Cultural challenges and barriers through the voices of nurses.

AIMS AND OBJECTIVES: To discover and describe challenges and barriers perceived by nurses in providing culturally competent care in their day-to-day encounters with diverse patient populations.

BACKGROUND: Nurses are challenged in today's healthcare environment to provide culturally competent care to a diverse patient population. To provide patient- and family-centred care, nurses must first acknowledge patient's and family's cultural differences, be willing to incorporate patient's and family's beliefs within the healthcare treatment plan, and respect the values and lifeways of differing cultures.

DESIGN: Qualitative description with thematic analysis was used to describe nurses' perceptions of barriers and challenges in providing culturally competent care. The qualitative component of the study was part of a larger research study that used a prospective, cross-sectional, descriptive survey. Participants responded to two open-ended questions about potential challenges and barriers to providing culturally competent health care.

METHODS: Nurses were recruited in a south-eastern state in the USA. Research surveys were mailed to 2000 nurses throughout the state using a stratified sampling method.

RESULTS: Three hundred and seventy-four nurses participated in the study. Three themes emerged from the qualitative description: great diversity, lack of resources, and prejudices and biases.

CONCLUSIONS: The provision of culturally competent patient- and family-centred care is an ethical imperative and professional mandate. Describing nurses' perspectives on challenges and barriers to providing culturally competent care is the first step in helping to redesign care delivery practices.

RELEVANCE TO CLINICAL PRACTICE: Challenges to providing culturally competent care included diversity in patient populations, lack of resources to provide culturally competent care and biases/prejudices. Strategies to address these challenges in the areas of nursing education, nursing research and nursing policy were proposed.