Cultural diversity: what do we fear?

Cultural diversity is a major issue in healthcare in the US because of demographic changes, whichmean that services can no longer cater solely for a single, homogenous population. In some states such as ??, the white population is no longer the numerically dominant majority. These demographic changes present a major challenge for the nursing profession in providing culturally congruent care for all patients. Individual nurses have sought to address this challenge by instigating new approaches to educating students and staff (see for example Campinha Bacote, 2002; Purnell and Paulanka, 2004). However, considerable dissonance exists between the profession’s philosophical beliefs and actual practices. Nursing, the caring profession, has demonstrated inconsistencies regarding its commitment to acknowledging and managing issues related to promoting cultural diversity within the profession. It continues to struggle with the question of how best to provide culturally competent care to diverse populations, increase the representation and acceptance of nurses from culturally diverse backgrounds and train all nurses in the skills required for culturally competent practice (Gonzales et al, 2000). It is argued here that these inconsistencies arise from misplaced fear and misunderstanding of difference that have thwarted the profession’s ability to fully embrace cultural diversity as a professional value. Fear of difference manifests as anxiety and reluctance to face certain persons or situations perceived as threatening or dangerous. To ensure cultural competency in nursing care, the profession must identify and confront these fears. This article discusses the factors that have affected the nursing profession’s ability to embrace cultural diversity and respond to the challenges that it presents to healthcare and to the nursing profession.