Caring for Cuban, Amish, & Irish Populations

Full Answer Section

         

• • Potential Differences: These patients may have better access to healthcare due to socioeconomic stability. They may hold strong anti-Castro political views that can be a source of stress or identity. They may be less fluent in English but have a high degree of acculturation to the Miami-based Cuban-American community.
• Second Wave (1965-1974): The "Freedom Flights" brought a more middle-class, working-family demographic. While still political refugees, they had fewer resources than the first wave.
  • Potential Differences: They are also highly acculturated to the established Cuban-American community and are generally well-integrated into the U.S. socioeconomic system. They may have a strong sense of community and family support, which a nurse should recognize as a key resource in their care.
• Third Wave (1980): The "Marielitos" were a more diverse group that included many working-class individuals, some with mental health issues or criminal backgrounds who were released from Cuban prisons. They were met with more negative public perception and faced significant stigma.
  • Potential Differences: These patients may have experienced greater trauma, which can manifest in physical and mental health issues. They may face socioeconomic barriers and have less trust in U.S. institutions, including the healthcare system. A nurse must approach their care with a trauma-informed lens.

 

2. Making Hospital Care Culture-Specific for an Amish Client

  A nurse can take several actions to provide culture-specific care that respects the values and beliefs of an Amish client, whose life is centered on community (Gelassenheit), modesty, and a rejection of modern technology.

• Respect Modesty and Privacy: The Amish place a high value on modesty. A nurse should:
  • Provide same-sex caregivers whenever possible, especially for personal hygiene and intimate examinations.
  • Ensure the client is always adequately draped during examinations and procedures.
  • Knock before entering the room and respect their need for privacy.
• Facilitate Family and Community Support: The Amish community serves as the primary support system. A nurse should:
  • Understand and allow for a large number of visitors, as family and community members will want to be present and provide care.
  • Recognize that family members may want to participate in the care plan, and respect their role as decision-makers and support providers.
  • Ask if the client would like a community elder or bishop to be informed of their hospitalization.
• Mindful Communication and Technology: The Amish are not against modern medicine but may be unfamiliar with certain concepts and technologies. A nurse should:
  • Use simple, clear language and avoid medical jargon.
  • Explain the purpose of all medical equipment and procedures without assuming prior knowledge.
  • Respect their choice to not use hospital phones, televisions, or computers.

 

3. Etiological Reasons for Alcoholism in an Irish-American Family

  The development of alcoholism within an Irish-American family can be attributed to a complex interplay of both historical-social and genetic factors.

1. Historical and Social Context: The first etiological reason is rooted in the historical experience of Irish immigration to the United States, particularly during the 19th century. Facing extreme poverty, discrimination, and cultural alienation, the pub became a central social hub and a coping mechanism. It was a place to find community, employment, and temporary escape from the hardships of their new life. This historical context established a strong cultural association between heavy drinking and social bonding, celebration, and coping with adversity. This generational norm can normalize excessive alcohol consumption, making it an accepted and ingrained part of family and community life.

Sample Answer

       

Differences Affecting Cuban-American Patients Who Immigrated at Different Times

  The Cuban-American population is not monolithic; its health status, beliefs, and acculturation are deeply influenced by the historical context of immigration. A nurse must be aware of the distinct waves of immigration to provide culturally competent care:

• First Wave (1959-1962): Often referred to as the "Golden Exiles," this group was primarily composed of the professional, educated, and wealthy class who fled Castro’s revolution. They were political refugees who often arrived with resources and were actively supported by the U.S. government.