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Teaching culturally competent nursing care in a private Christian university ought to be easy, but it's not. Most of our students view cultural diversity as a politically correct phrase they have heard but not experienced.

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Figure. Student nurs... - Click to enlarge in new windowFigure. Student nurse Kayla Morris takes a break with Chandler Mountain kids in the Mexican Cultural Center.

Early in the curriculum, we immerse students in the content of transcultural nursing and how to give culturally sensitive nursing care. This content includes attending non-Christian religious services, taking cultural field trips, doing group projects and interviewing someone from another culture. Our program offers a variety of international nursing experiences through mission opportunities and through our graduate missions nursing track.


However, student interest dramatically rose after an experience less than fifty miles from our school. Each week last summer, two faculty and three students experienced diversity, putting culturally sensitive nursing care into action. A grant funded by the Baptist Health System Mission Tithe Fund enabled them to provide health services for the Hispanic migrant population in Chandler Mountain for three months.


Chandler Mountain is a rural community northeast of Birmingham, Alabama, with approximately 500 farms. These farms average 141 acres each and grow mostly tomatoes. Migrant farm workers, primarily Mexicans, provide most of the field labor. This migrant group is part of the East Coast migrant stream and has its primary home base in Florida.


We carried the necessary supplies and equipment in a van and set up tents for health screenings and nursing care. In July, the health team also used an old school building that presently serves as the Mexican Cultural Center. Those who needed physician referrals were transported to the Baptist Health Clinic, thirty-six miles from the screening site.


Each participating nursing student had expressed an interest in working with the Hispanic culture. One was the daughter of missionaries and had lived most of her life in Venezuela. The other two were taking Spanish classes along with their nursing curriculum.


Ministry Challenges

The team quickly discovered that taking the van and tents into the tomato fields made serving this population difficult. Many farm owners were suspicious of us and did not want work time used for health services. The farm workers could not afford to lose work time, since no work meant no money. The terrain and extreme heat also made it difficult to set up the tents in the fields.


Collaboration with the Mexican Cultural Center greatly improved our success. The center became a welcome relief from the heat for the farm workers. It also provided a clothes closet and food pantry. Setting up our tents near the Mexican Cultural Center, we were able to continue screenings and health care, either in the tent or the Center.


The workers often stopped at the tent on the way to the fields in the morning, or in the afternoon if the work ended early. The faculty and students worked for three months in over one-hundred-degree weather, providing services for over 1,000 individuals. Adjacent to our screening site, a Head Start Center served the migrant workers' children. We advertised our services there and met many of our families through this program.


The Head Start Center did not serve children after age five, which sent many children to the fields to work with their parents. On our weekly drives into the fields to give water to the workers, we would see children side-by-side with their parents, picking tomatoes. At first, both children and adults were wary of our van, as we drove into the fields. We discovered later that it looked similar to the immigration van that searched for undocumented workers. However, as the weeks passed, we became a welcome sight to adults and children.


Student & Faculty Reactions

During the three months of this project, the faculty and the students became part of another cultural group. It was no longer something we read about but a life that we experienced. The students wrote reflective journals at the end of the project, and these are some of their comments.


Lori Henderson: "This opportunity has been a wonderful, eye-opening experience for me. My love for these people grew as I observed their compassion, appreciation and willing hearts. I admired their self-sacrificing labor, peaceful demeanor, smiling faces and hardworking attitudes. They work long hours in hot fields, living and working under conditions that most Americans would consider unbearable. Some constantly hide from immigration officers to survive in a land that offers plenty. They live in poverty and barely make enough money to support a growing family, yet they never quit. This culture is admirable."


Mary Alice Denning: "I never could have imagined that this experience would be life changing. Many days we would take water and hats to the workers where they were working in the tomato fields. I will never forget their smiles and the looks on their faces. One man told me that at first he thought we must be from the immigration office. He said no one had ever been this nice to him in this country. I cannot imagine leaving everything to try to make a life for my family and myself. Yet, thousands are doing this every year. It grieves me to hear people calling them foreigners. God has taught me to see and love them through his eyes with his compassion. In his eyes there is no color, and there are no foreigners."


Missionary-kid Kayla Morris: "Translating for the Chandler Mountain Project was like going back to my childhood. As a ten-year-old in Venezuela, I loved to translate for the doctors and nurses who did volunteer medical work for the poor people in my hometown. They are the reason I went into nursing. Chandler Mountain was special to me because I was able to go a step beyond translating to put my nursing skills and knowledge to work. Crosscultural medical work has been my dream since age ten. Chandler Mountain was for me the first step in what I hope will be a lifelong career of crosscultural nursing."


Participating faculty also wrote enthusiastic reports. Jane Martin: "This project allowed me to 'practice what I preach' in the classroom. Working side-by-side with students was a powerful teaching tool. They were energetic and excited about caring for individuals and families from another culture. The summer project was also a way to practice my professional skills and to be spiritually fulfilled by doing God's work.


"The Hispanic people we served were delightful and hard working, dedicated to their children and extended family members. The people reached out to us, and we were able to respond with nursing care, as well as the basics of food, clothing and shelter. I was constantly reminded of my many blessings. In Matthew 25:40 Jesus said, 'I tell you, just as you did it to one of the least of these who are members of my family, you did it to me.'"


Faculty member Elaine Marshall: "To use my professional nursing skills in another culture has been a personal goal and my heart's dream. The Hispanic farm workers are some of the hardest-working individuals I have ever witnessed. Their personalities were warm and friendly. I thought that gaining their confidence as health providers would be difficult, but the trust grew quickly and turned to friendship.


"All along, we had felt that this project was divinely inspired and blessed. Nothing like this had ever been attempted for the Hispanic migrants in this county, and many local residents were not pleased with our project. We met many obstacles, but when one door closed, another opened."


We plan to continue the Chandler Mountain health project next summer by providing primary health care to the Hispanic farm workers and their families. We will screen for and teach about hypertension, heart disease, diabetes, tuberculosis, sexually-transmitted diseases and women's diseases, such as breast and cervical cancer. Health information will be available on heat stroke, heat exhaustion and pesticide poisoning. Basic needs of food, clothing and housing will be addressed through partnerships with the Head Start Center, Mexican Cultural Center and volunteer community groups.


As faculty, we have a responsibility to provide clinical opportunities for students to apply the theoretical content of transcultural nursing. One outcome of the Chandler Mountain health project was the development of a nursing elective, Health Care Needs of the Hispanic Migrant Farm Worker. This will be offered next summer to both graduate and undergraduate students, giving more students the opportunity a few enjoyed last summer. We look forward to returning to our friends on Chandler Mountain and sharing that experience with more students.