Nurses have been advised that the needs of different cultural groups are not being and that there is a need to ensure that health care practitioners are suitably prepared to enable this to occur However, there has been very little guidance offered by the statutory and professional bodies on how to make these recommendations a reality within health care practice and nurse cultural awareness.

On the recruitment of minority ethnic groups into nursing, midwifery and health visiting is another example of the evidence clearly indicating a need for a national policy. The Department of Health has already started this cultural change in health care, by ensuring that NHS Trusts adhere to Patients’ Charter standards with regard to privacy, dignity, and religious and cultural beliefs.

The lack of leadership in the health care service on cultural issues is how-ever, a reflection of what is happening in society as a whole. The United Kingdom Central Council for Nursing, Midwifery and Health Visiting

Practice sets out for nurses

Code of Professional Practice sets out for nurses, midwives and health visitors how they are expected to relate to the general public in the course of their work. It states the need to:

Recognize and respect the uniqueness and dignity of each patient and client and respond to their need for care, irrespective of their ethnic origin, religious beliefs, personal attributes, the nature of their health problems or any other factor.

The outcomes of research studies   and Department of Health initiatives are to support the implementation of professional recommendations, but there is a need for a common under-standing and appreciation of the issues to be addressed. One of the important factors influencing decisions about the needs of multicultural groups is that there is a shared understanding of different cultural backgrounds.

This involves understanding the use of language and terminology related to care. In the literature, three terms are frequently used in discussion about cultural care practices, namely culture, race and ethnicity. An understanding of the meaning of these terms in relation to health care is the focus of this article.

However, Baxter  cautions us about using the terms ‘culture’ and ‘multicultural’, in that such usage ignores issues of race and ‘does not provide an adequate explanation of how racial discrimination arises or how it can he addressed’. Whilst this is acknowledged, we have observed when teaching that if the broad cultural issues are explored first and students are clear about the background of different cultural groups, then the subsequent teaching and discussion of issues related to race and racism become easier and less confrontational, as the student has a clear and safe framework within which to explore his or her own views and experiences.

in this article will give both student and teacher the opportunity to begin this reflective learning process in order hopefully to bring about change in their own beliefs and practice, and in addition to begin to influence that change in others.


The terms culture, race and ethnicity arc often confused in their interpretation by health care professionals and the public in general. In order to deter-mine what is meant by culture, let us examine the following definitions:

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