reply1

The Haitian culture is a mixture of African, Spanish, and French influence from the colonization of Haiti and the transport of African slaves to the Caribbean island. Many Haitians sought asylum in the US in the 1970s when large-scale refugees migrated to the US in an attempt to escape Jean-Claude Duvalier’s dictatorship and the economic hardships that resulted. (Girault,2020). Many Haitians have settled in the United States blending in the cacophony of American life; many occupying jobs in varying positions of life including leadership positions in Healthcare, industry, and journalism. I have worked with many Haitian health care providers and have interacted with many of them as patients. Their culture is fascinating with the majority practicing Catholics with a mixture of spiritism called Voodoo a religious cult with roots from West African religions. (Girault, 2020). The major language spoken is French Creole and although the younger Haitians endeavor to learn English and get an education in this country, many of their elderly parents retain their unique traditions. Many individuals who migrate to the United States from other countries cling tenaciously to their traditional cultural practices and languages resulting in a phenomenon called multiculturalism. (Catalano, 2006).

Effective communication with the Haitian patient means assessing the patient’s ability to communicate fluently in English and may require using a professional interpreter preferably a health professional. I remember trying to teach an elderly Haitian woman deep breathing exercises to relieve stress because she was demonstrating symptoms of anxiety that were exacerbating her Chronic obstructive Pulmonary Disease (COPD) and although I used an interpreter she refused to follow the instructions. After speaking extensively with one of her family members I realized that the patient believed that her anxiety and depression was caused by an evil spirit that she thought could not be treated by modern medicine and her condition could only be improved with the help of a voodoo priest. A family member was allowed to bring a voodoo priest and the nursing staff gave them the privacy to carry out their rituals. Family is very important to the Haitian Culture and should be a part of the decision making process. As clinicians, we need to be sensitive to the root causes of health problems from the patient’s and family’s perspective and accommodate their religious beliefs as long as it does not interfere with medical treatment or cause harm to the patient. What was surprising to me and the other nurses was that she appeared calm a long time post ritual and did not appear to need her prn anxiety medications. Instead, she had several sacred items positioned around her bed which appear to provide her with comfort.

Lack of knowledge or understanding of cultural differences or unwillingness to accept the patient’s alternative beliefs, values or attitudes can lead to the inability to empathize or to respect the patient’s point of view and can jeopardize the nurse-patient relationship. Falvo, 2011). Open communication with the patient and the family members can cue the health professional to potential barriers to learning and assist in developing appropriate strategies to deal with them. For the elderly patient, health teaching materials should be in large print, colorful, and written in the patient’s language in simple layman’s terms.

References

Cataldo, J. (2006). Nursing now! Today’s issues, tomorrow’s trends. Philadelphia PA: FA Davis Company.

Falvo, D. (2011). Effective patient education. A guide to increased adherence. https://viewer.gcu.edu/RQBKXW

Girault, C. (2020). Haiti. Retrieved from. https://britannica.com.com/place/Haiti

reply2

I have personal experience with being a part of a culture that has specific values and beliefs. I am Russian and Armenian and can speak fluent Russian. I always took pride in that, however, it was difficult to balance the “American culture” and staying true to my roots. During nursing school, I had the experience of caring for a Russian patient and witnessed the importance of acknowledging the patients culture, values ad beliefs while caring for them. Russians highly respect and trust health care professionals. Health care professionals can present patient education by making direct eye contact, being firm and respectful and using “Mr.”, “Mrs.”, or “Ms.”. Russians are very big on respect, so there must be mutual respect from the patient and the health care professionals. One thing to remember is that Russian patients tend to have a high pain threshold and can present stoic regarding pain and care. Health care professionals can address this by using any evidence that presents the patient is in pain and reminding them the importance of staying comfortable during their stay. The Russian language, from an outside perspective, can sound very harsh and loud, so health care professionals should remember that this doesn’t necessarily mean that the patient is not happy or in distress, it is just a part of the Russian language. Lastly, Russian culture is all about family. Health care professionals should involve family members in the patients care and all patient education.

When I had the Russian patient, we were able to communicate very well because I happened to speak Russian and practice the culture. My preceptor, however, did not have the same experience. I think it was difficult for my preceptor to understand the culture at first because the patient heavily relied on her daughter for everything during her hospitalization. As well as not eating the hospital food and solely eating the food her daughter brought her. My preceptor made a comment how the patient was “harsh and rude”. It was a good learning experience for her because I explained the Russian culture to her. I reminded her that children are expected to care for their elderly parents, which is why the patient was so heavily dependent on her daughter for everything. Elderly Russian women are very stuck in their ways and are not good with change, which is why she requested meals from home. Lastly, I reassured my preceptor that her tone may seem harsh and rude, but that is just the culture and the accent. After giving my preceptor insight on the Russian culture, it made her day much easier because she had more understanding of why the patient was the way she was. Ultimately, as nurses we must remember culture defines an individual and working in health care we are responsible caring for all types of individuals, which is why assessing our patient thoroughly and educating ourselves are essential in treatment.

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