The American Nurses Association (ANA) is responsible for the contract between society and the nursing profession, including the nursing scope and standards of practice. In 2015, an ANA workgroup produced Nursing: Scope and Standards of Practice, 3rd Ed during a time of social change and an increase of culturally and ethnically diverse consumers. Subsequently, a subset of workgroup members and an invited transcultural nursing expert led to the creation of the new Standard 8: Culturally Congruent Practice, describing nursing care that is in agreement with the preferred values, beliefs, worldview, and practices of the healthcare consumer. This article records the history of the revised scope and standards and new Standard 8, the reasoning behind this standard and its impact on nursing practice, education, and research. The article also guides nurses in the application of Standard 8 to nursing practice and offers discussion about implementing culturally congruent practice through the nursing process. We also discuss cultural congruence for the graduate-prepared nurse; offer brief comments related to evaluation of culturally congruent practice using Standard 8 and future research; and conclude with a call to action.

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Aim This study qualitatively explored the impact mentoring relationships had on the professional socialization of novice clinical nurse leader. Background Professional socialization entails acquisition of the skills, knowledge and values associated with nursing. Model C clinical nurse leaders have completed a bachelor's degree before graduate‐level nursing programme acceptance. Thereby, the mentoring needs of model C clinical nurse leaders may differ from that of traditionally educated novice nurses. Method Focus groups were conducted with seven novice model C clinical nurse leaders during their first year of employment. Qualitative data were analysed via a grounded theory approach. Results The participants described an intense focus on patient care and how multiple mentoring relationships motivated them to become competent bedside clinicians. They described how the mentors’ actions enabled them to deal with negative feelings, which increased their confidence, comfort and competence with clinical skills. Conclusions Clinical skills improved when a novice model C clinical nurse leader worked with multiple mentors. The qualitative data did not show that the model C clinical nurse leaders needed different mentoring relationships than traditionally educated nurses. Implication for Nursing Management The results suggest multiple mentors should be used to develop the clinical competences of novice model C clinical nurse leaders.

Background: Patients living in rural areas experience a variety of unmet needs that result in healthcare disparities. The triple threat of rural geography, racial inequities, and older age hinders access to high-quality palliative care (PC) for a significant proportion of Americans. Rural patients with life-limiting illness are at risk of not receiving appropriate palliative care due to a limited specialty workforce, long distances to treatment centers, and limited PC clinical expertise. Although culture strongly influences people's response to diagnosis, illness, and treatment preferences, culturally based care models are not currently available for most seriously ill rural patients and their family caregivers. The purpose of this randomized clinical trial (RCT) is to compare a culturally based tele-consult program (that was developed by and for the rural southern African American (AA) and White (W) population) to usual hospital care to determine the impact on symptom burden (primary outcome) and patient and care partner quality of life (QOL), care partner burden, and resource use postdischarge (secondary outcomes) in hospitalized AA and White older adults with a life-limiting illness. Methods: Community Tele-pal is a three-site RCT that will test the efficacy of a community-developed, culturally based PC teleconsult program for hospitalized rural AA and W older adults with life-limiting illnesses (n = 352) and a care partner. Half of the participants (n = 176) and a care partner (n = 176) will be randomized to receive the culturally based palliative care consult. The other half of the patient participants (n = 176) and care partners (n = 176) will receive usual hospital care appropriate to their illness. Discussion: This is the first community-developed, culturally based PC tele-consult program for rural southern AA and W populations. If effective, the tele-consult palliative program and methods will serve as a model for future culturally based PC programs that can reduce patients' symptoms and care partner burden.