for underserved and diverse patient populations.