Black History Month: Cultural Competency in Healthcare

In 1926, Dr. Carter G. Woodson chose the second week of February to celebrate Black history—Negro History Week—in academia. Hoping that his movement would spread to public schools, Dr. Woodson encouraged other historians to focus on the contributions of Black people in their course lectures during this time. The second week in February was chosen for two reasons:

1. February 12 was popular among Black Americans as a day to celebrate Frederick Douglass, as this was the day he celebrated his birthday.
2. Abraham Lincoln was born on February 12. In 1976, Black History Month gained national recognition by President Gerald Ford.

So, what should Black history mean to you as a healthcare worker and professional? It means learning about Black history and the racism, biases, and disparities that your Black patients and coworkers face as your first step. It means your next step towards being a culturally competent healthcare provider is understanding that your role as a non-Black healthcare professional is to educate yourself, become an ally, promote antiracism, and advocate for your patients and colleagues. 

What is cultural competence?

One of the first steps to combating poor health outcomes, including the untimely death of Black patients, is for healthcare providers to receive cultural competence training.

Cultural competence in healthcare is the ability of providers and organizations to effectively deliver healthcare services that meet patients' social, cultural, and linguistic needs. Georgetown University's Health Policy Institute states, "A culturally competent health care system can help improve health outcomes and quality of care and can contribute to the elimination of racial and ethnic health disparities."

Race is one of many factors to consider when providing culturally competent care. However, cultural competency training in healthcare should include care for any group of individuals who may have different access, perception, or preferences for their care.

While definitions may vary slightly, a culturally competent healthcare provider acknowledges patient differences yet provides competent care while respecting their culture, practices, or beliefs. 

What is cultural sensitivity in healthcare?

Cultural sensitivity is the knowledge, awareness, and acceptance of other cultures and cultural identities. Still, a healthcare worker can be culturally sensitive without having cultural competence. While cultural sensitivity acknowledges cultural identities and beliefs, cultural competence implements that knowledge by understanding and changing how to care for a patient. 

The Role of Cultural Competency in Patient Care

Cultural competence is a must-have for travel nurses and allied health professionals. Culturally competent care consists of four components:

1. Awareness. When you're culturally aware of a patient's culture's norms, values, and perceptions, it can help you respond effectively to their needs and use understanding in your caregiving. 
2. Knowledge. It's important to understand how patients from different racial, ethnic, and social backgrounds may understand disease processes, illnesses, and medications differently. These social and emotional differences should be acknowledged to understand medical risks.
3. Attitude. If you understand diverse cultural attitudes, tonality, and vernacular, you can be more effective at communicating with patients and their family members. 
4. Skills. As a culturally competent nurse or health professional, developing and practicing these skills can literally save a life. 

Additionally, you'll demonstrate culturally aware behavior and can positively impact your colleagues. 

Benefits of culturally competent care

Being a culturally competent healthcare provider should give you the personal satisfaction of knowing that you're providing the best care to your patients, but in case that isn't enough, here are some more reasons why cultural competence in healthcare is beneficial:

• Promotes health equity. Health equity is providing quality healthcare based on individual needs. Understanding and being aware of how patients' cultural backgrounds influence their perceptions of healthcare and medical needs helps nurses and allied health professionals collaborate to establish a healthcare system that meets everyone's needs.
• Improves patient outcomes. For example, using culturally competent language while explaining procedures or medications may develop trust between the patient and you and encourage them to ask questions. Understanding a patient's culture while collecting their health history can also aid in clarifying questions or concerns that other members of the healthcare team may have.
• Increases a patient's involvement in their care. Patients who feel they can safely and effectively communicate with their healthcare are more apt to advocate for their needs. 

When introduced to culturally competent nurses and other healthcare professionals, patients may be more likely to develop trust in that specific healthcare facility, which may encourage them to continue seeking care. 

Providing Culturally Competent Care to the Black Community

It’s important for nonBlack healthcare workers to educate themselves about the oppression that Black patients face in healthcare so they can provide more equitable and empathetic care. Try these practical strategies:

1. Read and research. Find books, articles, and research papers by Black scholars, activists, and healthcare professionals. Look for topics on the history of healthcare disparities, structural racism, and experiences of Black patients in the healthcare system.
2. Listen and learn from Black voices. Actively listen to Black patients and colleagues. Listen to their experiences, challenges, and recommendations for improving healthcare delivery. However, do not expect them to do most of the teaching for you. Take the time to educate yourself without placing that burden on Black people. 
3. Self-reflect and unlearn biases. Identify your personal biases and assumptions. Consider how these biases might affect interactions with Black patients and commit to unlearning them.
4. Be an advocate and ally. Advocate for policy changes within your healthcare institution to address systemic issues contributing to healthcare disparities. Be an ally by actively supporting initiatives that promote diversity, equity, and inclusivity in healthcare.
5. Community involvement. Find time to volunteer and get involved with Black communities outside of clinical settings. Understand the needs and challenges by participating in community events or volunteering for health initiatives.
6. Understand cultural humility. Cultural humility is an approach to interactions and relationships that involves a lifelong commitment to self-reflection, learning, and understanding different cultures.

Cultural competence is an ongoing process. Stay updated on current research, guidelines, and best practices for addressing healthcare disparities. Actively seek input from Black patients and colleagues to improve cultural competency continuously.

Practical Strategies for Travel Nurses and Allied Professionals

So, how do you incorporate cultural competency into your daily practices? Here are a few scenarios and challenges that you might encounter in providing culturally competent care:

1. Language barriers. English is your patient's second language, and there is a language barrier causing the patient to have difficulty communicating their symptoms and needs. This causes the patient to become increasingly agitated and anxious. The challenge is to bridge the language gap to make sure your patient receives adequate care. 

• Culturally competent approach: You seek help from a translation service, a professional interpreter, or a colleague who is a certified medical translator. 

2. Religious practices impacting treatment. The patient follows a specific religious practice that restricts certain medical treatments or procedures. The challenge is to respect the patient's spiritual beliefs while providing the necessary health care. 

• Culturally competent approach: You should have an open and culturally sensitive dialogue with the patient and their family to understand their religious beliefs and how they intersect with their healthcare. Collaborate with the interdisciplinary healthcare team, including the social worker and chaplain, to find alternative treatments that respect the patient's religious beliefs but still ensure the best possible health outcomes.

3. Socioeconomic challenges. You interact with a patient facing socioeconomic challenges, such as lack of transportation, access to care or medications, and being unhoused or under-housed. Your challenge is to provide care considering these barriers.

• Culturally competent approach: First, acknowledge the impact of systemic inequalities and work to connect the patient with community resources, financial assistance programs, or support groups specific to their community. 

Fostering Inclusivity in Healthcare Teams to Promote Cultural Competence

Supporting and amplifying Black voices in healthcare settings, specifically on your unit, by promoting their contributions, ideas, and perspectives is a way to foster inclusivity. You should also encourage diversity on healthcare teams and in leadership positions. Here are other ways you can promote an inclusive healthcare team:

1. Leaders should mandate diversity and cultural competency training. The training should include cultural sensitivity, unconscious bias, and effective communication across diverse backgrounds. It should also include training specifically centered on cultural competency and racial disparities in healthcare. 
2. Create safe spaces for dialogue. Encourage open discussions about racism and unconscious biases. Actively listen to your Black colleagues about their lived experiences.
3. Offer training on effective communication strategies with patients from diverse cultural backgrounds, including language barriers.
4. Acknowledge cultural observances and celebrate the diversity within the team. Encourage sharing traditions and customs to foster understanding and appreciation.
5. Review and revise organizational policies to ensure they promote inclusivity. This review process should include Black and other marginalized employees. They should be compensated for their time.
6. Actively recruit and retain diverse workers and place them in leadership roles. Your workforce should reflect the community you serve.

Continuously seeking education, self-reflection, and engaging with the Black community can significantly enhance non-black healthcare workers' understanding of the challenges faced by Black patients and promote cultural competence in healthcare.

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