approach holds that working effectively in a diverse environment is largely the responsibility of the organization’s management team. Organizational leaders set the policies, decision-making process, and the emotional tone that affect the working environment. However, working effectively in a diverse environment is colored by the degree to which management promotes diversity.
Helpful PERSON-CENTERED strategies include:
1. Understanding differences in role relations. Relations, interpersonal distance, and formality between super- visors and staff differ among cultural groups.
2. Understanding differences in the concept of face and taking care not to injure the face or the strong sense of honor, which is an important concern of many who belong to collectivist cultures.
3. Learning to accept differences in the way people manage conflict.
4. Being aware of people’s conception of what constitutes a “good employee.” If staff members from a hierarchical society do not seem to take initiative on the job, they may be demonstrating respect, whereas nurses from an egalitarian society expect to challenge authority and work more independently.
5. Being aware of personal space and touching. All cultures have different customs and rules about interpersonal space and touching.
6. Understanding that cultural communication styles differ in their level of formality. Some staff members inter- pret a more formal communication style as “snobbish,” whereas others may view informal styles as “rude.” It’s best to be more formal, such as calling people by their last names, until trust is established.
7. Not being offended if staff members speak their own language when they are together.
8. Speaking clearly and facing staff members who have difficulty comprehending directions in English. Check understanding by getting them to describe what you have told them to do.
Helpful ORGANIZATION-CENTERED strategies from managers include:
1. Closely defining the job duties and expectations. Job de- scriptions are often taken more literally in other cultures than they are in the U.S. Culturally diverse staff may be afraid to step outside the boundaries of their position by taking on tasks not included in this description. Explain expectations regarding job performance carefully. If job expectations include making suggestions in meetings, giving opinions about improving the work environment and taking initiative, state this outright.
2. Facilitating the development of open communication between staff of diverse cultures. The supervisory team needs to watch and listen for signs of misunderstanding and conflict. Offer to serve as a nonjudgmental mediator to help clarify meanings. Avoid taking sides. Simply help staff clarify what was said or done.
3. Using diverse staff as resources for each other. For example, rather than asking culturally diverse staff to assume responsibility for the care of all the patients from their culture, ask them to serve as a resource and guide to other staff who come into contact with those patients. Ask them to explain any important rules of etiquette
Cultural differences in work patterns and communication styles
influence the nursing environment in many ways. In a society as diverse as ours, we need to develop sensitivity, awareness and tolerance of cultural differences. Differences enrich the work envi- ronment by bringing a variety of perspectives to patient care. While the burden of conforming to unit norms falls on individual nurses, there are many things we can do, both at a personal and an organizational level, to foster the highest clinical skills and work productivity in each other. Staff members and managers, along with
in treating patients from their culture or to explain any beliefs that may influence their response to treatment.
4. Helping culturally diverse staff learn the appropriate ways to behave and interact in the mainstream culture. Explain accepted ways to address each other and the patients. Review with them some of the norms about work styles, communication, formality or informality, and time orientation on the particular unit where they will work. Help orient them to the norms of nursing practice by giving them in-service programs and professional articles to read. Developing and rehearsing scripts or role-playing simulated situations may also be helpful.
5. Finding and using any resources available at the health- care facility. Federal regulations now require that health- care systems provide cultural competency training to staff in dealing with the population served. Training and information should be provided in user-friendly ways so that staff will readily take advantage of these offerings. Healthcare providers are now required to use interpreter services as needed. These interpreters can be a valuable resource for cultural information.
culturally diverse colleagues, can interact as a team to devise further ways to work together effectively in a multicultural workplace. •
EDITOR’S NOTE: Laina M. Gerace, PhD, RN, and Suzanne Salimbene, PhD, were the original authors of this educational activity, but have not had the opportunity to influence the content of this version. Rick Zoucha, PhD, APRN- BC, CTN-A, was a previous author of this activity but has not had the opportunity to influence the content of this version.
Kirtley Ceballos, MSN, RNC-NIC, PCNS-BC, is a clinical nurse specialist on the neonatal intensive care unit at University of Colorado Hospital in Aurora. Ceballos is founder and chairwoman of NICU Cultural Competency Committee and writer/editor/publisher of Transcultural Nursing Newsletter.
2016 • Visit us at
NURSE.com 29
Both person- and organization-centered approaches are vital
when formulating strategies for working together in a diverse environment. On one hand, nurses as individuals need to take responsibility for how staff interacts in the work environment. On the other hand, supervisors and managers can help cultural diversity through active leadership.20,21
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