Societal and cultural bias informs world history and may be as old as time itself. It is present in enterprise, government and healthcare. Acting in the patients’ interests is standard for healthcare professionals, but certain patient populations are still victims of this bias. Whether it’s conscious or not, bias can lead to negative patient outcomes.
In 2017, BMC Medical Ethics produced a comprehensive review of over 10 years’ worth of publications covering implicit bias among healthcare professionals. Findings showed that implicit bias does exist in healthcare settings and ultimately impacts quality and equity of care.
Because nurses are often the first and primary point of contact with patients, it’s important they have a thorough understanding of why cultural sensitivity and inclusivity is so critical. Nurses who pursue the subspecialty of transcultural nursing are uniquely qualified to provide their patients culturally congruent and competent care.
In addition, nurses with this specialty training may actually provide critical influence in their healthcare environments, spreading their knowledge to physicians, administration and leadership.
Transcultural Nursing: Encompassing Psychosocial and Biologic Considerations
Each culture around the globe possesses unique identities or characteristics that ring true to those who hold them close. Entering an unfamiliar or “different” culture can bring up feelings of uncertainty and fear, particularly when one’s health is in question.
Transcultural nursing takes these factors into account, recognizing that we all exist in an increasingly interconnected, interdependent globalized community. Nurses working in this specialty possess an understanding of a broad spectrum of cultural attributes: religious customs, familial values, gender roles, birth practices, stress related to one’s culture, emphasis placed on socioeconomic status, personal hygiene, and diet.
Even seemingly less consequential components like communication preferences, personal space, eye contact, punctuality, clothing, and view of leisure time all contribute to a transcultural nurse’s ability to provide the highest level of care.
Another significant factor in transcultural nursing is understanding different biologic variations, especially in regard to medications or supplements. Medications may produce adverse effects in certain cultural populations or not work at all in others. Many cultures are heavily reliant on herbal supplements or naturopathic therapies. It’s important not to judge these therapies or dismiss them as ineffective. Rather, nurses can use that information to better orient each patient’s attitude toward health and healthcare.
Understanding how all of these factors combine allows transcultural nurses to better serve their patients and help them manage illness, disease and healing.
Beyond the Patient: The Triad of Transcultural Nursing Interactions
In defining the role of transcultural nursing, the American Nurses Association refers to three reciprocal interactions based on the following:
Culture of the individual (patient)
Culture of the nurse
Culture of the environment (in relation to the patient-nurse)
Understanding the first component of this triad is imperative for successfully meeting patient needs, but the other two components play a key role in transcultural nursing as well. A nurse’s own cultural values will inevitably enter into the care conversation, so it’s vital for transcultural nurses to bring a heightened level of self-awareness to those interactions.
Similarly, the care environment must also be sensitive to values and beliefs. For example, if a patient is hospitalized, what religious practices might need to be considered? Are there specific rituals surrounding labor and birth? Culture-specific meal options may be required as well.
What Degree or Training Is Required?
As populations become increasingly diverse, the demand for transcultural nurses will only continue to rise. Whether working in a hospital setting, community clinic, or outpatient facility, these nurses will be indispensable for providing culturally congruent care.
In order to pursue this nursing specialty, individuals must first earn licensure as a registered nurse (RN), with either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). Certification is voluntary, but most employers prefer it. The Transcultural Nursing Society offers both basic and advanced certification programs.
Tapping Into the Power of Communication
Instead of allowing diversity to cause separation, honoring each patient’s background can bring patients and providers together. While there is no one recipe for each culture as a whole, being skilled in transcultural care provides nurses the tools they need to communicate with patients and uncover cultural intricacies for optimal care delivery.
