The Top Ways the Field of Nursing Embraces Immigration and Diversity

With U.S. census reports estimating that the country’s white majority will be gone by 2043, the U.S. health care industry, and particularly nurses, will need to begin making adjustments in how care is provided as the population continues to diversify. Nurses are typically at the forefront of patient care, so when interacting with patients of varying backgrounds, it is important to remember these ways in which the future of nurse leadership is changing and how to embrace and be engaged in the shift.


With the passage of the Affordable Care Act, an increased number of minorities now have access to health care services. However, they may not be aware of how to take advantage of the available services. When providing care to those from cultures different from your own, nurses should note that their patients may have differing values in how health care is administered or discussed in addition to what services might be beneficial for them. It’s important to remember that cultural values provide a sense of direction for individuals and are held on an unconscious level. While cultural biases are unconscious, they provide a direct connection to health practices. In order to meet the needs of culturally diverse populations, nurses must become culturally competent, which is developed over time and in stages.

Initially, a nurse must to “want to” — in contrast to “must” — engage in the process of becoming culturally aware, culturally knowledgeable, culturally skillful, and in pursuit of cultural encounters. This cultural desire involves caring for someone of a different culture, viewing that person as an individual, having a genuine passion to be open and flexible, willing to accept differences and build on similarities and willing to learn from others as cultural informants.

Once a nurse’s desire is established, cultural awareness will come into focus. This is the self-examination and in-depth exploration of one’s own cultural background. It involves recognizing one’s own biases, prejudices, and assumptions about those who are different. This will lead into cultural knowledge, which is the process of gaining a sound understanding about diverse cultural and ethnic groups and how the patient’s health-related beliefs and values shapes their worldview. By understanding their worldview, a nurse will have a greater understanding of how the patient will interpret his or her illness and how it will guide his or her thinking, doing and being.

Nurses will also need to gain cultural skill in order to collect relevant cultural data regarding the patient’s medical concern as well as accurately performing a culturally based, physical assessment. When conducting a physical assessment on ethnically diverse patients, it’s also imperative for the nurse to know how a patient’s physical, biological and physiological variations influence his or her ability to conduct an accurate and appropriate physical evaluation. Going hand-in-hand with cultural skill is cultural encounter. This is the process, which encourages a nurse to directly engage in face-to-face interactions with patients from culturally diverse backgrounds. Interacting with patients from diverse cultural groups will refine or modify one’s existing beliefs about a cultural group and will prevent stereotyping. Cultural encounters also involve assessing the patient’s linguistic needs. Using a formally trained medical interpreter is necessary to facilitate accurate communication during appointments to avoid miscommunication or misunderstanding related to medical terminology.

In addition to building a more robust cultural understanding within the field of nursing, the field of nursing itself must also culturally diversify. Without this diversity, it will be nearly impossible to provide quality medical care to people from different ethnic and socioeconomic backgrounds. Nurses can learn about other cultures, but this will not replicate a native understanding of the culture. Current estimates show that between 2000 and 2020, the percentage of total patient care hours physicians will spend with minority patients will rise from approximately 31 percent to 40 percent. In order to address this growing need, several nursing associations have formed to address health care diversity. They include the Asian American/Pacific Islander Nurses Association Inc., National Alaska Native American Indian Nurses Association Inc., National Association of Hispanic Nurses Inc., National Black Nurses Association Inc. and Philippine Nurses Association of America Inc.



The field of nursing as well as the patients being cared for will only grow in their cultural diversity. Therefore, current nurses as well as those in nursing school must learn how to provide care in culturally relevant ways. In addition, health care systems will need to diversify their nursing staff in order to provide more robust and culturally reflective care to their patients.


New mother with nurse image by edenpictures from Flickr’s Creative Commons.

Nurse with patient image by timefornurses from Flickr’s Creative Commons.


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