Analyzing Linguistic and Culturally Discordant Care from the Perspectives of Nurses and Nurse Practitioners in Ontario, Canada

Background and Objectives: Despite Canada's Official Languages Act, linguistic concordant care directives are lacking. This study investigates challenges faced by Ontario's nurses and nurse practitioners in caring for patients from minority linguistic and ethno-cultural groups, along with their adopted strategies. Approach: Adopting a qualitative descriptive approach, this study engaged nurses and nurse practitioners from diverse practice settings across Ontario through semi-structured interviews. Our bilingual recruitment strategy used convenience and snowball sampling from existing professional networks and through social media. Data were analyzed with Reflexive Thematic Analysis within an intersectionality framework. Results: Nurses commonly used professional interpreters and Google Translate. Major challenges included high costs and inconsistent access to interpretation services due to organizational and funding constraints. Nurses needed flexibility to adapt to each patient's needs and commented on the significant time required for care in linguistically and culturally discordant encounters. They emphasized understanding cultural nuances and sensitivity as integral to a holistic care model that encompasses physical, psychological, and social aspects. Nurses often pursued cultural-competency training independently and sought mentorship to improve their care quality for minority populations. Continuous professional development and skill advancement were crucial for managing the complexities of linguistic and cultural discordance in care. Conclusion: The study highlights the need for accessible tools to navigate linguistic and cultural barriers, and for continuous education and mentorship to foster culturally competent care. These elements are crucial for nurses to provide equitable, high-quality care to minority groups.