Resigned indifference: the importance of cultural competence education

This paper presents the findings of a PhD study, which explored how nurses' deal with their main concern when caring for patients from diverse cultural and ethnic backgrounds. Utilising theoretical sampling and the principles of a grounded theory approach, focus groups (n-10) and individual face-to-face interviews (n-30) were conducted with student and qualified nurses, in one region of Ireland. As data were collected, it was simultaneously analysed using constant comparative analysis during open, selective and theoretical coding. Uncertainty was the consistent main concern that emerged for participants in this study. Feelings of ambiguity of how to act were further influenced by a lack of knowledge, an awareness of potential ethnocentric beliefs and the culture of the organisation in which participants learn and work in. Resigned indifference explains how participants in this study dealt with their uncertainty when caring for patients from diverse cultures. It explains how participants adopted a range of disengagement strategies. Instead of doing what they sometimes knew to be right, participants adopted a range of disengagement strategies which were underpinned by a resigned indifference. The culture within the organisation allowed the disengagement strategies and indifference to also go un-noticed. As a result culturally insensitive care went unchallenged, often un-noticed and subsequently unchanged. The discomfort associated with providing culturally insensitive care was eased with shifting the blame to professional preparation or organisational constraints. As a consequence culturally insensitive care is sustained and perpetuated. This paper highlights the need for imaginative learning and teaching approaches that will replace uncertainty with curiosity and resilience, apathy with courage and commitment both at individual and organisational levels.