Journal of Modern Education Review, ISSN 2155-7993, USA July 2015, Volume 5, No. 7, pp. 723–728 Doi: 10.15341/jmer(2155-7993)/07.05.2015/011  Academic Star Publishing Company, 2015 http://www.academicstar.us 723 Cultural Competence in Critical Care: Case Studies in the ICU Julie Benbenishty, Seema Biswas (1. Medical Center, Hadassah Hebrew University, Israel; 2. Department of Surgery, Ziv Medical Center, Safed, Israel) Abstract: It takes years to develop clinical competence in critical care and trauma surgery. We learn, relearn and are tested every day. How do we develop our communication skills and competence in cross-cultural communication, though? This, too is through immersion and daily practice. Here, though, we learn from our patients and their families perhaps more than our own backgrounds and formal training. The case studies in this paper provide insight into the many and varied wavelengths at which intensive care unit, ICU, staff must communicate in order to effectively deliver care and earn the trust and cooperation of their patients at their most vulnerable. Dealing with illness and death is difficult in any environment but in Trauma and the ICU illness may come as a surprise and a shock, patients conditions change minute-by-minute and anxious families hang on every word we say, hoping that they heard good news, trying often not hear the bad news. In this account, we describe some of the special considerations in communication in the ICU and how to communicate at the wavelength of the patient and their family in testing, uneasy but urgent circumstances. Keywords: cultural competence, communication, intensive care unit, critical care, trauma, surgery 1. Introduction Cultural competence is crucial in acute and critical care, where emotions are running high, there is a sense of alarm and urgency, there are high-stakes decisions being made, consent may be problematic, key decisions, progress and bad news needs to be effectively communicated and expectations managed in what, for many, is a protracted, often stormy, course. The following account focuses on the challenges of culturally competent interaction in the critical care environment, in particular, informed consent and end of life care. We emphasize patient-centered practice and care of the individual within a dominant culture, which though traditionally, representing the majority culture in a society, in this account may actually more usefully apply to the culture within an institution, or indeed, the intensive care unit (ICU). 2. Defining Cultural Competence Betancourt (2006) defines a culturally competent healthcare system as one that “acknowledges and incorporates — at all levels — the importance of culture, assessment of cross-cultural relations, vigilance toward Julie Benbenishty, Trauma Coordinator RN MNS, Medical Center, Hadassah Hebrew University; research areas/interests: Shock, end of life, vasopressor dosage, cultural competence, trauma. Seema Biswas, FRCS, Department of Surgery, Ziv Medical Center; research areas/interests: medical education, surgery, trauma, global health. E-mail: seemabiswas@msn.com.