Question

Childbearing

Rosa is a 17-year-old female who also identifies herself as Mexican American and Catholic. She lives with her extended family: her mother, father, younger siblings, and a Spanish-speaking grandmother. She has not been feeling well lately, which is not normal for her, and her mother and grandmother accompany her to the nearby clinic for a checkup. Her urine sample indicates she is pregnant.

1. What is the meaning of the patient’s self-identification as Mexican American rather than Hispanic, Latina, or Chicana?

2. In caring for patients who live in intergenerational households, how does the nurse determine who is the key decision maker?

3. What is the role of the nurse in assisting the patient with making moral/ethical decisions associated with the pregnancy such as amniocentesis, eugenics, and genetics?

4. How does the nurse assure that the patient’s Spanish-speaking grandmother is able to fully participate in discussions?

Answer 1

Self-identification is defined as the assigning of a particular characteristic or categorization to oneself.

In the present scenario, Rosa is a 17-year-old female who also identifies herself as Mexican American and Catholic. She lives with her extended family: her mother, father, younger siblings, and a Spanish-speaking grandmother. She has not been feeling well lately, which is not normal for her, and her mother and grandmother accompany her to the nearby clinic for a checkup. Her urine sample indicates she is pregnant.

1. Discrimination based on one’s racial or ethnic background is one of the oldest and most perverse practices in the United States. It’s an emotionally charged topic and there are important usage variations depending on the region, generation, political inclination, etc. Many people prefer to identify themselves by their country of origin or heritage.

Here we can see her grandmother is Spanish speaking. Thus we can come to know that, they are actually of Hispanic natives or descends from, a Spanish-speaking country. (grandmother native is from Hispanic)

But still, she likes to identify herself as a Mexican American, rather than a Hispanic/Latina/Chicana.

2. Here in the present scenario, Rosa,17 years old, was not feeling well. Her mother and grandmother accompanied her to the nearby clinic for a checkup. Her urine sample indicates she is pregnant.

When caring for a patient who lives in intergenerational households, in an extended family, and the patient is having self-identity, as a nurse we can assume that the key decision maker is the patient(Rosa).

3. As a nurse when we assisting a patient with an intergenerational household with an extended family, we have to respect patients beliefs and values in making decisions about themselves associated with pregnancy such as an amniocentesis, eugenics, and genetics. We have to help them in making decisions appropriate for them. We have to explain them regarding the possibilities and adverse effects of these to her pregnancy or childbearing.

Medical genetic screening and testing is a choice. The goal of the first is sociological, the second, biological.

Genetic screening and testing often aim to avoid a medical situation in a family, not to “improve” the genetic structure of a future population. And we should never assume that all families will choose that path. Families must be allowed that choice. That’s what genetic counseling is all about. And so I don’t think that any medical genetic screening or testing is eugenic.

4.Communication techniques: Keeping communication short and direct, and giving the patient and family members give the  time to respond, assist the nurse in providing clear effective communication. Patients or relatives may have difficulty with rapid or lengthy explanations.

In case if the patients Spanish speaking grandmother is found difficulty in understanding the information, Use a professional interpreter to provide education in Spanish. Professionally certified interpreters can assist with simple or complex healthcare communications such as teaching instructions, test results, or education. Other healthcare workers who are not certified interpreters cannot be relied on to provide clear and effective communication of healthcare information or teaching. Thus it is helpful for the patient's Spanish speaking grandmother to participate in the decision-making process.