How does the nurse provide culturally competent care for a client at the end of life?

Providing culturally safe and sensitive care is an important component of patient-centered care. It is care that meets the social and cultural needs of diverse patient populations.   

An essential first step before learning about other cultures is an awareness of one’s own beliefs, biases, values and cultural practices. This self-understanding and reflection will support you in creating a practice environment that is sensitive and adaptive to patients' cultural differences.[1]

Part of our commitment to diversity, equity and inclusion is to strengthen nurse’s awareness and competence of culturally safe and sensitive care. This includes integrating accountabilities that incorporates the Ontario Human Rights Code and recommendations in the Truth and Reconciliation Commission Report into our entry-level competencies and nursing practice standards and guidelines.   

The journey to understanding diversity, equity and inclusion to support culturally safe and sensitive care, is one of learning and unlearning. We encourage nurses to reflect on where they are at in their journey, identifying learning needs and take steps to support their learning or unlearning to make long-term changes.

What’s next on our journey

CNO is currently working to modernize its practice standards to reflect the evolving health care needs of patients. Part of this work is to ensure modern standards reflect the principles of diversity, equity and inclusion.  There will be opportunities for input in the development of culturally safe and sensitive care accountabilities.

Here are some resources that can help in this journey of learning and unlearning. CNO will continue to add to this collection as additional resources become available.

Other resources

• Health Canada’s Indigenous Health 
• Truth and Reconciliation Commission of Canada 
• The Ontario Human Rights Code 
• Equity, Inclusion, Diversity and Anti-Racism - Ontario Health 
• Build Equity and Diversity Into Your Engagement Activities - Health Quality Ontario 
• National Collaborating Center for Determinants of Health 
• National Collaborating Centre for Indigenous Health 

[1] Brooks, L. A., Manias, E., & Bloomer, M. J. (2018, October 12). Culturally sensitive communication in healthcare: A concept analysis. Collegian. Retrieved March 14, 2022, from https://www.sciencedirect.com/science/article/pii/S1322769617303153

Nowadays, nurses are increasingly working with patients from different cultural backgrounds. This brings opportunities and challenges for nurses to deliver culturally competent services. Whether working at a hospital, in a nursing home, or within a school, nurses must have the ability to identify differences in others. It is expected that nurses understand patients’ differences in demographics, beliefs, norms, practices, and desires for medical care and take their perspectives into account when caring for them. Cultural competence is an important component of excellence in health care delivery and can contribute to the elimination of racial and ethnic health disparities.

Here are 5 ways to help you provide culturally competent nursing care.

1. Perform a cultural competence self-assessment.

Determining your own strengths and weaknesses when it comes to working with people who come from different cultures is probably one of the most important ways to help improve your cultural competence. Several organizations offer free cultural competence self-assessment tools and you can choose one that appropriate to your work.

2. Obtain a certificate in cultural competence.

You can increase your cultural awareness, knowledge, and skills through culturally competent training, a workshop, or a seminar. Journal articles, textbooks, and the internet also offer great information that can help you improve cultural competence.

3. Improve communication and language barriers.

The values, beliefs, and worldview of a particular cultural group are rooted within their language use; therefore, language is the key to accessing a culture. It is best if you can speak its language or find a translator (an individual providing language assistance) to help communicate with limited English proficiency patients. You also can use pictures, gestures, or written summaries to improve communication with your patients and reduce language barriers.

4. Directly engage in cross-cultural interactions with patients.

Understanding that each patient is a unique person can help nurses effectively interact with patients. Nurses need to have the ability to explore patients’ beliefs, values, and needs in order to build effective relationships with them.

5. Participate in online chats and networks.

Online networking and social media can have a great influence on improving nurses’ perceived cultural competency and cultural awareness and keeping them up-to-date on cultural competency issues.

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