Medical- Surgical Nursing 1 Cultural Diversity and Nursing Chapter 6

The Black-American Community

Members of the Black community have their origins in Africa; the majority were
brought here as slaves from the West Coast of Africa. There is a great number of
Blacks who have immigrated to the United States voluntarily - from African
countries, the West Indian Islands, the Dominican Republic, Haiti, and Jamaica.
However, vast majority of the people are the descendants of slaves.

Religion
For many American Blacks, religion is an essential and integral part of life. God is
viewed as the source of both good health and serious illness. Many followed the
Pentecostal movement long before its present popularity, and people had an all
consuming belief in the healing powers of religion.

It is not clear whether voodoo is fully practice today in the U.S., but there is
evidence that there are people who still believe and practice it to some extent. The
current practice evolved from early African rites, to which Christian rituals were
added to form the ceremonies that exist today. Leaders of the voodoo sect tend to be
women, and stories and evidence abound in New Orleans about the workings of the
sect and the women who ruled it.

Many other members of the Black community are practicing Muslims. Religious
believes are important part of the Muslim lifestyle, and health care providers should
be familiar with them.

Health practices
Many of the preventive and treatment practices have their roots in Africa, but have
been merged with native American to whom the Black were exposed and of the
whites among whom they lived and served. The most common and frequently cited
methods of treating illness is prayer. The laying on of hands is described quite
frequently. The traditional Black belief regarding health does not separate the mind,
body, and spirit.

Social customs
The elderly are held in high esteem, the living of a long life indicates that a person
has the opportunity to acquire much wisdom and knowledge. Death is described as
the passing from one realm of life to another, as a passage from the evils of this
world to another state. The funeral is often celebrated as a joyous occasion, with a
party after the burial.
 1- A Black female was the primary nurse for two black teenagers. When one got
out of line, she would simply say, "Boy, keep your mouth shut and go somewhere
and sit down." They usually complied.
One day, it was time for one of them to go to physical therapy, but he was giving the
Anglo nurse a hard time. Finally she tried the primary nurses' tactic and said "Come
on boy, I'm not kidding with you. You have to go to therapy." The young man flew
into a rage and started swearing at the nurse.
The Anglo nurse was confused, he had never responded that way to his primary
nurse. She had not considered that the term "boy" is inoffensive when used by one
Black person speaking to another but is highly insulting when used by Caucasians
because of its origins among slave owners.

2- Mary Smith, an elderly Black woman, was in the recovery room after surgery.
To assess her condition, the nurse, spoke her name, "Mary." The patient slowly
opened her eyes and turned her head but made no further signs of acknowledgment.
The nurse became concerned because most patients responded readily and clearly at
this point. She called the woman Mrs. Smith. She then became alert, pleasant, and
cooperative. The patient had perceived the use of her first name as a lack of respect
and a form of racism.
Nurses should refer to all adult patients as Mr., Miss, Ms., or Mrs., unless otherwise
instructed. To use a first name for anyone other than a close friend, is both
inappropriate and discourteous in most culture.

3- The patient was a nine-month-old Black male. His hands and feet were tied to
the bed to prevent him from pulling out the intravenous lines. When his grandmother
saw him tied down, she became very angry. "How come you got the baby tied down?
He's not doing anything. He ain't no trouble. He ain't no dog!" She had experienced
much discrimination at the hands of whites and perceived her grandson's treatment as
a racist act. Once the nurse explained the purpose of tying the baby down, she
relaxed.