Transcultural Heritage: People of Mexican Heritage –Reflective Exercise 21

Transcultural Heritage: People of Mexican Heritage –Reflective Exercise 21 – The patient is a 25-year-old Mexican immigrant who is an undocumented worker in the US construction industry recently diagnosed with a radial bone fracture he sustained when doing roofing and bricklaying…

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Solution

Case Scenario Overview

The patient is a 25-year-old Mexican immigrant who is an undocumented worker in the US construction industry recently diagnosed with a radial bone fracture he sustained when doing roofing and bricklaying. At the emergency room, a physician has recommended both surgery and physical therapy. Vincente mainly speaks Spanish, has limited ability in English, is a devout Roman Catholic, and leaves with three other immigrant workers who advise him to visit a bruja who will rid him of the spell cast upon Vincente, thus healing him. Prognostics indicate Vincente will be unable to work for the next 6 to 8 weeks.

What the Home Care Case Manager, a Registered Nurse Should Consider When Sending a Physical Therapist to Vincente’s Home

The home case manager has several factors to consider when offering physical therapy to Vincente, who is an undocumented worker and is, therefore, does not have health insurance of any kind. Home care physical therapy is suitable for him because the fracture that necessitated surgery makes the patient unable to leave the house for one and a half months to two months.

Top on the considerations list is the patient’s preference for Mexican origin; his receiving care at home could be a constant reminder of his illness and an unwelcome invasion of privacy. His living in a rented house may make him embarrassed of his living situation, amongst other preferences. The PT should respect and not disregard these preferences (Jacobs, 2016).

The second point of consideration is the PT’s concerns about the challenges that could deter the therapist from taking part in the home-based care. The Homecare case manager should also consider the presence or absence of infrastructure that supports the PT, like assistive durable medical equipment. Other factors include the need for an interpreter trained in cross-cultural interpretation, one proficient in Spanish, the primary language of Vincente, and who understands and respects the Mexican culture.

What the Nurse Needs to Know About What Part of Mexico Vicente and His Family Are From

The RN should also be aware of the part of Mexico where Vincente and his family hail from because even among the Mexicans, differences abound depending on whether one lives in a rural or urban residence, the extent to which they have adopted Anglo behavior, and the region of origin as each of the region has its distinct historical, political and economic experiences.

In Vincente’s case, a specific stressor is his undocumented immigration status hence his need to avoid public programs as he fears being caught. The region of origin would also shed light on the type of healers Vincente’s family has interacted with, like Curandero (use prayers and artifacts), /Yerbero (herbalist), or Espiritisa( practitioner of Espiritism). This would help the PT to involve spiritual healers ad priests to intervene during crisis and therapy.

Potential Communication Needs of Vicente, His Friends, and His Visiting Family

Mexican immigrants in the US are greatly influenced by significant cultural values and behaviors that should guide the non-verbal and verbal communication styles that the healthcare providers need to use in the clinical application (CDC, n.d). One of the non-verbal communication needs is for the care provider to let the client define body space parameters as Mexicans sit and stand closer than Anglos while avoiding prolonged eye contact as they interpret it as disrespectful.

Additionally, the professional should conduct the PT sessions in Spanish or use a qualified cross-cultural interpreter as the patient has a limited understanding of English. Since most Mexicans are nonconfrontational, the clinician must first establish trust, support, warmth, and caring before addressing the more complicated aspects required to ensure wholesome therapy.
Why Vicente is concerned about Letting His Boss down Because of Illness

A two-month absence from work for Vincente means that as an undocumented immigrant, he will not be entitled to a sick leave allowance, nor will he get the wages he needs to send back home in Mexico so that his father can get money for his colon cancer treatment. It also means it might be too late before he has saved enough to bring his father to the US for advanced treatment.

He even fears his employer will fire him and find a replacement. He has saved little over the last one and a half years and may be depleted as he seeks treatment with no health coverage. According to Joseph and Marrow (2017), undocumented immigrant patients face considerable barriers and challenges as they seek access to healthcare despite the enactment of the Affordable Care Act (ACA) in 2010.

Conclusion

In conclusion, this essay has established the benefits of reflective learning and practice as the learner or practitioner develops their skills better. The case of Vicente has also highlighted the needs that a home care case manager has to consider while initiating a home-based physical therapy specifically to a Mexica undocumented immigrant patient. The communication needs comprise both verbal and non-verbal needs that the clinician should apply to offer transcultural competence.

References

Centers for Disease Control and Prevention (nd) Cultural Insights Communicating with Hispanics/Latinos URL: https://www.cdc.gov/healthcommunication/pdf/audience/audienceinsight_culturalinsights.pdf assessed, April 20th, 2021.
Jacobs, S. (2016). Reflective learning, reflective practice. Nursing2020, 46(5), 62-64.
Joseph, T. D., & Marrow, H. B. (2017). Health care, immigrants, and minorities: lessons from the affordable care act in the US.
Koshy, K., Limb, C., Gundogan, B., Whitehurst, K., & Jafree, D. J. (2017). Reflective practice in health care and how to reflect effectively. International journal of surgery. Oncology, 2(6), e20.

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Transcultural Heritage: People of Mexican Heritage –Reflective Exercise 21