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.
References
Galanti G.A.: Caring for Patients
from Different Cultures. University of Pennsylvania Press,
Philadelphia, 1991
Spector R.E.: Cultural Diversity
in Health and Illness. Appleton-Century-Crofts, New York, 1979
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. 
