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# Culturally competent care in practice

- Safe practice

The nurse asks about each person's beliefs and customs and adapts care to them, as long as safety and treatment are not harmed.

Updated Nov 12, 2026

## Key points

- Ask, do not assume: a person's culture is learned from them, not guessed from their group.
- Campinha-Bacote: cultural awareness, knowledge, skill and encounters.
- Cultural negotiation: adapt care to beliefs whenever treatment is not significantly harmed.
- Use a trained medical interpreter when the language differs; provide written material in the patient's language when possible.
- Reflect on your own biases: stereotypes harm care.

## What it is

Culture shapes how people speak, behave, understand illness and decide about care, often without saying so. Cultural competence is a lifelong process of giving evidence-based care that fits the patient's values, beliefs and practices. Campinha-Bacote's model describes the culturally competent nurse through cultural awareness (reflecting on one's own values and biases), cultural knowledge, cultural skill (doing a cultural assessment) and cultural encounters. In practice the nurse creates a safe space, asks rather than assumes, uses a trained interpreter when the language differs, and negotiates care: the patient's cultural needs are accommodated whenever they do not significantly harm the treatment. In Colombia this includes indigenous, Afro-Colombian, rural and migrant communities.

## What it requires

- Self-reflection on one's own values, prejudices and ethnocentric views.
- A cultural assessment for every patient, not only for «foreign» ones.
- An environment where the patient can express beliefs and identity without judgement.
- Access to an interpreter (in person or by phone).
- Willingness to negotiate times, food, modesty and rituals.

## Components

- Quick assessment of the patient's view of the illness: what they think the problem is, its cause, how they are coping and how worried they are.
- Fuller assessment when needed: language, religion, diet, home remedies, who decides in the family, beliefs about transfusion, organ donation and death rituals.
- Accommodation and negotiation of the care plan.
- Evaluation with the patient of whether the plan respects their values.

## How it is applied (and why)

- Reflect before the encounter on your own assumptions about this patient: unexamined bias leaks into care.
- Ask the preferred language and arrange a trained interpreter if needed: misunderstanding is a safety risk.
- Ask how the patient explains the illness and its cause: it shows what treatment will make sense to them.
- Ask about diet, religious practices, modesty, preferred gender of caregiver and who takes part in decisions.
- Ask before entering personal space or touching, and explain why: touch and distance carry cultural meaning.
- Negotiate the plan, for example the time of a medicine or keeping a head covering under a surgical cap.
- Record the patient's preferences in the chart and share them at handoff: this keeps care consistent.
- If a practice conflicts with safety, explain the reason and seek an alternative with the patient and the team.

## In nursing practice

- Some families make decisions as a group; ask the patient how they want decisions to be made.
- Eye contact means different things in different cultures; notice cues and mirror the patient when possible.
- Home remedies are asked about without judgement, so the team can check for interactions.
- Leininger's transcultural theory gives the nursing framework for this practice.

## Common mistakes

- Using relatives, especially children, as interpreters for clinical information.
- Assuming beliefs from appearance, surname or region.
- Labelling a patient «uncooperative» when the plan clashes with their values.
- Forgetting to record preferences so the next shift repeats the conflict.

## Test yourself

Think of the answer, then tap the question to see it.

## What are the four components of cultural competence in Campinha-Bacote's model as described here?

Cultural awareness, cultural knowledge, cultural skill and cultural encounters.

## What is cultural negotiation?

Nurse and patient agree an approach that balances the prescribed care with the patient's cultural needs, accommodating them whenever treatment is not significantly harmed.

## What does the nurse do when the patient's language differs from the team's?

Arranges a trained medical interpreter, in person or by phone, and provides written material in the patient's language when possible.

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## Connections

## Related 4

- [Madeleine Leininger's transcultural nursing and culturally congruent care](https://durgical.com/en/nursing/madeleine-leininger-s-transcultural-nursing-and-culturally-congruent-care/)
- [Therapeutic communication: techniques and barriers](https://durgical.com/en/nursing/therapeutic-communication-techniques-and-barriers/)
- [Spiritual care](https://durgical.com/en/nursing/spiritual-care/)
- [Family assessment: structure, life cycle, genogram, ecomap and family APGAR](https://durgical.com/en/nursing/family-assessment-structure-life-cycle-genogram-ecomap-and-family-apgar/)

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Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: [Nursing Fundamentals, 3.4: Cultural competence](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/03%3A_Diverse_Patients/3.04%3A_Cultural_Competence) (Open RN, Wisconsin Technical College System (CC BY 4.0), LibreTexts, 2021); [Nursing Fundamentals, 3.7: Cultural assessment](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/03%3A_Diverse_Patients/3.07%3A_Cultural_Assessment) (Open RN, Wisconsin Technical College System (CC BY 4.0), LibreTexts, 2021); [Nursing Fundamentals, 3.8: Culturally responsive care](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/03%3A_Diverse_Patients/3.08%3A_Culturally_Responsive_Care) (Open RN, Wisconsin Technical College System (CC BY 4.0), LibreTexts, 2021); [Nursing Fundamentals, 2.2: Basic communication concepts](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/02%3A_Communication/2.02%3A_Basic_Communication_Concepts) (Open RN, Wisconsin Technical College System (CC BY 4.0), LibreTexts, 2021).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/culturally-competent-care-in-practice/