Editorial: Nurses Responding to Cultural Relevance in End-of-Life Care

■ EDITORIAL Meeting the Needs of Our Patients through Cultural Competence and End-of-Life Care

Few subjects are more intimate and multifaceted for nurses than dealing with issues related to cultural competency and end-of-life care. The assurance that patients receive high-quality care is a core healthcare goal. Nurses, like good shepherds, can drive quality care by supporting each other, and by building relationships with their patients and their patients’ families.

The articles contained in this issue of The Journal were written to help meet the needs of nurses in providing both culturally competent and compassionate care, and to help nurses facilitate better patient outcomes.

Federal legislative initiatives and, additionally, legislation in New York State (NYS) have recently focused on culturally competent and end-of-life care. In 1997, the Offce of Minority Health (OMH) addressed culturally competent care on the federal level and undertook the development of national standards to provide a much-needed alternative to the patchwork of independently developed defnitions, practices, and requirements concerning culturally and linguistically appropriate services (CLAS). The national CLAS standards issued by the U.S. Department of Health and Human Services’ (HHS) OMH were published in fnal form in the Federal Register on December 22, 2000. On the NYS level, the OMH developed Offcial Policy Directive PC-502 titled Cultural and Linguistic Competence. This directive, which applies to state hospitals directly operated by the OMH, codifes the agency’s commitment to developing and maintaining mental health services that are culturally competent, consumer guided, and community based. This directive is also intended to assist state-operated facilities in complying with NYS Executive Order No. 26, which directs state agencies that provide direct public services to translate vital documents, as well as to fulfll the accreditation requirements of the Joint Commission. Additionally, NYS Health Code 14 NYCRR Section 527.4 directs the commissioner to promulgate regulations to address the communication needs of non-English-speaking individuals seeking or receiving services in facilities licensed or operated by OMH in order to facilitate their access to services.

In 2011, the NYS Palliative Care Information Act was passed, which requires physicians and nurse practitioners to offer terminally ill patients information and counseling concerning palliative care and end-of-life options. On the national level, Medicare regulations will soon provide reimbursement to doctors to discuss end-of-life issues with their patients. Indeed, all of these initiatives are steps in the right direction.

As the population ages and becomes more diverse, those of us in nursing need to self-assess whether we are meeting the specifc needs of our patients. Whether you practice in an emergency department (ED), an inpatient, or a community-based setting, we trust that these articles will guide you both personally and professionally as you encounter challenges in providing culturally competent and end-of-life care.

Coreen Simmons, PhD-c, DNP, MSN, MPH, RN Dana Deravin Carr, DrPH, MS, MPH, RN-BC, CCM Caroline Mosca, PhD-c, MSN, RN Meredith King-Jensen, MA, MSN, RN