Caring and Carrying the Cost: Hispanic Nurses’ Challenges and Strategies for Working with Co-ethnic Patients

• In Event: 243 - Regular Session. Health Care and Care Delivery

Abstract

Policymakers argue that immigrant healthcare workers are well-suited to serve as cultural brokers for co-ethnic patients because of their shared cultural backgrounds. While endorsing the goal to diversify the healthcare profession, many sociologists challenge the assumption about shared cultures between co-ethnic professionals and patients. But to date, little research has been done on how immigrant healthcare workers themselves view and manage their role of cultural brokers. We address this question through a qualitative study based on 26 in-depth interviews with Spanish-speaking nurses (22 Hispanic; 4 non-Hispanic white) in Northern California. Our analysis reveals that, in contrast to the common strategy of “code-switching” adopted by middle-class minorities straddling multiple social worlds, the Latina nurses in our study engage in “code hybridization,” blending their ethnic and professional identities at work. Specifically, three key findings are reported: (1) Immigrant healthcare professionals cannot successfully function bi-culturally without larger institutional transformations, e.g., greater access to resources and more flexible institutional norms and regulations. (2) Expected to bridge the clinical and co-ethnic patients’ lifeworld without much structural support, many Latina nurses are forced to internalize the cost, adopt a biased view of patient lifeworld, or, for the most part, struggle with institutional tensions as individual workplace problems. (3) The nurses’ patterns of code hybridization reveal several emergent workplace identities, which we describe as the “cross-functional professionals,” “reformers within,” “medical missionaries,” and “contradictory co-ethnics.” Our study contributes to theories of identity formation among bicultural immigrants and bears key policy implications for culturally competent social services.

Authors

• Ming-Cheng M. Lo, University of California-Davis

• Emerald Thai Han Nguyen, University of California Davis