Culturally-sensitive nursing care : a critique.
The aim of this investigation was to explore the lived experiences of nurses and
patients about the nature of culture, how nurses incorporated cultural issues into their
work and the extent to which patients felt that their cultural needs were met. A
phenomenological approach was used because this facilitated interpretation of takenfor-
granted aspects of daily life in order to gain insight into the hidden meanings that
participants ascribed to everyday events.
Nurse and patient participants included members of White, Black and other minority
ethnic groups, men and women, young and mature adults. A total of 85 nurses
working in, and 54 patients recently discharged from, acute hospital wards spread
over four NHS Trusts, agreed to be interviewed. A number of methodological issues
were addressed. These included interviewing across cultural and racial boundaries and
the ethical dimensions of constructing the sample.
The phenomenological approach was helpful in clarifying understanding and
meaning, particularly through the analysis of stories. These revealed that the nurses
had some practical knowledge of cultural issues and, like the patients, saw good care
as being linked to interpersonal skills. This practical knowledge was not sociallyembedded
and shared by members of ward teams. The nurses' formal knowledge
about cultural issues was very limited. Nurses and patients demonstrated rigid views
of culture and its relationship with care that helped to reinforce negative stereotypes
and racism. The experiences of two nurses in cultural liaison roles were explored as
potential forms of higher-level nursing practice but revealed, instead, some of the
pressures to which nurses who are members of minority groups are exposed.
Recommendations include the need for nurses to possess knowledge and skills that
will enable them to develop and expand their competence. They also require skills, confidence and support from senior staff in dealing effectively with racist behaviour.