This article explores relationships between rural nurse cultural self-efficacy and job satisfaction using an online survey of 104 rural nurses in the Northwest. The authors found that self-efficacy was associated with personal characteristics: rural lifestyle and job satisfaction. Nurses who were older, experienced, and with urban backgrounds reported more efficacies when caring for people of different ethnic or racial backgrounds, preferences, and health conditions. Nurses with high cultural self-efficacy expressed intention to leave employment. Rural background nurses expressed the most job satisfaction. The authors conclude exposure to diversity may increase cultural self-efficacy.