Among her words of advice:

“{F}irst educate yourself. You can do that by surrounding yourself with ‘cultural informants,’ as I once heard them called — people from diverse backgrounds who can keep you informed of what is important to that group. With good cultural informants you’ll stay ahead of emerging issues and can anticipate the effect on your team. Develop cultural informants both on your team and off, inside your care facility and out.”

“Patient acceptance can be a bit trickier than staff acceptance, but it is equally as important and often overlooked. I counsel many nurses from minority backgrounds after they’ve experienced negative comments or behavior from patients at their care facility. ”

“Your team members can influence patient acceptance by modeling it when in front of patients. Younger and minority nurses are particularly vulnerable, so ensure all team members always treat one another with respect. It may also help if you explain how their behavior can affect patients.”

“Culturally diverse nurses will need sufficient education about U.S. norms in general and U.S. patient expectations specifically. Ensure that you have access to comprehensive training that prepares nurses from other countries for U.S. perceptions, body language, beliefs, customs, holiday observances, humor, religious beliefs and so forth.”

“What is quality of care? It seems like a simple question, but the answer really depends on the culture or age of the person you ask.”

“A nurse might have difficulty informing a patient about their elevated blood pressure because the nurse doesn’t want to add to the patient’s stress. The nurse might avoid speaking loudly to an elderly, hearing-impaired patient because the nurse may believe it is rude to raise your voice. Instead, the nurse ‘courteously’ leans over and whispers the information into the patient’s ear — inadvertently violating a U.S. cultural and health care norm.”

“With training, cultural norms can be changed. It’s not that nurses abandon their cultural norms. They alter them for their situation while also helping teammates understand the health care expectations and norms of patients from other cultures.

“So, instead of speaking louder to be heard by elderly, hearing-impaired patients of certain cultures, you may choose to explore alternatives for your team members.”