First, hello to all

[ismnotwasm]

I'm very happy to see this group up and running, and I have a favor to ask
I am a white woman who despises racism whenever I see it, but I do take the time to root it out in myself first.

I'm also a nurse who works in a state teaching hospital

The favor:
We often have patients who are Latinos who may or may not speak English. Sometimes English is limited. Often, in fact usually, there is family there to help out with interpretation. As well as provide support.

My hospital makes an effort to train their employee's to be "culturally aware"-- a wonderful idea, which doesn't always pan out in practice. We do have interpretors when needed. I have from time to time, been bitterly disappointed in what I felt to be the lack of proper communication to my patients.
As a nurse, I'm also an patient advocate and what I would like from my fellow DUer's are any what we call "cultural cues" Any Latino culture. Our hospital on-line information is generalized, and therefore impersonal and not correct for all cultures. I guess what I'm asking for if there is anything I can do or say to be a better nurse, a better health care advocate.

Anything will help-- from general info to personal stories. I'm open for any information people are willing to share. If it's ok, I may come in from time to time to ask something a little more specific.

Congratulations on this new group and I know it's going to rock!

[EFerrari]

1. Hi there! I guess I could be more helpful if you could be more

specific as to context. Are you talking about interviews or bedside care or -- there are so many.

In general, I've noticed that it's highly impolite in many Latino cultures to say "no" directly. That should be a good start for you. :)

[Cybergata]

2. Latino Culture is a board term

Where is your hospital, and do you know what specific group of Latinos you are dealing with?

[ismnotwasm]

3. I kept it general because we get patients from all over

(Sorry for not getting back to this earlier.)
South America as well as Mexico. I'm in Seattle. My problem is not always race specific, I find lack of communication a huge problem with any patient in Heath care.

Specifically, I could start with Mexico. Family dynamics, the best way to approach a patient, modesty issues for men and women. I know a bit about culturally alternative medical approaches. Religion. We have on call chaplain services 25/7. They are very under-utilized.
If I thought a patient was depressed, because of a lengthy illness and possible prognosis, what would be the attitude toward what we call "a psych consult?" I step cautiously around this area, because I'm not sure if it would be considered an insult. Or rejected out of fear. I know many people would prefer not to take anti-depressants, and that's usually what ends up happening--The docs prescribe them.

Pain. This is a big issue with me-- I don't like seeing my patients in pain as a general rule, I find Hispanic males a bit stoic in this area. What would be the best approach to getting an accurate pain level? What would be the best way to explain pain management? Generally we tell patients not to let their pain get out of control because pain medication isn't as effective once the levels are high.
I'm a pretty good communicator, but I've seen some of these guys in agony before they agree to take anything.

One of the ideas I've had is to have a check list of problems that may come up and bring them up with an interpretor, but some things are considered very private, so I'm not sure of that either.

What is the general attitude toward dying? I work on a transplant unit, but we get a lot of surgical overflow so we have all sorts of end-stage or potential end-stage conditions. If a family from Mexico is facing the eventual death of a loved one, especially if it's going to be in the hospital, how would my role as a nurse work best? (I'm talking more as a supportive person, not medicines and dressing changes)I have a lot experience in this area, and it's a profound, life-changing experience. Some cultures I provide privacy and intrude as little as possible, The average white American tends to need a lot of reassurance. How is grief expressed? Is it private? I had a patient, a young man from Mexico one time who was going to die, (not in the hospital) but didn't seem to understand. Maybe, like a lot of people he wasn't ready to accept it. Some things are universal.

Anyway that's a start. I know there are wide cultural differences. I need to be careful because of privacy laws, but frankly I don't like the way Latino immigrants are treated sometimes. Especially if they are on Medicare funding. Which is one of the reasons I started this thread.

[Cleita]

4. In many cultures calling in the psych consult would be considered

crossing the line unless you were a personal and close friend. Mental health is considered a private family matter. It would be better to call a priest or chaplain of thier faith first who could talk to them and their family members. The priest then could suggest counseling for the patient to family members. The thing is to keep it very private.

Latinos of all cultures are very closely knit to their families. They understand death, I believe, better than Americans do, because most families look after their elderly at home so they are familiar with the grandmother and grandfather dying while very close to them. I believe the key in life and death situations is to get family involved. They know what to do.

I think you need to identify translators in your hospital setting. My mother worked at the Jules Stein Eye Clinic at UCLA and was utilized as a translator as were many bilingual hispanics working in the Medical Center. I myself as an office worker in Medical offices was often asked to interpret for a patient that didn't speak English.

Communication is important and I'm sure you will find many bilingual workers in your hospital. If not maybe they are deliberately not employing hispanic employees and that should be looked into as well.

[demosincebirth]

5. Much respect is given to those who, even, attempts to learn

their language.