Sameness in nursing care puts patients at risk

Editor's Note

Treating every patient the same may feel fair, but it can be dangerous, according to a September 2025 article from the American Journal of Nursing, which argues that cultural indifference in nursing practice undermines patient safety and trust.

Per the article, person-centered care requires more than standardized protocols. It calls for acknowledging each patient’s unique lived experiences, values, and cultural context. By confusing equality with equity, nurses risk applying “sameness” in care delivery that ignores cultural differences and perpetuates harm. The authors describe this as cultural ignorance, noting it can weaken therapeutic relationships and hinder safe, holistic care.

Unmanaged bias is a significant contributor to patient harm. The World Health Organization has identified cognitive biases as a leading factor in safety failures across healthcare. Biases are not eliminated but managed, the authors stress, and nurses must actively reflect on how personal beliefs shape professional practice. The National Commission to Address Racism in Nursing has defined racism as systemic assaults that cause moral suffering and perpetuate inequities. When nursing care forces Black patients and other marginalized groups to conform to “white normativity,” it further entrenches disparities.

The article emphasizes individualized care requires ongoing unlearning and relearning. Nurses must seek knowledge of diverse cultural practices, social determinants of health, and barriers to access. Practical strategies include pausing before making assumptions, using humility and curiosity to connect with patients, employing language services, respecting traditional practices, and suspending judgment.

Ignoring cultural differences, the authors caution, can cause irreparable harm to both patients and the profession. While nurses remain the most trusted professionals, recent Gallup polling shows confidence in healthcare is eroding. To maintain trust, nurses must shift from sameness to equity-minded care that is intentional, inclusive, and rooted in respect.