Providing culturally responsive care integrates an individual’s cultural beliefs into their health care. Begin by conveying cultural sensitivity to clients and their family members with these suggestions^[1]:

• Set the stage by introducing yourself by name and role when meeting the client and their family for the first time. Until you know differently, address the client formally by using their title and last name. Ask the client how they wish to be addressed and record this in the client’s chart. Respectfully acknowledge any family members and visitors at the client’s bedside.
• Begin by standing or sitting at least arm’s length from the client.
• Observe the client and family members in regards to eye contact, space orientation, touch, and other nonverbal communication behaviors and follow their lead.
• Make note of the language the client prefers to use and record this in the client’s chart. If English is not the client’s primary language, determine if a medical interpreter is required before proceeding with interview questions. See the box below for guidelines in using a medical interpreter.
• Use inclusive language that is culturally sensitive and appropriate. For example, do not refer to someone as “wheelchair bound”; instead say “a person who uses a wheelchair.”^[2]
• Be open and honest about the extent of your knowledge of their culture. It is acceptable to politely ask questions about their beliefs and seek clarification to avoid misunderstandings.
• Adopt a nonjudgmental approach and show respect for the client’s cultural beliefs, values, and practices. It is possible that you may not agree with a client’s cultural expressions, but it is imperative that the client’s rights are upheld. As long as the expressions are not unsafe for the client or others, the nurse should attempt to integrate them into their care.
• Assure the client that their cultural considerations are a priority their care.

Using Medical Interpreters

When caring for clients whose primary language is not English and they have a limited ability to speak, read, write, or understand the English language, seek the services of a trained medical interpreter. Health care facilities are mandated by The Joint Commission to provide qualified medical interpreters. Use of a trained medical interpreter is linked to fewer communication errors, shorter hospital stays, reduced 30-day readmission rates, and improved client satisfaction.

Refrain from asking a family member to act as an interpreter. The client may withhold sensitive information from them, or family members may possibly edit or change the information provided. Unfamiliarity with medical terminology can also cause misunderstanding and errors.

Medical interpreters may be on-site or available by videoconferencing or telephone. The nurse should also consider coordinating client and family member conversations with other health care team members to streamline communication, while being aware of cultural implications such who can discuss what health care topics and who makes the decisions. When possible, obtain a medical interpreter of the same gender as the client to prevent potential embarrassment if a sensitive matter is being discussed.

Discussing Sexuality

It is common for nurses to encounter clients who wish to have discussions pertaining to their sexuality. Sexuality encompasses sex, sexual orientation, gender identity, gender roles, among other topics. The need for sexuality discussions may be a result of medication sexual side effects, disease processes that may affect a person’s sexuality, surgical procedures affecting sexuality, sexually transmitted infections, sexual trauma, or other health needs of LGBTQAI+ and straight clients. Sexual topics can be uncomfortable for both the nurse and the client The client may feel embarrassed or as if they cannot initiate the conversation due to social stigmas about certain topics. For this reason, nurses should let clients know they can talk about sexual concerns in a non-judgmental environment by using the following guidelines.^[4]