Understanding nurses' concerns when caring for patients from diverse cultural and ethnic backgrounds.

AIMS AND OBJECTIVES: To explore the experiences of both student and qualified nurses of caring for patients from diverse cultural, ethnic and linguistic backgrounds, in one region of Ireland. Hearing the stories, experiences and attitudes of nurses has the potential to influence future clinical practice and has implication for nurses, nurse educators and nurse managers and leaders.

BACKGROUND: There is a wealth of international literature highlighting the importance of providing culturally sensitive care. However, global reports of culturally insensitive care continue. There is a paucity of in-depth research exploring the actual concerns and challenges nurses experience when caring for patients from diverse cultural and ethnic backgrounds, as well as what influences their actions and omissions of care in practice.

DESIGN: A qualitative exploratory descriptive design adopting the principles of a classic grounded theory approach was used.

METHODS: Focus groups (n - 10) and individual face-to-face interviews (n - 30) were conducted with student and qualified nurses studying and working in one region of Ireland. As data were collected, it was simultaneously analysed using the classic grounded theory methodological principles of coding, constant comparison and theoretical sampling.

FINDINGS: Uncertainty was the consistent main concern that emerged. Feelings of ambiguity of how to act were further influenced by a lack of knowledge, an awareness of ethnocentric beliefs and the culture of the organisation in which participants learn and work in. Instead of finding answers to uncertainties, participants demonstrated a lack of commitment to meeting patients' needs in a culturally appropriate way.

CONCLUSIONS: This study adds new perspectives to our understanding of enablers and barriers to culturally sensitive care. It explains the poignant effect of uncertainty and describes how nurses were unable (or unwilling) to find answers when in doubt. It raises questions that remain unanswered in the existing literature, as to why nurses feel it is acceptable to choose to do nothing about their lack of cultural knowledge and the uncertainties which follow.

RELEVANCE TO CLINICAL PRACTICE: Identifying the nature and implications of the uncertainty experienced when providing care for patients from diverse cultural and ethnic backgrounds is an important contributing factor to improving cultural sensitivity and quality care.