Healthcare is, by name and definition, a person-focused, empathy-driven, caring profession. And that means that nurses, doctors, and other healthcare professionals have a professional obligation to meet patients where they are, to understand and to respect their needs, values, and perspectives. In an increasingly diverse world, however, the importance of cultural competence in healthcare is only growing, becoming more urgent as patients from an array of social, cultural, and linguistic backgrounds enter the US health system.
What is Cultural Competence?
In today’s world, terms such as “diversity” and “inclusion” have become ubiquitous in our discourse. But if such concepts are to be put into practice, if they are to serve as more than trendy buzzwords, the core values which undergird them must be both recognized and put into practice.
And, in the healthcare profession, respect for and the embracing of diversity and inclusion requires care providers to cultivate cultural competence in their professional practice. This, on an actionable level, means that care providers must be aware of the role that cultural diversity can play in the provision of care; they must approach cultural diversity with an attitude of respect and tolerance; they must build their knowledge of the specific cultural differences which may impact patient care, and they must acquire the skills necessary to provide consistent, high quality, and equitable treatment for all patients, regardless of their background.
Cultural Competence and Language Barriers
Cultural competence in healthcare can be a determining factor in the quality of life and wellbeing of diverse patients. For instance, it is estimated that 8.5% of people in the US speak English poorly or not at all.
And such language barriers can take a profoundly detrimental toll on the quality of patient care, resulting in delayed or inaccurate diagnoses. Language barriers may also lead care providers to miss signs of domestic violence or other significant health threats their patients may face. Further, without the ability to communicate properly with patients, treatment failures are likely, as patients may be unable to understand instructions regarding medication, diet, or follow-up care.
It is not only that language barriers may lead to misdiagnosis or improper care, it’s also that such differences almost inevitably undermine the relationship between patients and their caregivers. After all, society does not operate only on the level of language. There are often significant perceptual differences relating to issues of faith, culture, and history.
Without an appropriate understanding of linguistic, behavioral, and attitudinal variations, healthcare providers are often unable to cultivate the understanding, trust, and openness on which the patient/care provider relationship depends. Nurses, for example, may be unable to appropriately interpret the nonverbal cues patients are giving them, while the patients themselves may be unable to explain their needs and perspectives.
If, for example, a care plan conflicts with a patient’s religious beliefs or personal values, linguistic and cultural barriers may make it impossible to express those concerns. They may simply fail to comply with the protocol, enabling the condition to advance and complications to occur.
A culturally competent care provider, however, would be more likely to recognize the linguistic and social differences that might lead to challenges with the patient’s acceptance of the standard protocol. This recognition, in turn, would enable practitioners to seek out alternatives and workarounds.
Technology as a Tool
In an increasingly diverse world, cultivating cultural competence can seem like a formidable task. After all, it is unreasonable and unfeasible to expect healthcare providers to develop expertise in every language and culture represented in the patient population. However, technology can play a powerful role in helping care providers quickly learn about their patients’ culture and language.
Translation apps, for example, are increasingly being used in crises to help the vulnerable communicate more effectively with caregivers, aid workers, and even attorneys. In a healthcare setting, such tools would empower patients and care providers to communicate more freely, collaborating on alternative treatment options which would not conflict with the patient’s needs, values, and beliefs.
Importantly, however, cultural variations in the healthcare setting are not exclusive to the provision of care for patients from international backgrounds. Indeed, even with the US, significant cultural differences exist. For example, the debate over mask mandates in the wake of the COVID-19 pandemic has illuminated important perspective and behavioral differences between collectivist and individualistic cultures, exemplified in the greater acceptance of mask requirements among patients from collectivist cultures.
And yet these variations can also be seen among US natives hailing from different regions of the country. Patients from more conservative areas of the US may be more likely to resist mandatory mask-wearing than those from more liberal parts of the nation. Once again, though, these variations can often be attributed, in large measure, to cultural differences from region to region. Such diverse views call on healthcare providers to exercise cultural competence not only for minority patients but also for US citizens and the vast heterogeneity they embody.
Cultural competence in healthcare isn’t just a lofty ideal. It is a necessity that not only helps to save patients’ lives but also to make their lives better. It centers on the awareness of and respect for linguistic, perceptual, and ideological variations among patient populations and it is fundamental to the provision of equitable, accessible, and high quality of care for all patients. And that means, ultimately, that cultivating cultural competence is a sacred obligation of the ethical healthcare provider.
Ainsley Lawrence is a freelance writer that lives in the Northwest region of the United States. She has a particular interest in covering topics related to politics, social justice, and workplace issues. The views and opinions expressed in this article are those of the author.