In Canada, cultural competence is something you need to possess before you enter into practice (Schmalz et al., 2022). It is listed within our standards of practice and code of ethics that we need to demonstrate cultural competency in order to provide equal care to all populations. Cultural competence can be defined as “a set of behaviours, attitudes, and policies that enable a system or agency or individual to work within a cross-cultural context or situation” (Schmalz et al., 2022, p. 10). That is why it is important for us as healthcare professionals to ensure that we have some form of cultural competency training in order to develop an understanding of cultural backgrounds and provide equal and safe care.
Cross cultural awareness means that healthcare providers are more open to learning about unfamiliar attitudes and beliefs about health and treatment options (Tulane University, 2021).
How can we make sure we are providing care that is culturally competent?
Participating in cultural competence training.
Cultural competency can be taught through education programs and courses with the goal of improving the willingness of healthcare individuals to learn and understand other cultures from the perspective of the patient, rather than their own assumptions (Hughes et al., 2020; Stubbe, 2020). In order to be culturally competent, you as the professional need to be able to have cultural acceptance of more than just one culture, making achieving full cultural competency a life-long process (Stubbe, 2020).
Cultural humility is the process of being aware of, and responsive to, our patients’ diverse cultures and how aspects of their culture could influence their care decisions and needs (Stubbe, 2020). Healthcare providers who demonstrate cultural humility, have the intention of honouring patient beliefs and practices that contribute to their preferred treatments and care (Stubbe, 2020). In doing this, healthcare professionals are providing more equitable care by enabling an open environment to discuss and learn about patient culture, therefore decreasing their biases and assumptions (Stubbe, 2020).
Healthcare providers who display assumptions, stereotypes, and biases about other cultures during their patient interactions, unintentionally create negative impacts on patient care and inequities among populations (Hughes et al., 2020). Patients can pick up on biases and feelings of being stereotyped by their healthcare providers through their interactions and conversations, which can lead to miscommunications, misunderstandings, and a lack of trust in the healthcare system from vulnerable minority patients (Hughes et al., 2020). It can also lead to the likelihood that they will not access follow up treatment services.
The First Nations Health Authority in Canada has a vision statement for culturally safe health care systems that includes a cultural humility inspired position statement.
They state in their policy statement on cultural safety and humility that: “cultural safety means health care professionals adopt a humble, self-reflective clinical practice that positions them as respectful and curious partners when providing care, rather than then as a figure of higher knowledge and authority” (FNHA, n.d. p.3).
“When health care professionals engage with First Nations peoples from a place of cultural humility, they are helping to create a safer health care environment where individuals and families experience respect” (FNHA, n.d. p. 9). This means that healthcare providers allow individuals to voice their concerns, ask questions and have respect when decisions are made based on their beliefs and values (FNHA, n.d.).
As nurses, it is our duty to be mindful of what our assumptions and biases are in regards to culture and reflect on how those biases can impact care of our patients (Pelc, 2022; Tarver & Herring, 2019).
This is the act of having cultural humility and using it to become competent in interacting with other cultures openly and professionally.
In a practice setting, nurses and doctors are constantly engaging with patients from diverse cultures. Part of their role in having cultural humility is to critically question, reflect, and evaluate themselves and their surroundings as they engage with diverse populations (Hughes et al., 2020; Schmalz et al., 2022).
Learning Activity 2 - Question: Can you think of a time in your practice setting where cultural competency or humility may have been neglected, leading to a negative patient outcome?
Patients who have language barriers, or are unfamiliar with medical terminology and treatment methods, may be at risk for not accessing healthcare services in the future if they have a negative experience with healthcare providers. Demonstrating cultural humility and competence with patients means that you as the professional take the time to adapt and change your approach to explaining health information, or utilize resources, like an interpreter. Perhaps you can ask them how they will understand the information best, and provide handouts in their language, or a short video on the process of a medical procedure.
Part of the reflection process is to become more flexible and adaptable to the needs of the patient and their family in order to remove the power imbalance and create a more respectful and trusting relationship between you and the patient (Tarver & Herring, 2019).
Hughes et al., 2020 listed three ways to grow your cultural humility in the practice setting.
1) Intrapersonally- Intentionally perform self-evaluation and self-critque to recognize any biases or assumptions.
2) Interpersonally- Engage in active listening with your patients and ask meaningful open-ended questions to understand cultural beliefs.
3) System level- As an organization, offer opportunities for self-critique and reflections within a practice setting, offer courses for staff to take or workshops, and develop policies that support a work environment that has cultural humility.
Cultural Competency Assessment
Let’s assess how culturally competent you are towards minority populations by completing this “Cultural Competency Assessment Checklist.”
https://www.unitedwaydm.org/hubfs/Cultural-competence-self%20assessment-checklist-1.pdf
Please click the above link