Culturally responsive nursing communication begins with the individual: what they believe, what matters to them and how they want to take part in care. It requires curiosity about a person's perspective without assuming that a group label explains their preferences.
The National Standards for Culturally and Linguistically Appropriate Services, or CLAS, provide a blueprint for healthcare organizations. They call for services responsive to cultural health beliefs, language, health literacy and other communication needs.
Ask what matters in this encounter
AHRQ's SHARE guidance emphasizes that patients have individual beliefs and values. It recommends asking about their understanding of a health issue, recognizing the clinician's own cultural perspective and inviting patients to explain what is important when the clinician is unfamiliar with their context.
Possible questions include:
- “What is your understanding of the concern we are discussing?”
- “Is there a belief or practice you want the team to consider?”
- “Who would you like involved in this conversation?”
- “How would you prefer to receive information?”
- “What have we not asked that would help us understand your needs?”
Use only the questions relevant to the encounter. The purpose is to understand this person's needs, not ask them to explain an entire culture.
Separate preferences from communication access
A patient's preferred language is a concrete communication need. Their preference about who joins a discussion is a different question. Avoid combining both into an assumption that a relative should interpret.
CLAS addresses language assistance, the competence of people providing it, and understandable materials and signage. For nursing practice, identify the patient's communication needs and use the organization's qualified services and approved process. Working with medical interpreters discusses that workflow separately.
Confirm rather than infer
In a fictional encounter, a patient says that speaking with a family member before a decision is important. A useful follow-up is to clarify which person they mean, how they want that person involved and whether they have questions for the clinical team first.
Do not write that “patients from this culture require family permission.” Record the preference the individual actually expressed and the agreed next step, following the applicable privacy and decision-making process.
AHRQ encourages appropriate family involvement and patient questions. Neither recommendation supplies a reason to assume that a companion should speak for the patient.
Review the service around the conversation
Cultural responsiveness is also an organizational task. CLAS includes workforce education, community engagement and assessment of service needs. A nursing team can bring recurring communication problems into that work.
For example, if patients repeatedly describe a confusing instruction or difficulty obtaining a preferred-language resource, record the service problem and route it to the team responsible. Check the revised resource with the intended audience rather than treating a translated document as the end of the process.
A useful review asks what the patient requested, what support was provided and what remains unresolved. It does not grade the patient for fitting staff expectations. Related topics include language access and patient goals.
Sources
- National CLAS Standards (accessed 2026-09-17) — HHS Office of Minority Health.
- Cultural Competence and Getting To Know Your Patient (accessed 2026-09-17) — AHRQ, October 2024.