NUR3655 – Nursing in a Multicultural Society is a 3-credit upper-division nursing course on delivering care across cultural, linguistic, and social difference. It is a standard requirement in RN-to-BSN completion programs, which Florida state colleges offer widely, and it is one of the components that distinguishes BSN from associate degree preparation.
The course rests on an evidence claim rather than a sentiment: health outcomes differ measurably by race, ethnicity, language, and socioeconomic position, some of that difference is produced within the health care encounter itself, and nurses are positioned to affect it. The objective is not to catalogue cultural traits — that approach produces stereotyping — but to develop the assessment habits and communication practices that let a nurse understand an individual patient's beliefs, constraints, and preferences.
Content covers culture and its influence on health beliefs; cultural competence and cultural humility and the difference between them; transcultural nursing theory — Leininger, Campinha-Bacote, and Purnell; cultural assessment models and their clinical use; health disparities — documented differences in access, treatment, and outcomes; social determinants of health; implicit bias and its measured effects on clinical decisions; communication across language difference — working with interpreters and the risks of ad hoc interpretation; health literacy; religious and spiritual practices affecting care, including dietary requirements, modesty, and end-of-life practices; family structures and decision making, including where decisions are made collectively rather than individually; complementary and traditional practices and how to ask about them; pain assessment and treatment disparities; immigrant and refugee health; and organizational and policy responses including the CLAS standards.
Offered at approximately 11 Florida institutions with BSN or RN-to-BSN programs.
The most concrete and consequential content in the course. Health care organizations receiving federal funds are required under civil rights law to provide meaningful access to patients with limited English proficiency, which in practice means qualified interpreters at no cost to the patient. Using a family member — especially a child — as interpreter is discouraged and in many circumstances impermissible: it produces documented errors of omission and substitution, compromises confidentiality, and places an inappropriate burden on the family. Nurses frequently take the shortcut because an interpreter takes longer. Students should leave knowing the obligation, the error evidence, and how to work with an interpreter efficiently — speak to the patient, not the interpreter; short segments; check understanding with teach-back.
Florida is among the most linguistically and culturally diverse states in the country, and the practical implications are immediate rather than theoretical. Roughly a third of Florida residents speak a language other than English at home; Spanish and Haitian Creole are both widely spoken, with substantial Portuguese, Vietnamese, Russian, and Arabic-speaking communities as well. Florida also has a large older population, significant migrant and seasonal farmworker communities, and — because the state has not expanded Medicaid — a substantial uninsured working population whose access constraints shape when and how they seek care. A nurse practicing in Florida encounters these realities in the first week, which makes the course's content operational rather than aspirational.
Older approaches taught cultural traits by group, which reliably produces stereotyping — assuming a patient holds beliefs because of their apparent ethnicity. The better-supported stance is cultural humility: recognizing the limits of one's own knowledge, treating the patient as the authority on their own beliefs and circumstances, asking rather than assuming, and accepting that learning is continuous rather than completed. The practical form is a small set of questions asked of every patient — what they think is wrong, what they think caused it, what they have already tried, what worries them most — rather than a set of facts memorized about groups.
Research documents measurable differences in clinical decisions — notably in pain assessment and treatment — associated with patient race and ethnicity, occurring among clinicians who sincerely reject bias. Students often find this material personally difficult. The productive framing is diagnostic rather than accusatory: bias operates below deliberate intent, which is precisely why it requires structural countermeasures — standardized assessment tools, protocols, checklists, and auditing outcomes by demographic group — rather than good intentions.
The 3000-level number means upper-division coursework within a BSN program, requiring program admission and, for RN-to-BSN students, typically an active unencumbered Florida RN license. It is not open to general enrollment. This course commonly sits alongside NUR4169C (Evidence Based Practice) and community health in the RN-to-BSN core. SCNS equivalency applies to the same number at the same level, never across numbers — verify what a receiving program requires.
Generated August 31, 2026 · Updated August 31, 2026