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Introduction

Cultural competence, a relatively new concept in the world of healthcare professionals, has been increased over the last years. The recent movement of populations around the world brings new challenges in nursing care to patients with different healthcare beliefs, issues and practices. That is the new reason why we must provide nursing care for patients with diverse cultural backgrounds (Douglas et al.,2014).
This discussion will be focus on an awareness and knowledge of our patient’s culture and why this concept is so important. An appropriate assessment of knowledge, skills, attitudes and strengths of the nurses in delivering culturally competent nursing care appears to be a key part in new education plans. Our nurses must have awareness and help their multidisciplinary team to work effectively with all healthcare professionals from another cultural background to show up skills of better understanding of the different needs of patients from minority ethnic backgrounds.

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Discussion
Do you know of any simple methods that nurses can use to improve cultural awareness and cultural knowledge?
This question has become more typical as we have become a more global society. Today, a nurse has to have a caring skills and knowledge for patients from her own culture; the nurse also has to be able to show this knowledge for patients from different cultures and beliefs,
The online Merriam-Webster dictionary defines “culture” as the customary beliefs, social forms, and material traits of a racial, religious, or social group as well as everyday existence shared by people in a place such as one’s work environment.
Developing Cultural Competence
“Cultural competence” has been described as providing competent care to individuals. Culturally competent care includes behaviours, attitudes, and guidelines that support our process of appropriate care of people from the other cultures and languages. This care should also be temporally based (Garret et al.,2008). In the busy everyday healthcare practice, how can we increase our cultural awareness?
Everyone also has an internal culture. This culture is composed of gender, birth order and experience. To provide culturally competent patient care, as well as work within the increasingly global healthcare system, nurses must consider not only the internal and external culture of patients, but also their own cultures. Nurses must develop both general skills as knowledge and respect.
Framework for delivering cultural competency

The concept of cultural competence has appeared in the nursing literature more frequently in the past 10 years than ever before and has been defined by the American Academy of Nursing (Lenburg et al., 1995) as “a complex integration of knowledge, attitudes, and skills that enhances cross-cultural communication and appropriate effective interactions with others” (p. 35). Cultural competence has been identified as a critical component of nursing research and continuing nursing education (Campinha-Bacote, 1999).
Campinha-Bacote and Munoz (2001) introduced a five-component model for developing cultural competence, consisting of
1. Cultural awareness (self-examination, assess a nurse’s level of cultural awareness).
2. Cultural knowledge (cognitive dimension seeking a different cultural data and getting an information based on the nurse’s ability to gain cultural data)
3. Cultural skills (the nurse’s ability to gain relevant cultural data to perform a culturally specific assessment)
4. Cultural encounter (nurses are interacting with patients from dissimilar cultural background)
5. Cultural
Each of these components of cultural competence should be addressed in nursing clinical practice, and another research. All Cultural needs in relation to equal access to treatment and care are peak in transcultural health care (Gerrish et al, 1996; Polaschek, 1998; Royal College of Nursing, 1998; Gerrish and Papadopoulos, 1999; Henley and Schott, 1999; Narayanasamy,1999a) .There is a consensus that a sense of cultural safety is most likely to promote trust and therapeutic relationships which are very important for interventions suggested to meet cultural needs (Narayanasamy, 2002). Some people may share similar religious beliefs and practices but may differ in their cultural beliefs and their value (Henley and Schott, 1999).
Nurses have to focus on respecting beliefs and they have to practising and try to identify nursing care needs connected to cultural beliefs and empiric experience. Numerous writers have identified the significance related to cultural beliefs. Henley and Schott (1999) create a guideline for health carer professionals with reflection of the cultural and spiritual needs of multi-ethnic patients. Very important is knowledge of the effect of treatment in various ethnic groups. For instance, a risk of developing pressure ulcers.
The Waterlow score is the most commonly used pressure ulcer risk calculator in the UK (Dealey, 1997). Pressure risk assessment tools have been developed on a white population and pressure ulcer risk assessment tools that have been validated for darkly pigmented skin may be required (Bethell, 2005). A large study to explore the relevance of ethnicity in the development of pressure ulcers compared white and Pakistani patients using the Waterlow scale, and found that once age is taken into consideration, there is no evidence that the risk of pressure ulcers to Pakistani patients is higher than to white patients (Anthony et al, 2002).
Overall, here we discussed cultural competent care on the five dimensions of cultural awareness. The evidence exists, that nurses and nursing students possibly have the cultural awareness, but we need to increase post graduate programs and training to improve this cultural awareness and knowledge in future.

Conclusion and Recommendations

Finally, here is a recommendation to develop culturally competent nurses in Ireland. Providing care in a transcultural community is very challenging. There is the need to set up nursing education for nurses and teach all nurses culturally competent practise and watched their progress. Our nurses need to deal with sensitivity to meet a proper transcultural care at least in some aspects. Many of them need further education to meet the cultural needs of their patients and become competent.
There is a cultural diversity as a key challenge for the Irish health care sector, both in terms of diversity in the workplace and the development, delivery and impact positively on cross-cultural patients. There is challenging to build a cultural diversity into our health care policy strategies including the recommendations contained in the National Intercultural Health Strategy 2007–2012. Also gender focus should be involved in these specific strategies. The main stream is cultural diversity awareness and the training to improve the knowledge of nurses and their ability to deliver a good care in a multicultural society. We must remember, that culture is both external and internal and cannot be easily summarized. We can see all through our own life experience.

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