How Can We Solve the Lack of Culturally Competent Care in Hospitals?

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If COVID-19 taught us anything, it’s that this country not only needs more accessible healthcare available to everyone, but that to have universally effective healthcare, we need culturally competent care. 

This means we need more diversity in healthcare, more bilingual nurses, and more care focused on medicine, education, spiritual and physical transformation, and cultural connections between healthcare workers and patients. 

Beyond that, we need compassionate care that not only accepts the cultural beliefs and traditions of others but also prioritizes those cultural and linguistic differences to offer the best and most comprehensive care.

The idea of comprehensive care for all seems like an obvious goal, but it’s often not as simple as it should be.

Because to have truly accessible care, there needs to be culturally competent care in medicine. The harsh reality in America is that cultural competence in healthcare, especially in hospitals, is currently lacking.

According to the 2020 U.S. Census, Latinos currently comprise nearly 20 percent of the population, with 62.1 million people. Yet, Latinos only make up 5.7 percent of all nurses, according to 2017 data from the Department of Health and Human Services. By comparison, 73.5 percent of nurses were white in 2017, NBC News reported. 

At the same time, nurses are leaving their professions at a record pace, which is not shocking but alarming, especially considering the toll that the pandemic took on frontline workers. 

According to a recent McKinsey survey, nearly 30 percent of registered nurses reported that they are considering leaving their nursing positions or possible leave the workforce entirely. 

With more nurses and medical workers leaving the workforce, a workforce already understaffed and underrepresented in terms of diversity, it’s more important than ever that healthcare facilities focus on culturally competent care.

What Exactly is Cultural Competence in Healthcare?

But what exactly does it mean for medical care to be culturally competent? It means that health care is delivered effectively, offering quality care to patients considering their diverse beliefs, attitudes, values, and behaviors. It means healthcare workers not only speak the patient’s language but also can communicate with them in their messaging, cultural beliefs, spiritual influence, and more. For care to be culturally sensitive and driven by equality and consideration, it must consider the cultural differences of patients and how that might impact their decisions and care. For example, factors to consider include race, socioeconomic situations, disabilities, health education, and more.

Healthcare workers must think about:

  • How patients perceive symptoms and health conditions.
  • When and how patients seek care.
  • Patients’ willingness to follow doctor recommendations or treatment plans.
  • Who patients believe should participate in making healthcare decisions. 

And so much more.

Consider the dilemma many patients, especially Latinos disproportionately impacted by the pandemic, faced during COVID-19. Patients were going to hospitals sick, terrified, confused, and overwhelmed by the difficult health choices they had to make. And to make an already challenging and devastating situation worse, in many cases, these patients did not speak English, and their healthcare workers did not speak Spanish. The doctors and nurses may not have understood these Latino patients’ cultural and religious beliefs. It’s a reality too many people were (and still are) faced with. Many professionals and healthcare workers are dedicated to fixing this disconnect in the medical system, with innovations such as these medical translation badges designed to help minority patients navigate the healthcare system. But there are also many obstacles in place that make culturally competent care a challenge.

Barriers to Culturally Competent Care

Part of the problem with culturally competent care is that there are simply not enough minorities, especially Latinos, in medical fields such as nursing. 

If there are not enough Latino nurses, how can those nursing staff be expected to offer culturally sensitive care to the Latino community? 

Several barriers that have existed for decades perpetuate a flawed medical system in which cultural competency in care is tough. 

According to Antonia Villarruel, the dean of Nursing at the University of Pennsylvania, structural barriers get in the way of encoring more Latinos to enter nursing. The first barrier is education – high schools with large Latino student bodies are often in underserved communities, where students aren’t getting access to the science courses they need to work in nursing. “So, if you don’t come from a good high school, get good science grades, it’s not easy,” Villarruel told NBC News. “There are barriers in almost every junction you move forward in.” 

Adrianna Nava of Chicago, president of the National Association of Hispanic Nurses, or NAHN, echoed those sentiments. She explained that a lack of access to the funds to pay for their educations and a lack of mentors to help them navigate the profession are two of the biggest obstacles Latinos in nursing face. 

According to Isabel Bogdan, a women’s health Nurse Practitioner and founder of belev. co, a modern women’s health and online wellness platform that offers a targeted approach to women’s healthcare, it’s up to local healthcare institutions to prioritize cultural competence in care. “As a leader in the Nursing profession, I believe that local healthcare institutions should begin to invest and bring in their own local resources. For example, I grew up in El Paso, Texas and the local hospitals offered college tuition and stipends to students with the desire to continue their education in the nursing profession,” she explained to BeLatina.

Culturally Competent Care and Culturally Competent Nurses are Needed More Than Ever Before

As the population ages, and with every new pandemic and illness, we see an increasingly dire need for diverse healthcare. At the same time, the U.S. population is becoming more ethnically diverse than ever; it is becoming increasingly Latino, so it’s more urgent than ever to encourage more Latinos to enter nursing. 

“I believe COVID-19 has taught us the vast differences within social-political demographics and their relationship to health,” said Bogdan. “COVID taught us about the differences between essential workers, race, and the lack of available care to people of color in America. We definitely need to have a louder voice,” Bogdan explained to BeLatina. 

While increasing Latino nurses is certainly important, it’s just the first step. According to Esther Sciammarella, executive director of the Chicago Hispanic Healthcare Coalition, hiring more bilingual nurses is only part of the process of offering culturally competent care to patients. In addition to having more diverse nurses, healthcare systems need to ensure those nurses understand the cultural differences of all communities.         

“Cultural competence means knowing the belief system of the culture of the people you serve,” Sciammarella said. “Sometimes, you need a consultation of the entire family. Sometimes, you don’t explain only to the patient [but also] to different members of the family … the culture, particularly in the Latino community, the family is part of the whole issue, all working together.” 

Bogdan agrees that culturally competent care is about more than just the language you speak or where you come from. Bogdan sees firsthand the obstacles faced by minorities, especially Latinas, where healthcare is concerned. She knows how crucial it is for healthcare providers to take the time to connect with their patients. “Building trust in the community, from patients to physicians, is key — it lets patients know that there’s somebody there that can understand cultural diversity,” she told BeLatina. 

Understanding the language barriers and cultural differences is essential if you want to provide quality, thorough, thoughtful care. 

“It is important to speak to your patients with respect while promoting culturally cognizant care when assessing what’s going on,” Bogdan said. 

Furthermore, patients need to know they can (and should) advocate for their own health and individual needs based on cultural beliefs. Ask for a translator if you do not speak English. If you need an interpreter to help you not only understand the doctor or nurse but navigate the care instructions, ask for assistance. 

“Every single patient deserves to be given the same degree of health education, informed consent, and satisfaction, regardless of their ability to speak English,” argues Bogdan. It starts with health education and continues with access to culturally competent caregivers.

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