Part 1 | From Awareness to Action: The Role of NPs in Inclusive Care
As nurse practitioners serve on the frontlines of care for an increasingly diverse populace, the ability to engage with patients from varied cultural backgrounds is more important than ever. Culturally competent practice is a key component in providing equitable, effective care to all patients. In this series, we’ll explore what cultural competence is and how NPs can incorporate it into their work. In Part 2, we’ll discuss how cultural competency builds trust and offer practical strategies for creating a culturally responsive practice.
Cultural competence refers to the ability to adapt your approach to provide care that works with patients’ cultural identities, rather than around them; even when they differ from standard medical practice. Rather than a checkbox or endpoint, cultural competence is a dynamic framework that evolves alongside patient needs and social contexts.
The paradigm of cultural competency challenges NPs to shift their perspective by asking thoughtful questions, listening actively, and avoiding assumptions about patients. Approaching patients from different cultural backgrounds with respectful curiosity rather than caution can help you provide care that embraces cultural identity as part of the healing process.
One of the biggest challenges of learning to provide culturally competent care is that it isn’t something you can fully master. Rather than just memorizing traits and patterns, it’s more like learning a language. There are levels of fluency, but even the most fluent must continue learning and adapting to changing conventions. Being culturally competent means recognizing that each patient encounter offers a new opportunity to listen, reflect, and refine your practice.
Since 2020, the COVID-19 pandemic has brought renewed attention to longstanding healthcare inequities, particularly in access and treatment for marginalized communities. These disparities are compounded by a long history of mistrust, especially among Black, Indigenous, and LGBTQ+ patients. While the idea of cultural sensitivity in healthcare may seem like a newer concern, it has been part of professional discourse and education for decades.
In the 1970s and ‘80s, nursing educators and healthcare professionals began exploring how to serve patients from diverse backgrounds more effectively. The creation of the Office of Minority Health in 1985, followed by the American Academy of Nursing’s 1986 commitment to promote cultural competency in education, marked a national turning point. Since then, a growing body of research has shown that culturally competent care leads to improved patient satisfaction, treatment adherence, and health outcomes.
While most nursing programs include some level of cultural competency training, applying that knowledge in clinical practice can be a challenge, especially in the real world where schedules are packed and resources are tight. When you’re juggling back-to-back appointments, administrative tasks, and the emotional weight of care, it’s understandable to feel like there’s little time left for deeper conversations about a patient’s values or beliefs.
Many NPs also find themselves navigating unfamiliar cultural dynamics without much formal training or feeling unsure of the “right” way to ask sensitive questions. That uncertainty is normal, and part of the ongoing process of learning a new skill. Like with other skills, confidence increases alongside continuous practice. Don’t worry about perfection; focus on growth.
Overcoming these barriers begins with awareness and a commitment to continuous learning. Even small shifts, like using inclusive language, building rapport with local communities, or seeking feedback from patients and fellow staff, can move a practice toward a more culturally responsive model of care.
Next week, we’ll look at how cultural competency directly strengthens patient trust, with real-world examples that show its value in NP practice. We’ll also share actionable ways to build a more inclusive and responsive care environment, one thoughtful conversation at a time.
