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6 ways nurses can improve cultural competency at work

Dr. Claudia Vellozzi, left, and Karen Sutton talk to Alex Harris, a participant in the Chronic Care Clinic program at Grady Memorial Hospital in Atlanta. Vellozzi is the medical director of the clinic that gets doctors, nurses, assistants, pharmacists and community health workers deeply involved in a patient’s situation to reduce visits to the emergency room. Sutton is a licensed clinical social worker in the program. HYOSUB SHIN / HSHIN@AJC.COM

Metro Atlanta is becoming an increasingly diverse area, so nurses often find themselves caring for patients who represent many different cultures. This can affect everything from a patient's comfort with the health care system to practices and beliefs that can impact their health.

“I think that what people don’t know in the general public is minority stress impacts physical and psychological health,” said Dr. Patricia Moreland, assistant clinical professor at the Emory University Nell Hodgson Woodruff School of Nursing. The impact of minority stress is not simply a matter of minorities not getting the health care they need. It also puts stress on them, she said, that affects both physical and mental health.

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Cultural competency or cultural humility is an important part of reducing health disparities, according to registerednursing.org. The site says the Golden Rule is no longer applicable and that nurses should instead follow the Platinum Rule: "Treat others as THEY wish to be treated."

To provide the best possible care, nurses can improve their cultural competency/cultural humility in the following six ways:

Educate yourself and then continue that education.

Education is key, said Nikeisha Whatley-León, who is a licensed clinical psychotherapist and the system director for Behavioral Health Services at Northside Hospital in Atlanta. This includes learning about how minorities are at a higher risk of developing many types of illnesses as well as the discrimination that they face in their daily lives. It’s also important to keep learning through continuing education, she said. “When we know better, we do better,” Whatley-León added.

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Assess your own cultural competency.

Minoritynurse.com suggests using an online cultural competence self-assessment tool to determine your own strengths and weaknesses when caring for patients who come from different cultures.

Encourage hiring a staff that represents your diversity.

Your staff should represent your diversity, Whatley-León said. “If you want people to feel like they belong, you hire people who represent the diverse population,” she said.

Be humble.

Humility is important, and in fact, the term “cultural humility” is now sometimes used instead of cultural competency, said Dr. Helen Baker, global and community engagement coordinator at the Lillian Carter Center for Global Health and Social Responsibility. “It’s going into an encounter with somebody and being really humble,” she said, and acknowledging that you don’t know everything.

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Ask questions.

“Come in with a blank slate, not making any assumptions,” Baker suggested. A single patient can represent several different cultures, and health care providers need to find out what’s important to them. Ask about everything from spiritual and cultural practices to teas they may be using to combat certain symptoms, she added.

Improve communication.

Language is key to accessing a culture, so it's best if you can speak a patient's language or find a translator to assist you, minoritynurse.com said. This may not always be possible, so using pictures, gestures, and written summaries can also help bridge the language barrier.

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