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Nursing skills in cultural competence are well recognized as being essential to high-quality care. We typically associate the concept with a patient-centered approach that takes into account our patients' ethnicity, socioeconomic status, language, religion, expectations, and customs in care planning. But I'll assert that we also need to develop our skills in intraprofessional cultural competence. This is our ability to work harmoniously with the myriad cultures and subcultures that comprise professional nursing and the health team overall.
When you think about it, each patient-care setting, department, and service line evolves its own culture. Add in the cultures or subcultures that emerge when nurses elect to work specific shifts or assume education and management responsibilities.
The fact that diverse cultures exist within our profession isn't a concern; they're a natural byproduct when people with similar interests, backgrounds, or role functions come together. A big problem occurs, however, when individuals within one culture allow preconceived notions to negatively impact working relationships with another culture.
How often have you heard statements like, "I don't trust anyone who goes into management," "night shift nurses are lazy," "ICU nurses are prima donnas," "nurses become educators to avoid doing the real work," or "new grads just won't cut it here"? Making broad assumptions about someone's level of expertise, work ethic, motivation, or world view impedes healthy collaboration and propagates biases.
These sorts of disparaging remarks illustrate a lack of intraprofessional cultural competence. Ultimately, teamwork breaks down and islands of conflict are created. More energy is spent dealing with the discord than on positive, productive activities that could make the world a better place. Perhaps most disturbing is that toxic relationships create patient safety risks when team members stop communicating effectively with one another.
What's the solution? We need to establish clear expectations for intra- and interdisciplinary cultural competence as a professional standard. Individuals gravitate to roles and practice settings based on interests, talents, and needs. Wouldn't it be nice if we could all walk a mile in each other's shoes to view the world from a perspective different than our own? At the very least, we can aspire to stand together on the platform of mutual respect and be role models.
Until next time-
Linda Laskowski-Jones, MS, RN, ACNS-BC, CEN, FAWM
Editor-in-Chief, Nursing2011 Vice President: Emergency and Trauma Services, Christiana Care Health System, Wilmington, Del.
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