A transcultural nurse specializes in the care of patients from all cultures, belief systems, language backgrounds, and nationalities. All the diverse cultures represented in the United States come with their own healthcare customs, traditions, and values. A patient’s cultural background can affect how they want to be treated and spoken to, especially in a health setting.
Transcultural nurses understand cultural beliefs can drive how patients deal with sickness and death, and they facilitate culturally sensitive healthcare to provide dignity and respect to all patients with equity. All nurses must attend to cultural differences with each patient, but transcultural nurses take their care of the culturally diverse to the next level, and in this specialty, nurses work with patient populations who may be at risk for lower-quality healthcare because of their culture.
Where Do Transcultural Nurses Work?
Transcultural nurses can work in a variety of settings. They may find more work in urban medical centers, as many immigrants and refugees are housed in metropolitan areas. With this in mind, transcultural nurses can often find work in:
Community health centers
Home health
Hospitals
International non-governmental organizations (NGOs)
Outpatient clinics
Private medical practices
In community health centers and home health care, a transcultural nurse may be tasked with case management work; helping their patients make appointments, calling their healthcare providers, contacting their insurance company, and navigating the healthcare system.
In hospitals, transcultural nurses may receive referrals from staff and visit every unit, attending to the cultural needs of that patient population. Whether they help the bedside nurse contact a translator or notify a chaplain of a patient’s wishes, transcultural nurses must use critical thinking to solve diverse needs.
Some NGOs hire transcultural nurses to advocate for and assist at-risk populations. In outpatient clinics and medical practices, transcultural nurses may see patients as staff nurses, with the additional responsibility of educating staff on cultural sensitivity as well as assisting patients in the office with cultural wishes.
What Does a Transcultural Nurse Do?
Since transcultural nurses work with a diverse population, they must know the basics of every major culture, religion, and ethnic group that may seek healthcare at their facility. In the U.S., many immigrants and refugees are assigned to certain cities by ethnic group, to allow a cultural community to grow there. For example, refugees from Bosnia settled heavily in St. Louis, MO and Chicago, IL, whereas immigrants from Bolivia have mostly settled in the Washington, D.C. area.
Transcultural nurses must know the populations in their area, and educate themselves on those cultures more heavily. Once they are equipped with this information, they can begin to use their knowledge and empathy to truly assist people of all cultures in their facility.
Some common transcultural nurse responsibilities include:
Ascertaining a patient’s cultural and language preferences
Communicating with foreign patients and families
Detailing all home remedies used by the patient
Determining the socioeconomic status of a patient and collaborating with other departments to ensure patients can stay healthy after discharge
Educating patients and families on medical status and procedures
Establishing a patient’s wishes regarding their medical illness and care
Investigating whether a patient’s health issue may be related to cultural practices
Providing emotional and spiritual support to patients and their families
Serving as a liaison between patients, families, and healthcare providers
Cultural differences have the potential to upend even the most basic interaction between healthcare provider and patient if ignored. Women who practice Islam, for example, sometimes may not speak to a male without her husband, brother, or father present in the room. Similarly, some cultures do not allow a male physician to examine a female patient. In situations like these, transcultural nurses are an indispensable part of the healthcare team.
How Do I Become a Transcultural Nurse?
The first step for aspiring transcultural nurses is to attend and graduate from an accredited nursing program with a Licensed Practical Nurse (LPN) certification, an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). Once nurses have their degree, they can begin working in health settings as graduate nurses (GNs). Healthcare settings often hire nurses as GNs and train them until they pass the NCLEX, their state licensing exam. After they pass the NCLEX, GNs become licensed practical nurses or registered nurses (RNs). After an orientation period, new LPNs or RNs can practice on their own.
While new nurses may not be able to jump into a transcultural nursing role right away, they may choose to work in a health facility with a large population of patients from diverse cultural backgrounds. Experience with many cultural groups will help them on their path toward transcultural nursing.
After practicing for a year or two, transcultural nurses can earn a specialty certification. They may also choose to return to school for an advanced practice degree to become a nurse practitioner (NP) or a doctor of nursing practice (DNP) with a concentration in transcultural nursing. Transcultural nurses can earn a Master of Science in Nursing (MSN) and become nurse practitioners. Nurses can graduate with an MSN in two years, but it may take longer to complete this degree while working full-time. Nurses who choose to go the DNP route can check their chosen program’s accreditation through the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN).
Transcultural nurses can get certified in their specialty through the Transcultural Nursing Society, with a basic or advanced option. The requirements for the basic transcultural nursing certification (B-CTN) include:
A current RN license
A diploma, associate degree, or BSN degree from an accredited nursing program
Currently practicing as a nurse (full-time or part-time)
A minimum of one completed course in cultural diversity and promotion of cultural competence
2400 hours of transcultural nursing practice as a registered nurse during the five years prior to submitting an application
The requirements for the advanced transcultural nursing certification (A-CTN) include all the requirements for a B-CTN, in addition to a master’s, post-master’s, or doctorate in nursing, education, philosophy, or other related fields. They must also demonstrate three out of these five requirements:
Evidence of professional growth in transcultural nursing
Evidence of creative and innovative ways to promote and maintain transcultural nursing practice
Evidence of research in transcultural nursing
Evidence of substantive or unique contributions made to advance transcultural nursing
Evidence of transcultural nursing leadership in teaching, research, or consultation to improve care in diverse cultures
How Much Does a Transcultural Nurse Make Per Year?
Transcultural nurses’ annual salary depends largely on the type of degree they have and the type of position they fill. RNs, for example, make an average of $81,220 per year as of 2022, according to the U.S. Bureau of Labor Statistics (BLS). Salary can differ by location and experience, from the low-end average of $61,250 to the high-end of $129,400. Depending on your workplace, your employer may be able to offer higher or lower compensation:
General Medical and Surgical Hospitals: $90,600
Home Health Care Services: $82,920
Offices of Physicians: $79,810
Outpatient Care Centers: $97,200
Salaries also vary depending on which state a transcultural nurse practices. The West Coast, New England states, and Alaska pay their nurses the best, but the cost of living in these areas can also be high. The lowest paying states are in the Midwest and some southeastern states.
Licensed practical nurses may earn a little less than RNs, with an average salary closer to $55,860. Depending on location, an LPN can earn anywhere from $40,490 to $72,650.
Transcultural nurse practitioner salaries are higher than RNs and LPNs, with average annual earnings of $121,610, according to BLS data from 2022. The low-end average was $87,340, and the high-end was $165,240. Salary can also change based on employment type:
General Medical and Surgical Hospitals: $129,330
Home Health Care Services: $148,960
Offices of Physicians: $121,880
Offices of Other Health Practitioners:$112,660
Outpatient Care Centers: $134,030
The location of employment can affect transcultural nurse practitioners as well, with differences similar to RNs.
The top paying areas for transcultural nurses and nurse practitioners include:
San Jose-Sunnyvale-Santa Clara, CA
San Francisco-Oakland-Hayward, CA
Napa, CA
Vallejo-Fairfield, CA
New York-Newark-Jersey City, NY-NJ
Yuba City, CA
Sacramento-Roseville-Arden-Arcade, CA
Transcultural nurses with specialty certification and higher-level education can earn more than nurses who are not certified. The more experience a transcultural nurse has, the higher their salary can climb.
Are Transcultural Nurses in High Demand?
The Migration Policy Institute reports that just over 45 million people emigrated to the United States in 2021, up from almost 40 million in 2010. In 2021, first-generation immigrants made up about 13 percent of the U.S. population. That percentage represents an enormous number of potential patients with a vast array of cultural differences and needs. With new immigrants headed to the U.S. every year, transcultural nurses should see opportunities abound.
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