You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
Incorporate a minimum of 2 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles should be referenced according to the current APA style (the online library has an abbreviated version of the APA Manual).
FIRST REPLY
Caring for African American, Mexican, & Navajo Populations
Gilberto Leon
St. Thomas University
NUR-505
Dr. Derby-Davis
January 18, 2024
The Importance of Folk Medicine Practices and Folk Healers
Cultural relevance and healthcare accessibility are the key factors that make folk healers and folk medicine practices vital. Folk medicine provided African Americans with an alternative form of healthcare when they couldn’t access the mainstream system because they mistrusted doctors, their financial situation, or the prejudice and unfair treatment they experienced across the country. African Americans were hindered from receiving treatment and other healthcare services due to the Jim Crow laws and the Hill-Burton Act, which imposed racial segregation and discriminatory policies. According to Giger and Haddad (2020), the Hill-Burton Act gives public or private hospitals the right to discriminate in hiring employees and treating patients.
Regarding cultural significance, some African Americans preserved their customs (the African cultural legacy) by using folk medicine and seeing folk healers. They were deeply religious and thought that folk healers knew a lot about different kinds of folk medicine that could be utilized to treat various ailments. Even though they have legal access to conventional healthcare, some African Americans still seek the advice of folk healers and utilize folk medicine. They still don’t trust doctors, and the healthcare expense is increasing; therefore, they won’t use the system. Some African Americans assert that they are sick of being treated insensitively and with shame by white healthcare professionals. Even though some African Americans visit hospitals for medical care and prescription drugs, they don’t think the medical staff has more education or experience than them (Giger & Haddad, 2020).
The concept demonstrated by Mrs. M, A Mexican American
The nurse failed to consider Mrs. Ms cultural customs and beliefs, which illustrated the lack of cultural competency in Mrs. M’s case. To deliver culturally competent care, nurses must integrate their expertise, understanding, and interest in their patient’s cultural beliefs with empathy. Better health care and patient outcomes result from a positive feedback loop sparked by cultural competence and increased nursing reputation and trust. By respecting and accepting Mrs. M’s cultural views and values, the nurse was expected to build a rapport of trust and support. Cultural competency changes throughout a nurse’s career and must be developed by practice, motivation, and time (Williams, 2021).
Two Communication Barriers Encountered by non-Navajo Nurses
The primary obstacle to communication is that non-Navajo nurses require assistance in caring for and corresponding with non-English speaking Navajo clients. Therefore, Navajo patients who do not speak or comprehend English need a Navajo translator to get or seek medical care. But since there isn’t a word in English that can adequately describe a Navajo word, the only way to translate a Navajo language into English is by descriptive and interpretive means. Language difficulties can be complicated when giving care because words can be mistranslated, or one could need assistance comprehending the circumstances. It’s essential to use the right tools to prevent mistakes, spend time getting to know your patients, and recognize that first impressions are a chance to build rapport and familiarize yourself (Giger & Haddad, 2020).
The second obstacle to communication is the Navajo practice of kinesics, which forbids non-Navajo nurses and other people from performing specific finger signals or making eye contact with Navajo clients. In Western society, eye contact is important. Therefore, if Navajo clients do not support eye contact when chatting with non-Navajo nurses, it may cause suspicion or concern. On the other hand, the Navajo view making direct eye contact as invasive and impolite (Giger & Haddad, 2020). In conclusion, productive teamwork at work is facilitated by effective collaboration, which improves patient outcomes.
References
Giger, J. N., & Haddad, L. (2020). Transcultural nursing – e-book: Assessment and intervention. Elsevier Health Sciences.
Williams, P. A. (2021). Fundamental concepts and skills for nursing – e-book. Elsevier Health Sciences.
SECOND REPLY
The Module 2 Discussion: Initial Post
Jasmyne S. Moore
St. Thomas University
NUR505-AP2: Diversity in Advanced Health Practice
Dr. Marcia Derby-Davis
Thursday, 18 January 2024
The Importance of Folk Medicine Practices and Folk Healers to African Americans in the Rural Setting
According to Cherry et al. (2021), African Americans from rural areas, especially those raised in the South (and urban ghettos of the North), may have been raised on folk medicine and may not have been seen by physician until adulthood. Growing up with folk medicine makes an individual more likely to seek healthcare from a folk practitioner. Examples of folk medicine (depending on your culture these could be religions or religious aspects) include witchcraft, voodoo, and magic; practices are based on degrees of spirituality (2021). Some members of the African American community still practice their folk beliefs and only seek out formal healthcare providers for prescription medications (2021).
Folk medicine for African Americans perceives illness as a result of natural or unnatural circumstances (2021). A natural illness may be the result of exposure to the natural elements without proper protection, such as pneumonia or the common cold. An unnatural illness may be the result of Gods wrath or the work of Satan, an example of this type of illness is cancer (2021). The three main types of folk healers or practitioners include the old lady or granny, a spiritualist, or voodoo priest or priestess (2021).
The importance of folk medicine and folk healers to African Americans in rural settings is deeply rooted in history. Slaves brought in from African to the Americas and the Caribbean brought African beliefs and rituals that continue to be passed on to this day. Many African Americans in rural areas prefer to see folk practitioners because of the history of discrimination in the South, especially due to the Jim Crow Laws and other discriminant laws that endorsed discrimination against people of color. The Hills-Burton Act of 1946 allocated federal funds to acute healthcare facilities that participated in not servicing African Americans (2021). This practice went beyond discrimination against serving certain patient populations, this also included discrimination in their hiring practices (2021). The practice of discrimination forced African Americans to refer back to their roots and employ folk medicine, the issue of affordable healthcare was also another factor (2021). In these modern times, many African Americans still have distrust of the American healthcare system due to historical discrimination, as well as the dispassionate treatment of non-Black healthcare professionals (2021).
Mrs. M., a Mexican American who just gave birth, tells the nurse not to include certain foods on her meal tray because her mother told her to avoid those foods while breastfeeding. The nurse tells her that she doesnt have to avoid any food and should eat whatever she desires. What concept does this demonstrate?
The nurse is demonstrating ethnocentrism, the tendency to view ones own cultural or ethnic group as superior and to judge other groups based on the values and standards of ones group (Guy-Evans, 2023, p. N/A).
Key points of ethnocentrism include (Guy-Evans, 2023):
Believing that ones own culture or ethnic group is better than others
The perception that the culture of others is of lesser importance
Utilizes ones own cultural norms and values as the standard for comparison
The unwillingness to become educated on the culture of others (because they are seen as inferior)
Has the ability to usher thoughts, feelings, and behaviors of bias, discrimination, and discord amongst cultures
Ethnocentrism is a common phenomenon that occurs mostly because we know our own cultures best and subconsciously measure other cultures to our own. When individuals do something outside of our own norms, we perceive this as taboo, and the individual from the opposite culture naturally does the same. Ethnocentrism can be seen as a negative concept when we as individuals are not open-minded and accepting of others. The concept of ethnocentrism can lead to the distribution of misinformation, contributing to ill consequences (2023).
In the matter of Mrs. M and the nurse, I do not believe the nurse intentionally meant to demonstrate this concept, I do believe her in her eagerness to ensure that her patient is properly nourished to support breastfeeding, she did not consider that Mrs. M is of a different culture than her own. Instead, she should have assessed what the cultural practices are for breastfeeding in Mrs. Ms culture and then provided her with suggestions that fit her cultural practices, as well as ensure her nutritional requirements are being met.
Two Communication Barriers Encountered by Non-Navajo Nurses While Providing Care to Navajo Clients
Two barriers to communication encountered by non-Navajo nurses while caring for Navajo clients includes verbal (spoken language) and nonverbal communication, as well as lack of understanding of the Navajo culture.
The Navajo spoken language is very complex with verbal and nonverbal elements that influence its interpretation. According to Kahn-John (2021), the Navajo language is thought to reflect the concept of the universe that is in constant motion (p. 244). The Navajo language does not always have one word to match an English term, there may be multiple terms for one English word (Kahn-John, 2021). Other characteristics of the Navajo language include interchangeable vowels that contribute to a number of variations and meanings of one word, tone of voice and pitch, touch, silence, and eye contact. All of these factors make it difficult to navigate the Navajo language and culture.
For non-Navajo individuals (and individuals unfamiliar with American Indian cultures), understanding their culture can be difficult. The Navajo culture is deeply family oriented which extends beyond the core family (Kahn-John, 2021). The family structure and role is highly important, the nuclear family is the center of the social organization, to include the extended family. In Navajo culture, to be without family is perceived as poor (Kahn-John, 2021). It is extremely important for the non-Navajo nurse to take time to learn and understand their Navajo clients in order to establish and build a rapport. For nurses and other healthcare professionals wanting to establish trust with their Navajo patients, they should take care to provide care that align with the beliefs and norms of Navajo culture, as well as assess their beliefs concerning illness and wellness. Nurses should also keep in mind that they should advocate for these patients at every opportunity, especially in regard to family presence. Because family is crucial to Navajo culture, nurses may have increased compliance, trust, and communication when family is present.
References
Cherry, B., Powell-Young, Y., & Giger, J. N. (2021). African-Americans. Transcultural nursing: Assessment
and intervention (8th ed.) (pp. 160-207 ). Elsevier.
Kahn-John, M. (2021). Navajos (Diné)a. Transcultural nursing: Assessment and intervention (8th ed.)
(pp. 241-261). Elsevier.
Guy-Evans, O. (2023, December 7). Ethnocentrism in psychology: Examples, disadvantages, & cultural
relativism. Simply Psychology. https://www.simplypsychology.org/ethnocentrism.htm…
THIRD REPLY
Advocacy
Bermadean Mends
St Thomas University
NUR-505-AP2
Dr. Anjelis Oliveira
1/18/2023
Advocacy
Nurses play a vital role as advocates and as a link between patients and the healthcare system. They help patients understand complex medical information and encourage them to participate actively in healthcare. Advocacy is critical to patient-centered care, emphasizing a comprehensive healthcare approach that considers physical and emotional health. Factors (Davoodvand et al., 2016).
As a nurse, I have been a patient advocate in numerous situations where my role extended beyond providing care. Patient advocacy is a critical aspect of nursing, which involves actively fighting for patients, promoting their independence, and ensuring they receive fair and ethical treatment. In my experience, advocacy has played a pivotal role in ensuring patient’s well-being and rights. Empowering patients with all the information they need about their health is essential for healthcare advocacy. I had a patient recently who was diagnosed with cancer. They felt overwhelmed by the diagnosis and did not understand what the doctor was discussing. After a few hours, the patient and family wanted to speak to the doctor again to learn more about the recent diagnosis. The patient was timid and did not want to bother the doctor. That is when I stepped in to explain to them that it was okay to ask more questions if the diagnosis was unclear. I provided them with all the information they needed about the illness, the different treatments available, and the potential outcomes and risks of each. I also asked the doctor to return to the room and speak with the patient and family. With all this knowledge, the patient could make an informed decision about their care. They felt more confident about their decision because they had all the needed information. The outcome was positive, and the patient felt they controlled their healthcare journey. So, by advocating for patient education and empowerment, we can help patients make informed decisions that lead to better health outcomes (Empowering the Patient Voice in Healthcare Decisions, n.d.).
Secondly, as an advocate, it is essential to ensure that patients receive fair and just treatment. One instance that comes to mind was when I witnessed a patient not receiving the care they needed due to a language barrier. I collaborated with the healthcare team to ensure the patient’s needs were met. This involved contacting an interpreter to help the patient voice their concerns and ensuring they had all the necessary resources and support. I also collaborated with the team to develop a plan tailored to the patient’s needs. My goal was to ensure that the patients received the care and attention they deserved, regardless of any language barriers that may have existed. Language barriers in healthcare can cause miscommunication, leading to misunderstandings, medication errors, and other safety issues. Advocating for patients with language difficulties can help reduce medical errors and ensure their safety. (Healthcare Standards Across Language Barriers, 2022). Informed consent is essential when making healthcare decisions. By advocating for patients with language difficulties, we can ensure they understand the suggested treatments, procedures, and potential risks before consenting.
In summary, advocacy is a fundamental component of nursing that involves safeguarding the rights and interests of patients. As nurses, we are privileged to provide care, share knowledge, and support patients as they navigate the healthcare system. However, we are also responsible for advocating for patients, even when it means speaking up against powerful interests or challenging established norms. This may involve securing patient resources, promoting equitable treatment, ensuring informed consent is obtained, and advocating for the patient’s autonomy and dignity. Advocacy is a vital aspect of nursing that enables nurses to act as agents of change, promote social justice, and empower patients to participate actively in their own care.
References
Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016). Patient advocacy from the clinical nurses’ viewpoint: a qualitative study. Journal of medical ethics and history of medicine, 9, 5.
Empowering the patient voice in Healthcare Decisions 01122021 V3. (n.d.). https://impact.economist.com/perspectives/sites/de…
Healthcare standards across language barriers. (2022, September 1). Default. https://med.uc.edu/landing-pages/uccom-tribunal/co…
4TH REPLY
Discussion 2
Amanda Perea
St. Thomas University
NUR 506: Influencing Health Policy
Dr. Oliveira
January 18, 2024
In nursing, advocacy is a large part of the profession. Whether a nurse is in the clinical setting or trying to get policies to pass, advocating for patients is one of the main goals (Chiu et al., 2021). I currently work as a case manager for a health insurance company. I assess patients and their health conditions and am a resource for them to be able to get help. I constantly find myself having to advocate for my patients. My patients are a special group of members that have both Medicaid and Medicare and require us nurses to be their voices to the insurance company.
Advocacy in health policy is when nurses get involved and make a change to the already in place policies and procedures in order to benefit the community (Scott & Scott, 2021). One way this happens in my daily nursing practice is after listening to all the patients and their main complaints, the case managers report back to the insurance company and advocate for our patients. For example, my specific group of patients are from low income families and rely on the extra help the insurance company can provide since they are also struggling with chronic health conditions. After doing the assessments and realizing most of the community needed extra assistance to purchase food and basic needs, the nurses reached out and voiced our opinions regarding certain benefits. We let them know what the patients needed and were able to get the monthly benefits increased. The feedback we have received from this change has been amazing and they are now able to get the basics to survive and have a healthy lifestyle.
Another example of advocacy in my nursing practice is our weekly company meetings where we present difficult cases to an interprofessional group. During these meetings the nurses present certain patients that have multiple chronic conditions, need extra assistance, and have increasingly gotten worse since the year before. These cases are presented to doctors, social workers, pharmacists, mental health professionals, etc. Its all hands on deck in order to see what the next steps are for the patients plan of care. As a nurse, it is our responsibility to present these cases and advocate for our patients in order for them to receive the help they need.
In nursing school nurses are taught that the main goal is to always be the patients advocate especially when they are unable to have a voice of their own. This goes beyond the clinical setting. Nurses need to be aware of the laws and policies that are in place that influence the rules and regulations. Just like technology, healthcare is always evolving and with that so do the policies in place (Chiu et al., 2021). Nurses are the eyes and ears on the ground that have the experience to be able to know what patients need and what health professionals need to be able to provide great quality care. Every nursing position is different and can range from the clinical setting at a hospital working bedside to case management. No matter the position, nurses will always have an influence on these policies that are being made but it is crucial that we actively use our voice to constantly be advocating for what is best for the community.
References
Chiu, P., Cummings, G. G., Thorne, S., & Schick-Makaroff, K. (2021). Policy Advocacy and Nursing Organizations: A Scoping Review. Policy, politics & nursing practice, 22(4), 271291. https://doi.org/10.1177/15271544211050611
Scott, S. M., & Scott, P. A. (2021). Nursing, advocacy and public policy. Nursing ethics, 28(5), 723733. https://doi.org/10.1177/0969733020961823
