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Standard 8: What Every Nurse Should Know About Culturally Congruent Practice

Properly handling cultural diversity is an important part of every nursing career.

As America’s premier organization representing nurses, the American Nurses Association (ANA) takes on the mission of advancing the nursing profession to improve health for all. This mission includes publication of Nursing: Scope and Standards of Practice, a comprehensive guide laying out how RNs and APRNs should perform professionally. If you’re looking to start or advance your nursing career, you’ll want to fully understand each of the 17 standards. In particular, you’ll want to understand the new Standard 8, included in the recent third edition.

What Is the New Standard 8?

While developing the third edition of Nursing: Scope and Standards of Practice, the ANA wanted to better address the increasing cultural and ethnic diversity of the patient populations nurses treat. Because good care cannot come from a place of ignorance or intolerance, the organization included the new Standard 8 to guide nurses toward behavior that is respectful of diversity and inclusive of all patients.

Standard 8: What Every Nurse Should Know About Culturally Congruent Practice

Titled “Culturally Congruent Practice,” Standard 8 states, “The registered nurse practices in a manner that is congruent with cultural diversity and inclusion principles.”*

But the ANA doesn’t leave it at that. Standard 8 includes a list of competencies nurses should master in order to meet the standard.

What Are the Standard 8 Competencies?

Standard 8 includes 13 competencies for RNs, another five competencies for graduate-level prepared nurses, and two more for APRNs such as nurse practitioners.

Competencies for the Registered Nurse

  • Demonstrates respect, equity, and empathy in actions and interactions with all healthcare consumers
  • Participates in lifelong learning to understand cultural preferences, worldview, choices, and decision-making processes of diverse consumers
  • Creates an inventory of one’s own values, beliefs, and cultural heritage
  • Applies knowledge of variations in health beliefs, practices, and communication patterns in all nursing practice activities
  • Identifies the stage of the consumer’s acculturation and accompanying patterns of needs and engagement
  • Considers the effects and impact of discrimination and oppression on practice within and among vulnerable cultural groups
  • Uses skills and tools that are appropriately vetted for the culture, literacy, and language of the population served 
  • Communicates with appropriate language and behaviors, including the use of medical interpreters and translators in accordance with consumer preferences
  • Identifies the cultural-specific meaning of interactions, terms, and content
  • Respects consumer decisions based on age, tradition, belief and family influence, and stage of acculturation
  • Advocates for policies that promote health and prevent harm among culturally diverse, underserved, or underrepresented consumers
  • Promotes equal access to services, tests, interventions, health promotion programs, enrollment in research, education, and other opportunities
  • Educates nurse colleagues and other professionals about cultural similarities and differences of healthcare consumers, families, groups, communities, and populations   

Additional Competencies for the Graduate-Level Prepared RN

  • Evaluates tools, instruments, and services provided to culturally diverse populations
  • Advances organizational policies, programs, services, and practices that reflect respect, equity, and values for diversity and inclusion
  • Engages consumers, key stakeholders, and others in designing and establishing internal and external cross-cultural partnerships
  • Conducts research to improve healthcare and healthcare outcomes for culturally diverse consumers
  • Develops recruitment and retention strategies to achieve a multicultural workforce

Additional Competencies for APRNs

  • Promotes shared decision-making solutions in planning, prescribing, and evaluating processes when the healthcare consumer’s cultural preferences and norms may create incompatibility with evidence-based practice
  • Leads interprofessional teams to identify the cultural and language needs of the consumer

How Can You Meet the Standard?

In addition to striving to follow the guidance of the Standard 8 competencies, you can promote your growth in culturally congruent care in a number of ways. Specifically, nursing scholars recommend spending time on your professional development and performing regular self-assessments. When you take your professional development seriously, you can gain many of the competencies by paying attention to colleagues and patients, and by choosing to learn from experience. As for self-assessment, by recognizing your own cultural preferences and biases, you can better recognize the differences in others and make a more focused effort to remain respectful and avoid confusion.

Another way to improve your ability to provide culturally congruent care—and improve your overall nursing skills—is to earn a Master of Science Nursing (MSN degree) from Walden University. Walden’s mission of social change and its diverse student body can help you expand your cultural competency. Plus, there are many other advantages to attending the university’s nursing school.

When you choose to earn your master’s degree in nursing from Walden, you’ll study with a 100% doctorally prepared MSN program teaching faculty. Walden offers its master’s in nursing online, meaning you can complete your degree coursework from your home. Plus, because you’ll be in an online MSN program rather than a campus-based program, you won’t have to attend classes at specific times of the day. Instead, Walden’s master’s in nursing program offers a flexible learning platform that lets you access your online classroom at whatever time of day works best for you, giving you the ability to work full time while enrolled in the program. On top of that, Walden offers RNs an RN to MSN online program path that streamlines the process of going from your RN to MSN.

Walden is No. 1 in Master of Science in Nursing graduates in the U.S., making it an attractive option when looking to earn your master of science in nursing and expand your competencies through online education.

Walden University is an accredited institution offering a Master of Science in Nursing degree program online. Expand your career options and earn your degree using a convenient, flexible learning platform that fits your busy life.

*American Nurses Association, “Standard 8: Culturally Congruent Practice,” Nursing: Scope and Standards of Practice, on the internet at

†L. Marion et al., “Implementing the New ANA Standard 8: Culturally Congruent Practice,” The Online Journal of Issues in Nursing, on the internet at

‡Source: National Center for Education Statistics (NCES) IPEDS database. Retrieved July 2017, using CIP code 51.3801 (Registered Nursing/Registered Nurse). Includes 2016 preliminary data.