Editorial


 5
 

Editorial 
 

CARING FOR MEXICAN-AMERICAN CLIENTS 
 

Bette Ide 
 Editorial Board Member 

 
 

There are growing Mexican-American populations in rural areas. This editorial is a 
continuation of the previous column on communicating with those clients.  

Dr. Loretta Heuer, associate professor at the University of North Dakota, again offers 
suggestions to help rural nurses in caring for them. One major issue is the use of an interpreter. 
There are two styles of interpreting, line-by-line and summarizing. Line-by-line interpretation 
ensures accuracy but takes more time; one can only speak few sentences at a time and must 
use simple language, no medical jargon. Summarizing is faster and useful in teaching 
relatively simple health techniques with which the interpreter is already familiar.  

Who should the nurse use as interpreter? Family and friends may be readily available 
and anxious to help. Unfortunately, their use violates confidentiality for the client, who may 
not want personal information shared. Also, they may be fluent in ordinary language usage 
but unfamiliar with medical terminology, hospital or clinic procedures, and medical ethics. 
Medically trained interpreters are ideal; they know interpreting techniques and are 
knowledgeable about the cultural beliefs and health practices. The nurse needs to be aware of 
certain differences between client and interpreter – sex/gender, age, and socioeconomic 
differences. The interpreter needs to be asked to translate as closely to verbatim as possible. 
The nurse should also be aware that a non-relative interpreter may seek compensation for 
services rendered. It helps to maintain a computerized list of interpreters who may be 
contacted as needed, to network with area hospitals, colleges, universities, and other 
organizations that may serve as resources, and to even use translation services provided by 
telephone companies. 

What does the nurse do when there is no interpreter? Be polite and formal, greeting 
the person using the last or complete name. Say your name, gesturing to yourself. Offer a 
handshake or nod. Proceed in an unhurried manner and speak in a low, moderate voice, using 
any words known in the patient’s language. Use simple words, such as pain instead of 
discomfort. Pantomime words and simple actions while saying them. Be careful to give 
instructions in proper sequence, to discuss only one topic at a time, and to validate whether 
the client understands by having him/her repeat the instructions, demonstrate the procedure, 
or act out the meaning. You can also obtain phrase books from a library or bookstore or even 
make flash cards.  

Overall, it is important for the nurse to remember that, under stress, clients may revert 
back to their first language and you should avoid responding to a client in a joking manner. 
Assessment of their ability to communicate and understand is especially important when 
teaching is involved.  

For more information concerning the above points, see the following: 
 

Andrews, M.M., & Boyle, J.S. (1999). Transcultural concepts in nursing care (3rd ed.). New 
 York: Lippincott.  
Purnel, L.D., & Paulanka, B.J. (1998). Transcultural health care, a culturally competent 
 approach. Philadelphia: F.A. Davis.  

 Online Journal of Rural Nursing and Health Care, vol. 5, no. 1, Spring 2005