The True Face of Diversity


Cultural Humility and the Nurse-Patient Relationship

When people think about the word “diversity,” they tend to focus only on physical characteristics such as race. However, language, family dynamics, gender identity, religion, beliefs, traditions and values are also elements that make each patient unique.

As the central touchpoint of patient care, nurses have the opportunity to develop a valuable connection with patients that provides the healthcare team insight into how to best approach caring for each diverse patient. Nurses should strive to provide person-centered care, a type of care that focuses on the patient as a whole person – taking into account the patient’s beliefs, traditions and all elements that make each patient diverse, in order to provide optimal care.

diversity-therapiesEvery year, the United States grows increasingly more diverse, as the nation’s population is expected to rise to 438 million in 2050, up from 296 million in 2005. According to projections, 82 percent of the growth during this period will be the result of immigrants arriving since 2005, along with their descendants.1

In order to care for this influx in population, the next generation of nurses will be expected to work in a more diverse and constantly evolving workplace than ever before. Being able to understand the specific needs of each patient enables the nurse to treat not only the physical needs, but also a patient’s emotional and spiritual needs.

Cultural Humility Requires Lifelong Learning

According to Richard Cowling, PhD, RN, AHN-BC, ANEF, FAAN, Vice President of Academic Affairs for Chamberlain College of Nursing, person-centered care is essential to improving patient outcomes. When nurses put patients in the center of care, they are better positioned to listen to and understand a patient’s concerns and help alleviate stress by taking the diverse culture and beliefs of their patient into account when administering care.

diversity-perceptionRather than focusing on the mastery of many cultures as in cultural competence, Dr. Cowling suggests that nurses should show cultural humility, which combines person-centered care with a lifelong commitment to learning about other cultures.

Cultural humility is a continual process of self-reflection, self-awareness and self-critique by healthcare providers in order to develop and maintain mutually respectful and useful partnerships with individuals, families and communities.2 In the healthcare community, this encourages an intentional examination of how a nurse’s own beliefs, values and assumptions influence the delivery of healthcare and the development of relationships with patients and their families.3

One example of cultural humility in action is when students participate in Chamberlain’s Global Health Education Program trips to countries such as India, Brazil, Kenya, the Philippines, Haiti and the Dominican Republic. During these unique learning experiences, students are able to advance their nursing skills by venturing beyond the classroom, gaining both clinical experience and a deeper understanding of the role of culture in healthcare while developing their own cultural humility.

Developing Skills to Make a Global Impact

Debbie Burchfield, DNP, APRN, FNP-C, Visiting Professor for Chamberlain’s Global Health Education Program, often accompanies students on these international trips that provide much needed medical and healthcare education to diverse communities around the globe. Students often tell Burchfield that the experience was transformational and helped them realize the positive impact they can make as nurses when they focus on caring for the person as a whole.

Here in the U.S., the Hispanic population is one of the fastest growing ethnic groups, making it very important to have nurses who have the cultural humility and understanding to address the unique needs of these communities.

diversity-perceptionb0d6741abfe3631f99edff0000f5a604To help prepare future nurses to develop the skills they need to not only provide clinical services but also be able to develop a deeper relationship with Hispanic patients and their families, Chamberlain recently piloted its Bachelor of Science in Nursing (BSN) Concentration in Serving Hispanic Communities, which emphasizes opportunities for students to communicate and connect with Hispanic communities during clinical experiences.

Susana Gonzalez, MHA, MSN, RN, CNML, Associate Dean of Academic Operations at Chamberlain’s Chicago campus and Board Member of the National Association of Hispanic Nurses (NAHN), reminds her students about the vital role family plays within Hispanic culture and within the community. For nurses, that means including the family while providing care to the patient. For example, educating a Hispanic patient’s family about the aftercare instructions may help ensure the patient is compliant, thereby improving safety and health outcomes. Additionally, it’s important for nurses to learn how to communicate with both patients and their families in all practice settings and throughout the healthcare continuum for better outcomes.

“Although each patient is unique, all patients deserve to be treated with respect and cultural humility,” said Dr. Cowling. “When nurses recognize the true face of diversity and provide extraordinary person-centered care, they have the potential to not only impact the health of that patient but also help transform how healthcare is approached both in the local communities and in diverse communities around the world.”



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