Given the diversity in our world today, take a moment and ask yourself: Are you a culturally competent nurse or nursing student? Do you demonstrate cultural humility?promoting-cultural-competence-humility-in-nursing

You may have explored the concepts of cultural competence and humility in nursing school, but let’s take it a step further and consider how to apply these concepts in everyday interactions with members of diverse groups and communities.

Whether working in a hospital, walking into a local store, or interacting with neighbors, cultural competence and humility are cornerstones of building strong relationships. Practically speaking, this isn’t a skill you check off your to-do list once. Instead, developing cultural competence and humility is a lifelong process and journey involving continuous reflection, learning, and unlearning. It makes the individuals and groups we interact with feel seen, heard, and valued.

What is Cultural Competence vs Cultural Humility?

Cultural competence is about equipping yourself with knowledge of diverse cultural practices and beliefs, which enables you to provide respectful and appropriate care to patients from varied backgrounds. According to the American Academy of Nursing, cultural competence includes integrating knowledge, attitudes, and skills to facilitate intercultural communication and interactions between people from different racial, ethnic, socio-economic, and religious backgrounds. It’s understanding different cultural customs, traditions, beliefs, and behaviors and utilizing this knowledge to communicate effectively with others.

Here’s what cultural competency as a nurse might look like:

  • Using appropriate words and phrases that are familiar to the individual
  • Respecting an individual’s choices and preferences (e.g., diet, treatment)
  • Refraining from labeling an individual who comes from a particular group
  • Advocating for an interpreter to translate to facilitate informed decision-making
  • Acknowledging what is acceptable and not acceptable to say or do with an individual  from another culture/background
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Cultural humility, a new concept introduced more than thirty years ago, embraces the idea that we must all critically explore and critique ourselves as the first step to learning from and about others. It’s more than being knowledgeable about other cultures and practices. Cultural humility is being ‘others-oriented’ instead of “me-oriented” and recognizing that our understanding of different cultures constantly evolves. It’s a lifelong process of critical self-reflection and an openness to learning from the experiences of others. Humility acknowledges the power imbalances, emphasizing the importance of being receptive to learning from those who may not look, act, or believe in the same things we do.

  • Demonstrating cultural humility can include:
  • Participating in cultural competency training
  • Actively listening to an individual’s beliefs and practices without judgment
  • Respecting individual autonomy and cultural values when making decisions
  • Asking open-ended questions to understand an individual’s cultural preferences
  • Customizing healthcare delivery to align with the individual’s cultural, religious, or linguistic needs

These examples above, rooted in an attitude of openness and self-reflection, can lead to strengthening and maintaining effective relationships built on trust, respect, and collaboration.

How Do I Become More Culturally Competent and Demonstrate Cultural Humility? 

Being culturally competent and demonstrating cultural humility takes time to happen. It is also not about choosing cultural humility over cultural competence or vice versa. Instead, it’s about cultivating and enabling both to work in unison.

Here’s how you can begin your journey towards cultural competence and humility.

1. Examine your ‘Blind Spots’

Start by examining and reflecting on your biases, assumptions, attitudes, and values and how they may influence your interactions with others. Identify any implicit bias that might be at play. Implicit biases are those unconscious stereotypes and attitudes you’ve learned and carried toward specific groups of people. These biases are like “blind spots”—you aren’t aware they exist unless you intentionally look!

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Identifying your blind spots may involve asking yourself:

  • Am I tolerant enough to learn from others?
  • Are there privileges that I have that others don’t?
  • What do I think about other cultures that are different from my own?
  • Do I actively seek out perspectives or experiences that differ from my own?
  • Do I recognize and challenge my assumptions about people different from me?
  • Do I refrain from having deep conversations about social issues? If I do engage in dialogue, am I listening with intent or just talking?

Once we can identify our blind spots, the work can begin to address those stereotypes and attitudes. We can start unraveling, challenging, and correcting our learned biases.

2. Consider Others’ Point of View

Putting ourselves in another person’s shoes, or “shoe-shifting,” helps us begin to consider the experiences and perspectives of others. Cultural humility and competence require us to avoid being distracted by what we think we know. It’s asking ourselves whether there is anything we ought to know and framing our interactions with others as a partnership. So next time you’re interacting with someone who may appear different than you or may hold different  beliefs and values, ask yourself, “What else should I know?” instead of “What do I know?” Be intentional about incorporating humility into your interactions – listening more than speaking, feeling comfortable with not knowing or understanding everything, and demonstrating genuine curiosity. Although we know empathy and compassion are the right things to do, it can be challenging to put these into practice when faced with our stereotypes and implicit biases. Why, though? Perhaps because to truly put ourselves in another person’s shoes, we must be willing and able to remove our shoes first!

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3. Get to Know People Different From You

It’s easy to get along with people who are similar to us. Seriously, think about those people who are closest to you, and more than likely, many of them will resemble….well, you! But if you want to develop cultural competence and humility, you’ve got to stretch a little and step outside your backyard. This involves active and intentional efforts to experience others.

  • Reading books (e.g., autobiographies) to gain new perspective/appreciation
  • Volunteering or participating in organizations that serve diverse communities
  • Attending community/multicultural events to promote direct dialogue and interaction
  • Listening to podcasts with hosts/guests who have different lived experiences or beliefs

When we stretch ourselves this way, we can challenge our stereotypes and attitudes toward others and begin to value their unique experiences. We can create meaningful connections built on respect, appreciation, and a deeper understanding beyond superficial interactions. These proactive strategies allow you to enhance cultural competence and humility and contribute to more inclusive and united communities.

Conclusion

As you strengthen your cultural competency and humility skills, consider yourself and the individuals you live, learn, and work with. Every interaction with an individual is an opportunity to practice, demonstrate, and enhance these skills.

Cultural competency says, ‘I’m the expert.’

Cultural humility says, ‘You’re the expert.’  

Whose expertise will you prioritize next?

References

Canada International Royal Arts College (2023). 10 Questions to challenge your implicit biases.

Gradellini, C., Gómez-Cantarino, S., Dominguez-Isabel, P., Mecugni, D., & Ugarte-Gurrutxaga, M. I. (2021). Cultural Competence and Cultural Sensitivity Education in University Nursing Courses. A Scoping Review. Front Psychol, 12(1).

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Hughes, V., Delva, S., Nkimbeng, M., Spaulding, E., Turkson-Ocran, R.-A., Rushton, C., . . . Han, H.-R. (2020). Not missing the opportunity: Strategies to promote cultural humility among future nursing faculty. Journal of Professional Nursing, 36(1), 28-33.

McDaniel, V. P. (2021). Cultural Humility in Nursing Building the Bridge to. Virginia Nurses Today, 29(2), 12-14.

Stubbe, D. E. (2020). Practicing Cultural Competence and Cultural Humility in the Care of Diverse Patients. Focus (Am Psychiatr Publ), 18(1), 49–51.

Justine Bailey
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