Objective: This study examined Native American perceptions of attitudes and behaviors desired in their client/nurse relationships for the purpose of informing cultural-competency education and practice.

Design: A descriptive-qualitative methodology was used and face-to-face interviews were conducted.

Sample: A targeted sampling approach was applied; the sample included Native Americans employed at a western reservation casino.

Analytic strategy: Thematic analysis involved constant-comparison through the examination of similarities and differences, and relationships between concepts.

Results: Theme I, Native American Experiences with Nurses and Theme II, Native American Experiences with Other Native Americans. Subthemes offer participant perspectives of the dynamics within their client/nurse interactions. Participants offer advice to both nurses and other Native Americans that promotes mutual understanding and respect.

Conclusions: Becoming a culturally competent nurse is a complex developmental journey. Four implications are offered. First, nurses can feel confident doing what they do best; valued nurse attributes and behaviors are being taught and practiced that are foundational for cultural competence. Second, within the context of a population-health focus, consider individual preferences and beliefs. Third, empower Native American self-advocacy. Lastly, disrupt racism at the relationship level by seeking cultural humility and practicing critical self-reflection and dialogue.