Cultural Competence In Nursing: Benefits, Models, & Examples For Inclusive Care

examples of cultural competence in nursing

Healthcare disparities remain one of the toughest challenges in nursing. Factors like race, language, religion, gender identity, and income often create barriers that keep patients from receiving safe, effective care. Studies show that patients who feel their cultural needs are respected are more likely to follow treatment and report higher satisfaction.

That’s why cultural competence in nursing isn’t optional — it’s essential. From using professional interpreters to adjusting care during religious fasting, cultural awareness helps close gaps in health equity. In this guide, you’ll find examples of cultural competence in nursing that show exactly how to turn inclusion into everyday practice.

What Is Cultural Competence in Nursing?

Cultural competence in nursing is the ability to provide care that respects the diverse cultural backgrounds of patients. It’s about recognizing and adapting to the cultural values, beliefs, and practices that influence how patients experience health and make decisions.

A culturally competent nurse doesn’t need to know everything about every culture. Instead, they focus on:

Asking open-ended questions to understand the patient’s preferences.
Listening with empathy to better grasp the patient’s needs.
Adapting care to ensure it aligns with the patient’s values and beliefs.

Example: When caring for a patient who avoids direct eye contact, a culturally competent nurse recognizes this as a sign of respect in some cultures — not disinterest or avoidance.

By practicing cultural competence, nurses can build partnerships with patients, ensuring that care is both effective and inclusive. This approach encourages collaboration, where both nurse and patient contribute to the care process.

Cultural Competence vs. Cultural Humility

Though often mentioned together, these concepts are distinct yet complementary:

Cultural competence focuses on skills—like using interpreters, avoiding jargon, and adapting care for dietary or religious needs.
Cultural humility focuses on attitude—remaining open, self-aware, and willing to learn from patients.

Together, they create a complete framework for inclusive care.

Example: A nurse may know how to use a medical interpreter (competence) but humility prompts them to ask, “Am I making assumptions about this patient’s understanding or preferences?”

When skill and humility work together, nurses create care experiences that are both informed and compassionate.

Importance of cultural competence in nursing

Cultural competence is essential for creating inclusive, patient-centered care. It has a direct impact on the quality of care and patient outcomes:

For patients:
- It fosters trust, encouraging open communication and participation in care.
- Patients are more likely to follow treatment plans when their cultural needs are respected.
- It reduces misunderstandings and anxiety, leading to better treatment adherence.
For nurses:
- It helps to minimize conflict and ethical dilemmas.
- It increases confidence when working with diverse populations.
- It builds stronger relationships with patients and improves teamwork.
For healthcare organizations:
- Cultural competence aligns with CLAS (Culturally and Linguistically Appropriate Services) standards, ensuring access and equity for all patients.
- It improves patient satisfaction scores and contributes to better overall care quality.

Ultimately, cultural competence in nursing enhances patient outcomes, builds trust, and creates a healthcare environment where all patients feel seen, heard, and respected.

Core Frameworks and Standards in Cultural Competence

Cultural competence in nursing is not just about learning a set of skills. It’s about using frameworks and professional standards to guide care and ensure inclusivity. Below are key models and standards that provide a structured approach to cultural competence.

Campinha-Bacote’s ASKED Model

This model breaks cultural competence into five stages of growth, helping nurses continuously develop their skills.

Awareness: Reflect on your own biases and how they impact patient care.
Skill: Learn to use interpreters, plain language, and teach-back techniques.
Knowledge: Gain a deeper understanding of cultural health practices and beliefs.
Encounters: Engage with patients from diverse backgrounds to reduce discomfort and increase competence.
Desire: Stay motivated to learn and improve your cultural competence.

How to Apply It:
When interacting with a new patient, mentally walk through the ASKED model. Start by reflecting on your assumptions (Awareness), use an interpreter if needed (Skill), and inquire about their health beliefs (Knowledge). Each encounter is a learning opportunity.

Leininger’s Transcultural Nursing Theory

Dr. Madeleine Leininger’s Sunrise Model emphasizes that nursing care should align with the patient’s cultural values and practices. The model highlights the need for nurses to assess cultural factors that influence health decisions.

Example: A Muslim patient fasting during Ramadan may need adjustments to their medication schedule.
Example: In maternity care, some cultures value the presence of extended family for emotional support during labor.

How to Apply It:
Use this model to guide care plans that respect cultural practices. For example, consider meal timing for fasting patients or the role of family in decision-making. The goal is to align your care with patients’ cultural norms to promote comfort and trust.

ANA & CLAS Standards

The ANA Standard 8 and CLAS (Culturally and Linguistically Appropriate Services) standards provide clear guidelines for delivering culturally competent care. Both stress that inclusivity is a professional responsibility, not a voluntary practice.

ANA Standard 8: Requires nurses to adapt care based on the patient’s cultural and linguistic background.
CLAS Standards: Encourage health systems to provide language assistance, staff training, and equitable access to care.

How to Apply It:
These standards should be embedded in every nursing practice. For example, use certified interpreters whenever possible and document cultural preferences in the patient’s chart. Ensure that language barriers don’t prevent patients from receiving safe and inclusive care.

These frameworks and standards provide essential tools for nurses to improve cultural competence. They give you the structure to apply cultural sensitivity in a way that benefits both the patient and the healthcare system.

Real-Life Examples of Cultural Competence in Nursing

Below are common nursing situations where cultural awareness directly impacts patient outcomes. Each scenario shows how cultural competence can be applied in daily practice to improve patient care, communication, and trust.

1. Overcoming Language Barriers

Problem: Language differences can lead to confusion, errors, or distress, especially if a nurse relies on family members to interpret.

Example: A Spanish-speaking patient needs discharge teaching on managing new medications. The nurse requests a professional interpreter.

Script: “For privacy and accuracy, I’ll use a certified interpreter. What language do you prefer?”
Documentation Tip: “Interpreter ID #2435, session via phone. Patient demonstrated understanding of medication instructions using teach-back.”

2. Respecting Religious and Spiritual Beliefs

Problem: A patient’s faith may influence their healthcare decisions, including treatment acceptance or daily practices like fasting or prayer.

Example: A Muslim patient requests prayer breaks during their hospital stay. The nurse adjusts care times to accommodate prayer.

Script: “I’ll provide you with a private space for your prayers. If you need any help, just let me know.”
Documentation Tip: “Patient requested prayer before procedure. Privacy provided, care resumed post-prayer.”

3. Adjusting for Dietary and Lifestyle Needs

Problem: Food and cultural practices are often deeply intertwined. Nurses must accommodate dietary restrictions while ensuring proper nutrition and care.

Example: A Jewish patient requests kosher meals. The nurse verifies the meal plan with dietary services.

Script: “I’ll confirm with dietary services to make sure your meals are kosher and meet your needs.”
Documentation Tip: “Diet adjusted to halal per patient request. Dietary services notified.”

4. Recognizing Family Roles in Decision-Making

Problem: In many cultures, family members have a significant role in making healthcare decisions. Ignoring this can lead to confusion or tension.

Example: A patient prefers to have their adult children involved in decision-making. The nurse includes the family in care discussions while confirming the patient’s preferences.

Script: “I want to respect your family’s role in your care. Who would you like to be involved in decision-making?”
Documentation Tip: “Family present for treatment discussion. Interpreter used. Patient and family verbalized understanding.”

5. Understanding Pain, Touch, and Personal Space

Problem: Cultural norms influence how pain is expressed or how patients respond to physical touch and personal space.

Example: A patient from a culture that values endurance may underreport pain. The nurse notices facial tension and asks about pain levels using nonverbal cues.

Script: “I noticed you’re wincing during movement. Can I offer you something for your pain?”
Documentation Tip: “Patient denies pain but grimaces during movement. Offered PRN analgesic; declined. Nonverbal cues noted.”

6. Providing LGBTQ+-Inclusive Care

Problem: Respecting gender identity and sexual orientation is essential to creating a safe, inclusive healthcare environment.

Example: A patient who identifies as non-binary asks the nurse to use their preferred name and pronouns. The nurse respectfully acknowledges this and updates the chart.

Script: “What name and pronouns would you like me to use?”
Documentation Tip: “Patient’s chosen name and pronouns recorded in chart. Care team notified.”

These are just a few examples of cultural competence in nursing practice. Each situation demonstrates how a culturally aware nurse can build trust, improve communication, and offer care that is inclusive and respectful.

Barriers to Cultural Competence in Nursing

Even the most compassionate nurses face challenges when trying to provide culturally responsive care. Recognizing these barriers helps create practical solutions for better patient care.

1. Language and Communication Barriers

Problem: Language differences can cause miscommunication, errors, or patient distress. Even when a patient seems to understand, they may nod politely without fully comprehending.

Solution: Always use certified interpreters rather than relying on family or untrained staff. This ensures accurate communication and confidentiality. Confirm understanding through methods like teach-back to ensure the patient understands their care plan.

2. Implicit Bias and Stereotyping

Problem: Everyone has unconscious assumptions about others, shaped by personal experience and cultural background. These biases can impact clinical judgment and patient care.

Solution: Engage in self-reflection and bias-awareness training. Focus on neutral, curious questions and evidence-based assessments rather than assumptions. Being aware helps shift bias toward understanding and empathy.

3. Time and Workload Pressures

Problem: High-pressure environments can push nurses to prioritize clinical tasks over patient interactions. Cultural discussions often get lost in the shuffle.

Solution: Include cultural questions in routine assessments to make them part of the everyday care process. Share cultural information during handoff reports to ensure continuity. Small actions like asking about religious or dietary preferences can make a big difference.

4. Lack of Training or Institutional Support

Problem: Many healthcare systems provide limited cultural competence training, leaving nurses feeling unprepared.

Solution: Advocate for ongoing training and encourage leadership to create diversity committees or mentorship programs. Take advantage of external learning opportunities like workshops or webinars to continuously improve.

5. Fear of Offending Patients

Problem: Some nurses hesitate to ask about cultural or spiritual needs, fearing they’ll say the wrong thing.

Solution: Use gentle, respectful phrasing like, “Can you tell me what’s important for me to know about your care?” Normalize these conversations by asking every patient similar questions. Curiosity paired with respect often leads to greater patient comfort.

Strategies to Improve Cultural Competence

Cultural competence is not about mastering every cultural fact. It’s about practicing awareness, communication, and empathy every day. Here’s how nurses can strengthen these skills:

1. Begin with Self-Awareness

Take time to reflect on your biases and how they affect patient care. Journaling about challenging interactions can help identify areas for growth.

2. Make Cultural Assessments Routine

Ask cultural questions at the beginning of every patient interaction. Include questions about family roles, religious practices, or dietary restrictions early in the assessment process.

3. Strengthen Communication Skills

Use plain language and visual aids to ensure understanding. Always confirm comprehension using teach-back. Practice active listening and create a safe environment for patient questions.

4. Learn Through Exposure and Experience

Seek out opportunities to care for diverse populations. Volunteer in community clinics or participate in cultural outreach programs. Exposure helps turn theory into practical experience.

5. Continue Professional Development

Cultural competence evolves as healthcare and communities change. Commit to lifelong learning by taking CEUs, attending diversity seminars, or reading cultural case studies.

6. Advocate for System-Level Change

Push for inclusive policies, diverse hiring practices, and multilingual signage in your healthcare setting. Advocating for cultural competence at the system level improves patient outcomes and workplace culture.

Cultural competence isn’t about perfection — it’s about progress. Each patient interaction is an opportunity to practice and improve. Nurses who embrace ongoing learning and self-awareness build stronger relationships with patients and contribute to more inclusive, patient-centered care.

Demonstrating Cultural Competence: In Documentation and Interviews

Cultural competence isn’t just something you practice — it’s something you can prove. Two of the clearest ways to demonstrate it are through your documentation and your interview stories. Both show that you not only understand inclusive care but also apply it in real, measurable ways.

How to Document Culturally Competent Nursing Care

Documentation is where cultural awareness becomes visible in the care record. Well-written notes ensure continuity, respect patient preferences, and protect both you and your team.

The 3-Step Charting Formula

Keep your entries short, objective, and clear by following this structure:

What the patient expressed — beliefs, preferences, or concerns.
What you did — interpreter used, plan adjusted, or accommodation made.
How the patient responded — agreement, understanding, or refusal.

Example Documentation Entries:

Language Access: “Interpreter ID #3421, Spanish, video session. Patient correctly demonstrated inhaler use after teaching.”
Religious Needs: “Patient requested prayer before procedure. Privacy ensured; care resumed post-prayer.”
Dietary Requests: “Patient follows vegetarian diet. Menu adjusted and verified with dietary services.”
Family Involvement: “Patient chose son as decision-maker. Plan reviewed and confirmed by both.”
Personal Space: “Explained each step before contact; patient verbalized consent.”

Clear documentation shows that cultural care wasn’t an afterthought — it was part of the plan.

How to Discuss Cultural Competence in Nursing Job Interviews

Interviewers want stories that show you can turn empathy into action. They’re not testing what you know about culture — they want to see how you practice it in real situations.

A great way to do this is by using the STAR method — Situation, Task, Action, Result.

Example 1 – Overcoming Language Barriers

Situation: “During a clinical rotation, I cared for a patient who only spoke Spanish.”
Task: “I needed to teach discharge instructions clearly.”
Action: “I called a certified interpreter and used the teach-back method.”
Result: “The patient repeated the steps correctly and left feeling confident.”

Example 2 – Respecting Religious Practices

Situation: “I cared for a patient fasting during Ramadan.”
Task: “I had to give medications without breaking their fast.”
Action: “I collaborated with the provider to adjust medication timing.”
Result: “The patient stayed on treatment and felt respected.”

Example 3 – Addressing Health Literacy

Situation: “At a community clinic, I helped a patient newly diagnosed with diabetes.”
Task: “Teach them to monitor blood sugar correctly.”
Action: “Used plain language, avoided jargon, and asked them to demonstrate.”
Result: “They performed the steps accurately, and follow-up showed better control.”

Tips for Framing Your Interview Answers

Keep stories real and patient-centered.
Aim for 2–3 minutes per answer.
Reflect humility: mention what you learned.
Always end with the positive patient outcome.

Pro tip: You don’t have to know every tradition to be culturally competent — you just have to stay curious, respectful, and adaptable with every patient you meet.

Wrapping Up

Cultural competence in nursing isn’t about memorizing every cultural tradition. It’s about approaching each patient with openness, respect, and the right tools. Whether you’re using a medical interpreter, adapting care for religious practices, or documenting chosen pronouns, every small step builds trust and leads to better care.

Start small — one respectful question, one mindful adjustment, one documented act of care. That’s how cultural competence grows — one patient at a time.

Cultural Competence in Nursing: Benefits, Models, & Examples for Inclusive Care