Enhancing cultural competencies of advanced practice nurses: health care challenges in the twenty-first century

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From: Journal of Cultural Diversity(Vol. 11, Issue 3)
Publisher: Tucker Publications, Inc.
Document Type: Article
Length: 2,307 words

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Abstract: Shifting population demographics will have a major impact on the practice of advanced practice nurses (APNs). The ethnic composition of people in this country is becoming increasingly diverse. Massachusetts and, in particular, the city of Worcester is also experiencing changes in the diversity of its population. These trends testify to the great need for APNs who are sensitive to and competent to care for culturally diverse populations. To address these changes, specific curricula enhancements focused on ethnically diverse populations were implemented for the nurse practitioner specialties at the Graduate School of Nursing (GSN), University of Massachusetts Worcester. The processes used for this project included visiting community and clinical sites, identifying key curricular components, and evaluating existing didactic and clinical learning experiences. The GSN faculty developed a systematic plan for integrating these components into the graduate nursing core, advanced practice core, and specialty courses of the respective curricula. A major outcome of this project was the enhanced preparation of APN students to meet the multifaceted needs of ethnically diverse patients, families, and communities.

Key words: Cultural Competence, Advanced Practice Nurse


The United States is becoming more culturally and ethnically diverse because of the influx of immigrants from other countries. Nationally, non-white residents made up 30.9% of the total population in 2002, up from 24.4% in 1990 (U.S. Census Bureau, 2001). By comparison, minorities and other ethnic and racial groups also increased at a rate of 43.2% over the last decade, versus a 3.5% growth rate for whites during the same period (U.S. Census Bureau, 2001). By 2030, these demographics are projected to shift even more, leading to a 10% decrease in the proportion of White Americans (U.S. Census, 2000).

The city of Worcester site of the Graduate School of Nursing (GSN) is strategically located in central Massachusetts. It has an underserved immigrant community that is becoming more culturally and ethnically diverse. The total percentage of Hispanics, Blacks and Asians is 26.7%, far exceeding the statewide data of 16.1% (U.S. Census Bureau 2000). These data illustrate the need to prepare Advanced Practice Nurses (APNs) to provide culturally competent care to diverse ethnic clients. Many of these immigrants have limited access to health care, speak English as a second language, and economically have incomes below the federal poverty guidelines (MassCHIP Health Status Indicator Report 2000). As these people access health care systems, they will need culturally competent care from their health care providers. Advanced practiced nurses have frequently been the primary providers of care to the medically underserved and ethnically diverse populations.

Given the ethnic composition of the surrounding community, the GSN faculty felt it was imperative to enhance the cultural components of the curricula, particularly for the nurse practitioner specialties. The Faculty's goal was to train a cadre of APNs who could provide culturally competent care, for the growing, ethnically diverse population in central Massachusetts. This goal was also consistent with the GSN's mission to promote excellence and innovation in advanced nursing education and practice to meet the unique needs of...

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Gale Document Number: GALE|A125337673