In the rapidly diversifying landscape of school populations, culturally effective care is not just a supplementary aspect of school nursing—it is an essential component of providing equitable, high-quality, and respectful health services. Culturally diverse students have unique healthcare needs that impact attendance and academic achievement. By embracing and implementing the principles of cultural competence, school nurses can ensure that they are genuinely meeting the needs of all students, paving the way for a healthier, more inclusive future.

Understanding Cultural Competence & Culturally Effective Care

A culturally competent school nursing practice entails the delivery of effective and high-quality services and care to students with diverse beliefs, attitudes, values, and backgrounds. In their role, school nurses are well-positioned to recognize and address the cultural health requirements of the school population and work together to access resources, advocate for change, and develop solutions for diverse communities.

The Case for Cultural Competence in School Health Services

The School Nursing: Scope and Standards of Practice states that school nurses are to "practice in a manner that is congruent with cultural diversity and inclusion principles" (American Nurses Association and NASN, 2017). This involves recognizing students' diverse cultural backgrounds and incorporating this understanding into healthcare practices. The approach is predicated on empathy, respect, and a genuine desire to understand the cultural determinants of health that shape students' experiences. Research indicates that culturally effective care can lead to improved health outcomes, reduced disparities among minority populations, and enrichment of whole communities.

Strategies for Cultivating Cultural Competence

Continuous Education & Training

According to NASN, cultural competency is "a process." This includes formal training sessions, workshops, and online courses that cover a wide range of topics, from cultural sensitivity to specific health beliefs and practices among different cultures. A good starting point is the U.S. Department of Health and Human Services Think Cultural Health program.

Self-Awareness

School nurses must engage in self-reflection to understand their cultural biases and how they may impact their care delivery. Cultural humility, introduced in 1998, is a vital component of culturally effective care. Cultural humility places an "emphasis on lifelong nurturing of self-evaluation and critique, promotion of interpersonal sensitivity and openness, addressing power imbalances, and advancement of an appreciation of intracultural variation and individuality to avoid stereotyping."

Language and Communication

Effective communication with families and students in languages other than English can be an essential aspect of culturally compassionate school nursing practice. The NASN recommends using the National Standards for Culturally and Linguistically Appropriate Services as a reference for communicating with members of the school community who come from non-English-speaking backgrounds.

Policy and Practice Evaluation

School health policies and practices should be regularly evaluated for cultural inclusivity and responsiveness. This involves revisiting health forms, consent processes, and even the physical spaces within the school. Additionally, care plans should be developed that respect students' cultural beliefs and practices, including dietary restrictions, traditional healing practices, and religious observances related to healthcare.

Community Engagement

Working closely with cultural liaisons or experts within the community can provide valuable insights into diverse student populations' health beliefs and practices. This collaboration can also aid in tailoring health education and promotion activities to be culturally sensitive and effective.

Combining the Knowledge, Skills, & Attitudes for Cultural Competence 

Culturally effective care goes beyond the basic understanding of different cultural practices; it involves recognizing the complex interplay of cultural beliefs, values, and practices in healthcare delivery. By embracing cultural competence, school nurses can provide care that is respectful of and responsive to the diverse needs of their student populations.