What are the healthcare beliefs of Mexican American/Hispanic culture? 
How do nurses provide healthcare to Hispanics.  How are nurse looked
upon by Mexican American/Hispanic culture in assisting with healthcare.

trendsrn,

Before I get into the “factual” aspect of your question, I’d like
speak about my own experiences on this topic. Having worked with
migrant families as a health care worker for almost 30 years, I feel
very familiar with all aspects of Latino healthcare. Many of my
friends and neighbors are Latino, as indeed my own two daughters. (My
daughters tell me I am Latina by proxy!)

Mexican-American and Latino (Hispanic) culture is a very broad topic.
Beliefs vary from country to country, even region to region within the
same country. Without intending to generalize, I’ll lump my examples
into one “tamale pot”

Mexican culture is a rich mixture of indigenous, Spanish and African
influences and myths. Folk medicine and belief in curanderos (medicine
man, shaman) is common, particularly among the lower-income/less
educated families, although I have seen highly educated Latinos who
are unable to leave their traditional practices behind. Mexican herb
shops -- “hierberias”, and curanderos  abound here in Phoenix.

Even though they ALWAYS call me when one of them is ill, my Mexican
neighbors  rarely do what I suggest; such as eat a Popsicle or Jello
to ease a sore throat. Tying a scarf around the neck, putting an egg
under the bed (to draw away the cause of the illness), and men not
shaving while having a cold/sore throat are the “remedies” my
neighbors utilize.
Some Latinos will blow cigarette smoke into the ear of someone with an
earache.


My own in-laws firmly believe that eating black pepper will cause a
urinary tract infection. (I never saw a pepper shaker next to the salt
shaker in Caracas, Venezula). They also place a damp cotton ball on
the forehead of  a hic-cup sufferer. In some regions of Mexico, a RED
string on the forehead is used in place of the cotton ball.

Many Latinos I know will not bathe for an hour after eating a meal. (I
believe this myth, as do many, evolve from a misinterpretation of
languages. The word for “To bathe” and “To swim” are the same word in
Spanish – baņarse).

My friend Rosa believes that EVERYONE in the house MUST gaze upon a
newborn baby, or the baby will suffer “mal de ojo”, --- evil eye! She
was also very upset when she saw me lightly tickle my 9 month old
granddaughter, saying it would cause her to be “loca”…crazy. Ay, Ay,
Ay.

While cotton balls and red threads are harmless, many folk remedies
are actually harmful. In Mexico, a powdered remedy for diarrhea is
sold in a small package, similar to a Kool-Aid package. It DOES cure
the diarrhea, but it contains a large amount of lead, whicj causes
brain damage!

While very frustrating for a health care worker, I try to take these
cultural differences into consideration. Lack of education, lack of
resources,  lack of  medical services, strong familial traditions and
indigenous (Mayan, Aztec, etc.) influences  have promoted
misinformation and poor health care in Latin American countries. The
same practices have followed immigrants to the US. In the US, Latinos
may get substandard health care due to language barriers, racism, and
lack of insurance.

The digital divide affects how Latinos get health care information.
You and I can look up almost any topic and learn more about it, but
many Latinos don’t have internet access, and televison is often
limited to one or two channels, if at all.

Nurses and other medical personnel are respected and almost revered by
the Latinos I have dealt with. When in the ER or doctor’s offices,
most Latinos will not reveal to the medical staff that they have used
the services of a curandero, or taken herbal remedies, for fear of
criticism. The patients I have dealt with will listen intently when
given discharge instructions, but it is common for the instructions
not to be followed, as evidenced on return visits. I was always
treated with the utmost respect by Latino patients I dealt with. I was
always refered to by the formal "You" - "Ud.". and while I did care
for it, doors were held for me, and the patients would become very
subservient.

Nursing care can be frustrating and rewarding  when caring for Latino
patients. If the patient speaks no English, the treatment can be
treacherous. I was called into the ER one time to interpret for a
patient. The ER nurse had asked the patient to collect a stool sample
in a small cup. Since the patient did not understand English, the
nurse looked up “Stool” in a Spanish-English dictionary. The patient
was, according to the nurse, uncooperative. The nurse had found the
word for a stool for sitting, not bodily excrement!
Another time, I was called to help a hysterical woman. The nurse had
called in a housekeeper to interpret. The housekeeper barely spoke
English, and told the patient they were going to remove her kidneys!
In fact, it was to be a routine gall-bladder operation.
Another, potentially fatal, incident occurred when a Latina woman came
in the ER as an overdose patient. She had a package of medicine from
Mexico with her. ER staff ordered a test for Tylenol overdose, and
when the lab results showed no Tylenol, re-ordered it. As I was
passing through, a nurse asked me to speak to the patient. I did, and
asked to look at the medicine package she had brought in. It was
aspirin, not Tylenol. (Both have their own overdose problems, but they
are different). The Mexican package had the chemical name for aspirin
on it --- acido acetosalicilico. When the nurse read “acido” it was
misinterpreted as acetominophen-or Tylenol. These kinds of errors are
rampant when language is a problem.

Yet another impediment to quality health care for Latinos is
occasional racism and  xenophobia . Fortunately it does not happen
regularly, but it does happen. Many Latino patients don’t have
insurance or primary care physicians, and ER staff often get annoyed
with the abuse of ER services and the burden on public assistance
health care. (I am not opining here, merely stating what I have
experienced)

Hospitals here in the US have made great strides in the last few years
in trying to provide adequate health care to Latinos. Many hospitals
now have full time interpreters. I have been on the Language Bank for
medical interpreters for years…..we get called as needed from our
regular duties. A drawback of having an interpreter is that the
provider begins having the discussion with the interpreter not the
patient, and at times never even looking at the patient. Medical
terminology classes are available for health care workers, and most
ERs now have plenty of Spanish-English dictionaries, although they
must be used with caution.

For “factual” reading, visit these sites:


Understanding Hispanic health practices:
http://ohioline.osu.edu/hyg-fact/5000/5255.html


From an EMS site, a great article discussing Mexican-American health
beliefs:
http://www.merginet.com/emsnewsfiles/275_Bryan_E._Bledsoe_20020707.shtml


This website briefly identifies a few traditional cultural beliefs:
http://www.graduateresearch.com/kurzon.htm



National Alliance for Hispanic Health
http://www.hispanichealth.org/

http://www.chenowith.k12.or.us/tech/cgcc/projects/gabay/site/HETC/cultural-competency.htm

http://www.williecolon.com/health/latinohealth.html


If this answer is not clear to you, please ask for a clarification.

Adios,
crabcakes

This answer was more than I hoped for when I submitted my question. 
The personaliztion was an added bonus!  Having done some research for
a paper on this topic, I knew these answers were accurate and I look
forward to sharing them with my nursing colleagues.  Thank-you
crabcakes for your outstanding help from a very tired RN!