Cultural Competency Cultural Care

A Hispanic American Running head: A HISPANIC AMERICAN CULTURE

A Hispanic American culture Hemant Sule RN to BSN Presented to Dr. Leslie Paternoster In Partial fulfillment of NURS360 Health Assessment Eastern New Mexico University February 5 2009

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A Hispanic American culture Introduction As a health care provider, we must be aware of the cultural values, believes and perceptions of the individual we treat. Cultural awareness occurs when we take into account these entities. Cultural awareness becomes central when we have to interact with people from other cultures. What is considered an appropriate behavior in one culture may be inappropriate in another one. Attempting to understand others culture through one’s own can lead to fundamental misunderstandings. According to Jarvis (2008), development of cultural care is mandated by government for cultural competency. It is a concept that describes professional nursing and medicine that is culturally sensitive, appropriate and competent. (p. 38). Culture refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. Competence implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities [Based on Cross, Bazron, Dennis & Isaacs (1989).Cultural awareness helps us to explore cultural issues with our care recipients more sensitively. Culture itself is a fluid entity, undergoing transformations as a result of globalization and migration. The purpose of cultural awareness is to know our own cultural influences. We can understand that the behavior and beliefs of people within each culture can vary considerably. We can increase our knowledge about different cultural practices and issues through cultural background information sessions and resources and cultural awareness training. We can understand that the extent to which people adopt practices of their new country and retain those from their cultural background can vary within communities, even within families. I interviewed Mr. Armando Romero, a nurse who is

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Hispanic, he works with me. The interview occurred on the job. I interviewed him because he is a strong believer of values and morals. He is energetic and always pleasant to everybody. I am Hindu and would like to know about a Hispanic culture. According to Galanti (2003) Hispanics are the largest growing minority in United States. Discussion The person from my interview is from a Hispanic American Cultural background, an interesting personality. Having dual cultural back ground, gives him a versatile advantage to assimilate more fluidly in the society and friends. He believes that today’s American culture is a congregation of many different cultures. The American culture is of believer of freedom and independence. Being bicultural, it is not very difficult for him to live within American culture. He believes that western medicine is good and it does help, but it does not help with everything. He believes that his cultural values and believes are purely religious and based on teachings of bible. His view of the health care providers is that they try to do the best within given circumstances and try to help the people. He stated that he would pray to god, ask God to help his body, and use herbal remedies before seeking medical attention, but, he will treat himself with western medicine in the end. He mentioned that he will not mind to go to any care provider if he needs to see a doctor, although, he prefers to be seen by a specific care provider because of a previous relationship or experience with him or her. He prefers to be seen by a MD, rather than a nurse practitioner. He trusts the care providers and the current health care system. His points of stress in the health care are slow process and long waits. And if those are controlled then his point of stress is to not being able to control his sickness. When asked to compare his cultural believes and values with the society in which we live, he replied that people don’t base their values and beliefs on bible. In the post modern era society does not believe in absolute truth. They are relativistic. What is right for them is right for

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them. People come up with their own value system. He believes that in bible, god has defined what is right and what is wrong. He firmly believes that reading bible, and through prayers, the god transforms him and gives him a life that is pleasing to the god and that makes him more compassionate. (A. Romero, personal communication, February 4, 2009) He believes that we have god’s sprit in us and makes us work the way god wants us to be. His perspective is that god is real and he shapes his life all the time. He confirmed that he is not superstitious but he is pragmatic. He said that his grandmother mostly followed the curandero who performed certain religious ceremony to cure a disease, but he does not believe in that practice. He mentioned that the curandero would rub a raw egg on the child’s belly to cure an abdominal pain. If the egg cracks open and a bunch of hair comes out from the egg, instead of the yolk, it would be considered a successful treatment. He had seen a curandero rubbing a potato soaked in vinegar to help reduce fever. He does not remember if that worked. (A. Romero, personal communication, February 4, 2009) He was born in Albuquerque, NM: His father was born in California, mother in Albuquerque, NM. His maternal grandfather was born in Albuquerque, NM, and maternal grandmother was born in Bernalillo. His paternal grandfather was born in Mora, NM and paternal grandmother was born in Mexico. He has never visited his paternal grandmothers’ house despite visiting Mexico. He has one brother and two sisters. He grew up in an urban setting, in Duranes. His paternal grand mother grew up in Mexico and moved to USA as child, but the rest of the family mentioned above grew up in USA. He lived with parents and keeps in touch with all the other family members, like aunt, uncles and cousins, brother and sisters. Fortunately all of them live in Albuquerque and he visits them weekly. His original family name used to be “Abeyta” but now it is “Romero”, and he does not know why and how it was changed. (A. Romero, personal communication, February 4, 2009)

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He is a protestant Christian. His spouse is from the same background and same religion. He went to public school. He does not know the details about the religious and ethnic background of his neighbors. His religious institution is Protestant church. And he is an active member of it. He attends the church every week. He said he does practice religion at home like praying, bible reading and celebrating religious holidays. Mexican/ Hispanic posole, tamales, tortillas, beans, rice and chilies are the ethnic foods that are prepared at his home and holiday celebration is the ethnic activity that he participates into. Some of his friends are from similar ethnic back ground. Most of his friends are from the similar religious background. His native language is English, although he speaks fairly good Spanish. He speaks and also reads Spanish. He regularly participates in social activities with members of his family and has many friends from similar cultural background as he is. He enjoys eating the traditional family foods. And he also participates in religious traditions of the family. (A. Romero, personal communication, February 4, 2009) Regarding Christianity he explained me that there are two main streams: Catholic and Protestant. Protestants follow the Old and New Testament only .Whereas the Catholics follow some extra books from the ancient culture in addition to Old and New Testaments. The word Protestant was derived from protest meaning protesting the Pope. The Pope is not a leader of Protestant church alike Catholic churches which have Fathers who follow the Pope and guide people. The Protestant churches are small localized self governed entities. He said the that the difference between the two Testaments is that the Old Testament says that the Jesus is going to come and the New Testament says that He has come and he is going to come again. So the New Testament talks about resurrection of Jesus Christ. (A. Romero, personal communication, February 4, 2009) Conclusion

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The process of interview, readings from the websites given in the book and online versions of the books from the bibliography helped me understand the aspect of cultural competence. According to Jarvis (2008), cultural competence involves soul searching about my own heritage and health. When I care for an individual or family of this Hispanic American culture or other cultural heritage, it is important for me to remember that I am learning the modern, scientific meanings of health and illness and at the same time I am developing a frame of reference as to the traditional believes and practices relevant to these concepts. As a health care provider it is important for me to remember: the differences amongst people of different racial and ethnic background, differences in style, method and meaning in communications even where the dominant language is being used well, different belief systems will challenge firmly held western beliefs inculcated through years of professional development and different levels of trust in where individuals have come from countries where authority figures have misused their positions. Respect in that some cultures will so respect a clinical authority figures that they will agree with the clinician and seek to provide ‘acceptable’ answers. (Meyer, 1996).

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References Cross, T., Bazron, B., Dennis K., & Isaacs, M., (1989). Towards a culturally competent system of care volume I. Washington, D.C.: Georgetown University Child Development Center, CASSP Technical Assistance Center) Retrieved from http://www.omhrc.gov on February 2, 2009. Galanti, G. (2003, July).The Hispanic family and male female relationships: An overview. The Journal of Transcultural Nursing, 14(3), 180-185. DOI: 10.1177/1043659603253548 Jarvis, C. (2008). Physical examination and health assessment. Missouri: Elsevier Meyer CR. Medicine's melting pot. Minn Med 1996; 79(5):5