Cultural Competence

I recently became a manager of a unit where I have never worked. I set up interviews with the staff so I could start getting to know them and hear their thoughts about what worked well in the unit and what did not. One of the things that became clear to me is that there are issues with respect for cultural diversity. Staff have identified times that they feel uncomfortable in the workplace. There aren’t any displays of outward hostility, but they feel there is racism happening. I want to address this issue. What information might help me understand the expectations of RNs in relation to cultural safety?

• RNs are expected to practice using a holistic client/family centred approach, ensuring culturally-safe client care (1).
• RNs incorporate knowledge that reflects a deep understanding and respect for different ways of knowing that exhibits cultural competence/cultural humility (2).
• RNs have a responsibility to conduct themselves according to the ethical principles and core behaviors outlined in the current Code of Conduct and practice standards. These core behaviors outline how RNs understand and practice in compliance with relevant laws, legislation, bylaws, practice standards and employer policies, and do not breach them (3).
• RNs collaborate and communicate with the health care team in a clear, effective, professional and timely way to provide safe client care (4).
• RNs identify and do not act on or allow any stereotypes or assumptions they may have about clients to influence decision-making and interactions. RNs identify factors and personal attributes that may impact a client, their lived experience and perspective on health care by using trauma-informed care for clients and when interacting with members of the health care team (5).
• RNs adapt practice in response to the spiritual beliefs and cultural practices of clients (6).
• RNs take action to support culturally-safe practice environments (7).

What action can I take with my team to create a unit culture that embraces and celebrates diversity?

Here are a few ideas you might consider:

• Consider that cultural safety requires a positive anti-racism stance, tools and approaches, and the continuous practice of cultural humility. It involves listening to others without judgement, being open to learning from others and learning about one’s biases (8).
• Offer opportunities for staff to become informed in trauma-informed care and intergenerational trauma.
• Engage the staff to provide ideas that will be helpful in creating a unit that is culturally competent.
• Invite internationally educated nurses (IENs) to share their stories of differences between nursing in Canada versus nursing in other countries and challenges they have faced.
• Create an opportunity for staff to share their culture with the team. For example, a cultural celebration with displays and food to increase people’s understanding.
• Offer a general cultural diversity education session about being aware of own behaviors and how they can impact someone else.
• Invite a speaker from an organization focused on supporting immigrants to integrate into the community to attend a staff meeting to discuss how to best support IENs.
• Create a lending library of materials people can borrow and read.
• Remind staff of organizational mission/vision/value statements that include cultural competence. Consider incorporating cultural competence into your unit’s value statements.
• Explore learning modules that offer cultural awareness.
• Connect with community organizations such as the Anti-Racism Network.
• Invite staff who may be interested in developing a learning module as part of their continuing competence program (CCP) to approach you to develop a plan for sharing or presenting this information. As an RN manager, you may want to add this activity to your own CCP learning plan.
• Reflect on feedback regarding their own behaviors towards Indigenous Peoples, people of color, visible minorities, and newly arrived Canadians.
• Help colleagues to identify, acknowledge and eliminate racist attitudes, language, or behavior.
• Support clients, colleagues and others who experience and/or report acts of racism.
• Report acts of racism to an employer or regulatory body.
• Discuss the Anti-Racism Guideline for Registered Nurses with staff and use the tools to identify and take action when witnessing or experiencing racism.

What responsibility do RNs have regarding the recommendations found in the Truth and Reconciliation Commission of Canada Calls to Action?

"In order to redress the legacy of residential schools and advance the process of Canadian reconciliation,” recommendations 18 through 24 contain the health-related calls to action (9). Every RN is held to a standard of practice in which culturally-safe care is provided. Through CCP, RNs can begin to explore the recommendations individually and in groups to assist our health care system in moving forward with the recommendations and promoting Canadian reconciliation.

CRNS Resources

Anti-Racism Guideline for Registered Nurses (2026)

Registered Nurse Practice Standards (2026)

Toolkit for Managers of RNs Resource: Truth and Reconciliation

External Resources

RNAO Nursing Best Practice Guidelines. Embracing Cultural Diversity in Health Care: Developing Cultural Competence (2007)

Truth and Reconciliation Commission of Canada: Calls to Action

Canadian Nurses Association (CNA): Racism in Health Care

Government of Canada Truth and Reconciliation Commission of Canada

National Centre for Truth and Reconciliation

Crisis & Trauma Resource Institute 3 Pillars of Trauma Informed Approach

Anti Racism Network