Letter to the Editor by Rosa Green to “Implementing the New ANA Standard 8: Culturally Congruent Practice”

The Many Faces of Diversity: Providing Culturally Competent Care

April 27, 2017

Response by Rosa Green to “Implementing the New ANA Standard 8: Culturally Congruent Practice” by Lucy Marion and colleagues (November 18, 2016).

Dear Editor:

I applaud and agree with the implementation of the American Nurses Association’s (ANA) new Standard of Culturally Congruent Practice, Standard 8 (Marion et al., 2016). Hospitals, dialysis centers, and outpatient clinics across this nation are filled with patients that do not share the same appearance of the healthcare workers who provide their care.  Cultural diversity is a hot topic in education, business administration, and healthcare. However, to be effective in promoting and producing an optimal cultural climate in these arenas, this topic must move past mere conversations and into action. Standard 8 clearly identifies the blueprint to do just that in the nursing industry. 

A diverse nation calls for healthcare providers who are competent in providing culturally competent care to a population that may not mirror their own race, sex, religion, educational background, and/or socioeconomic status. According to the U.S. Census Bureau (2012), minorities comprise about a third of the U.S. population. Additionally, it is postulated that minorities are to reach majority by the year 2050 (U.S. Census Bureau, 2012). However, the nursing workforce continues to be predominantly White. While Whites comprise 66% of the population, they account for 83% of the nation’s RNs, per the National Sample Survey of Registered Nurses (2008). In contrast, the report finds that Blacks comprise 12% of the population but only 5% of the nation’s RNs. The discrepancy is duly noted also for Latinos, American Indian and Alaska Natives. To ensure delivery of culturally competent care, a growingly diverse nation requires a more diverse healthcare workforce. The Robert Wood Johnson Foundation works diligently to increase diversity in nursing (Ayoola, 2013). Yet, until that goal is actualized, the current nursing workforce must take needed measures to ensure proficiency in cultural diversity. 

Culturally competent care produces better patient outcomes and increased moral. A hallmark of nursing is the provision of competent and compassionate care. This care must be delivered to all; regardless of race, sex, background, or financial status. In a place and time where racial tensions are high and steadily climbing, the efforts of nurses must also climb to promote cultural competence in the healthcare delivery system.

Thank you,

Rosa Terrance Green, DNP, APRN, GNP-BC
Baton Rouge, LA


Ayoola, A. (2013, May 7).  Why diversity in the nursing workforce matters. RWJF News. Retrieved from http://www.rwjf.org/en/culture-of-health/2013/05/why_diversity_inthe.html

Marion, L., Douglas, M., Lavin, M., Barr, N., Gazaway, S., Thomas, L., & Bickford, C., (2016) Implementing the new ANA standard 8: Culturally congruent practice. OJIN: The Online Journal of Issues in Nursing, 22(1). DOI: 10.3912/OJIN.Vol22No01PPT20. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-22-2017/No1-Jan-2017/Articles-Previous-Topics/Implementing-the-New-ANA-Standard-8.html

U.S. Census Bureau (2012). U.S. census bureau projections show a slower growing, older, more diverse nation a half century from now. Retrieved from http://www.census.gov/newsroom/releases/archives/population/cb12-243.html