Culturally Competent Care for Mexican-Americans
Terry A. Stevens
Grand Canyon University: NUR 502- Theoretical Foundations for Nursing Roles and Practice
January 13, 2016

Culturally Competent Care for Mexican-Americans
For centuries nursing has been a dynamic, this is constantly evolving and adapting in response to a wide range of stimuli. A recent circumstance that has influenced nursing considerably is the consumer mandate for culturally competent care in an increasingly diverse, multicultural society. Although Euro-American culture has reign superior in the United States, the nation has shifted to a conviction where various ethnic, racial, and religious groups thrive in a single society. As a result, the importance of culturally competent care and understanding cultural differences is crucial for the nursing profession. This manuscript focuses on the Mexican-American culture. This particular culture was selected because Mexican-Americans represent the largest and fastest-growing minority population in the United States (Eggenberger, S.K., Grassley, J. & Restrepo E., 2006). Furthermore, Spanish is the second most commonly spoken language in the United States. The prevalence of the Mexican-American population suggests the need for nurses to become more accustomed with Mexican-American culture and values. The purpose of this document is to promote nurses’ awareness of culturally constructed concepts of the Mexican-American culture in order to provide culturally competent care for this particular group.
Summary of Article Between 1970 and 1980, the Mexican-American population nearly doubled, and then between 1980 and 2000, the number of individuals in this group residing in the United States nearly doubled again (Eggenberger, S., Grassley, J. & Restrepo, E., 2006). This data demonstrates the considerable increase in the Mexican-American population which then provides a reason for why nurses should become quite familiar with the Mexican-American culture in order to deliver culturally appropriate and competent nursing care (Eggenberger, S., Grassley, J. & Restrepo, E., 2006). Becoming culturally competent has been described as a process where a nurse continually strives to effectively deliver care within the cultural context of an individual, family, or community by seeking cultural awareness, knowledge, understanding and skills (Eggenberger, S., Grassley, J. & Restrepo, E., 2006). Culture has a crucial influence on the development of self identity and personality on an individual. It consists of norms and values that help govern a person’s thoughts, feelings, and actions. Acknowledging and comprehending the importance of culture and its supplements supply guidance for nurses when caring for an individual, family, or community. In 1991, registered nurses Joyce Giger and Ruth Davidhizar presented the Transcultural Assessment Model, which is a useful assessment tool in analyzing cultural differences and their effects on health and behavior. This tool helps nurses provide culturally competent care. Results from Transcultural Assessment Model specifically in regards to the Mexican-American patient, suggest that nurses must develop a trusting bond based on the understanding of the cultural existence of social organization and environmental control. This awareness is known as being at the heart of cultural competence (Eggenberger, S., Grassley, J. & Restrepo, E., 2006). Social organization is the structure of a culture and displayed patterns of relationships between individuals in a particular group. It has been empirically proven that family is a significant social organization system in the Mexican-American culture (Eggenberger, S., Grassley, J. & Restrepo, E., 2006). In Mexican-American culture, family serves as the foundation of the society. Mexican-American families stress unity and loyalty among family members. Mexican-American families tend to form strong ties among nuclear and extended family members. They receive support from each other during daily situations and occasional calamities. Although strong family ties provide many benefits, substantial family support may result in the lack of searching for professional health care outside of the family. Mexican-American families often depend on the daughters for aid when enduring health complications. The male in Mexican-American culture is often recognized as the head of the household. The female is often recognized as the glue that keeps the family together and teaches the young of the norms and values of the culture. A common complication that is linked to the role of male superiority and submissive behavior by the female in Mexican-American culture is family violence, a significant concern for nurses. However, recent studies have shown that more Mexican-American women are acquiring the position as the authority in the family. The role of the male is to be the provider and judge in decision-making. The role of the female is to nurture and maintain the health and well-being of the children. Environmental control evaluates an individual’s awareness of the effects of nature and specific aspects of the environment placed on the lives of people. Specifically for the Mexican-American culture group, investigating health beliefs, folk medicine, and locus-of-control are crucial starting points (Eggenberger, S.K., Grassley, J. & Restrepo E., 2006). Cultural and historical views shape the health beliefs in the Mexican-American culture. Mexican-Americans tend to believe good health is a reward or simply luck, whereas problematic health is God’s way of retribution. Some Mexican-Americans believe that health is portrayed by one of four categories: hot, cold, wet, and dry. According to this conviction, a health complication that is categorized as hot or dry should be treated with something cold or wet. Mexican-Americans tend to use traditional medicine during minor health inflictions as an alternative to professional healthcare. The folk remedies in Mexican-American culture are originated from the Roman Catholic Church and Mexican Indians (Eggenberger, S.K., Grassley, J. & Restrepo E., 2006). These remedies include herbs, amulets, and rituals. Roman Catholicism is the prime religion practiced in the Mexican-American culture. Spiritual and religious beliefs considerably impact the health and illness practices of the Mexican-American culture (Eggenberger, S.K., Grassley, J. & Restrepo E., 2006). Many researchers propose that Mexican-Americans have an external locus-of –control because many Mexican-Americans believe they have no control over their health. They believe God is in control of everything and decides the ultimate health status of an individual. Locus-of-control can effect both prevention and treatment measures. Since many Mexican-Americans have an external locus-of-control, they do not attempt to make personal decisions that will lead to a healthier lifestyle. They are less likely to seek healthy routines and professional healthcare.
Application to Practice When caring for a Mexican-American patient, the nurse should take into account a few cultural standards to provide culturally congruent care. The nurse should meticulously focus on communication. Communicating effectively to the patient will increase the chances of an optimal outcome. Nurses should provide oral and written notices and signage to clients in their primary language, including the right to an interpreter at no cost and ensure the language proficiency and skills of the interpreter (Barker, A.M. & DeNisco, S.M., 2013, pg. 483). Communication involves assessing, comforting, and teaching. When assessing a Mexican-American woman who appears brutally beaten and apprehensive, the nurse should consider the role of male dominance in Mexican-American culture. Family violence is a common issue in this culture. The nurse should speak with the patient unaccompanied by her husband to evaluate if the brutal condition is due to domestic violence or to some other reason. When comforting a Mexican-American patient, it might be suitable to remind them of their family or enable family members to come and provide support because family holds special significant value in the Mexican-American culture. It might also be appropriate to comfort the patient with God, since God controls every outcome in this particular culture group. When teaching a Mexican-American patient of the ways to reach optimal health, it is imperative that the nurse makes it clear that in order to obtain optimal health, it will take deliberate personal effort. Since many Mexican-Americans have an external locus-of-control, it is best for the nurse to assume the patient will not know how to personally contribute to moving towards a healthier lifestyle. The nurse must be clear and precise when informing the steps the patient should take towards recovery, and then reiterate that the patient’s own actions has the biggest impact on his/her health. Nurses should also make accessible patient education and other materials in the language of the predominant group in the relevant service area (Barker, A.M. & DeNisco, S.M., 2013, pg. 483).
Conclusion
The current patient population comprises of a wide range of lifestyles and is multicultural, multiethnic, and multilingual. Many patients might not read, write, or speak in English. They might be without health insurance. They may be immigrants, refugees, undocumented workers, or simply residents that have not yet familiarized themselves with the ideology of Western dominance and lifestyle (Barker, A.M. & DeNisco, S.M., 2013, pg. 482). Cultural sensitivity in communication is vital for the nursing profession because nurses experience different cultures daily. It requires nurses to meet the cultural, social and linguistic needs of the patient. Generally, cultural sensitivity in communication and providing culturally competent care is important because culture shapes self-identity, personality and perception in an individual. In the nursing profession, a patient-centered approach is taken for the restoration and maintenance of health. The nurse’s primary commitment is to the patient. To better assess, comfort, diagnose, treat and teach the patient, the nurse must be culturally competent. Being sophisticated of the cultural concepts and then incorporating this knowledge with the care provided will result in comfortability for the patient. Patients listen and respond more favorably in a comfortable predicament. Providing a more comfortable state for the patient leads to many benefits such as minimal length of stay and optimal health outcomes. Cultural sensitivity in communication can also contribute to the expulsion of ethnic and racial health disparities. Cultural sensitivity is definitely vital when communicating to a Mexican-American patient. Mexican-Americans are now the largest minority group in the United States, which prompts its culture as being one of the most prevalent cultures in the United States. Cultural sensitivity is crucial when communicating to a Mexican-American patient because in the Mexican-American culture, professional healthcare is not a priority. They tend to believe their fate is out of their hands, and so they will do nothing to promote a change or maintain health. If nurses are not aware of this fact and other cultural differences mentioned previously, Mexican-Americans will not feel the need or possibly feel comfortable to seek for professional care. It is the responsibility of the nurse to provide culturally competent care to ensure positive experiences and health outcomes for patients.

References

Barker, A.M., & DeNisco, S.M. (2013). Advanced practice nursing: Evolving roles for the transformation of the profession (2nd Edition). Boston: Jones & Bartlett. ISBN 13: 978-1-4496-6507-7
Eggenberger, S., Grassley, J., Restrepo, E. (2006). Culturally competent nursing care for families: Listening to the voices of mexican-american women. OJIN: The Online Journal of Issues in Nursing. Vol. 11 No.3.