Systems

0:00:00.0 Professor Walden: All right, we have gone live. So we are just gonna hang out for a minute or so and let everyone kind of pop in and join as they usually do. So we are… Well, we… We’re all very excited. I saw the emails, guys. But I, also, am very, very excited that this is happening, and that this is going down. We have a very special guest. We have been working hard to get her, Teresa, to get her here with us. And so we are just so excited that this is happening.

0:00:41.9 Professor Walden: So again, we are just gonna kind of hang out, and let folks join. Because we are doing it. I’ve got your… But hopefully everyone is doing well. And we’ve now taken… I was gonna say, “We’ve now taken mask off of the plane.” I don’t know, I have mixed feelings, but we… Here we are guys. Here we are. So we are popping in tonight, and we are doing this live tonight. And I am so excited for it, and I know you guys are as well. So, with that being said, let’s kind of jump right into it, okay.

0:01:29.7 Professor Walden: Guys, hello. It is professor Walden here, and we are going to get started. I’m very excited for you, NP Collective members. I know you guys are running short on time, but you know we like to pack a punch into our hour, and bring you everything that you need in order to strengthen your practice, and to be a very strong NP in whatever it is that you are doing, whatever specialty.

0:01:57.1 Professor Walden: I am so excited tonight, because we have Teresa with us. Teresa Maya, hopefully I’m saying that last name correctly. But she is going to be bringing to us a little bit of culture, from the Mexican-Latino culture, that we all are seeing in our clinics, and with our population. So she’s gonna bring us a little bit of that, and give us some education. Because again, our whole goal is to be able to treat our patients, and to be strong, and feeling strong as we treat our patients. But with that being said, part of that is communication, right? So in order for us to be able to treat our patients appropriately, and to be able to take care of them appropriately, we absolutely have to be able to communicate with them. And that is what Ms. Teresa is gonna do for us.

0:02:52.0 Professor Walden: So she’s gonna give us a little background on the culture, and then we are going to start launching into that between now and some other times. We are going to see her back with us about this population. So it’s gonna be so good. So with that being said, I am going to read her bio. So here we go.

0:03:13.9 Professor Walden: Teresa Romero Maya is a Mexican-Latino culture coach, and certified Spanish language teacher. She is a trilingual professional with a bachelor’s degree in teaching English as a foreign language, has a Spanish and French teaching certificate, and 30 years of international experience teaching languages in Asia, Europe and North America. Teresa now specialises in helping committed and caring healthcare providers, to improve their job performance and boost career progression, specifically concerning their work with their Spanish-speaking patients. She loves building bridges of communication and mutual understanding, which is why her work as a Latino culture coach is a core aspect of her Spanish programs and activities.

0:04:00.5 Professor Walden: Teresa currently lives in a small town in the countryside of the Mexican mid-east. After one year of lockdown, she abandoned the stuffy atmosphere of the big Mexico City, and changed it for the open spaces and relaxing landscapes of mountains and forests. In her free time, she loves walking with her two dogs, painting, reading, and baking sourdough bread. So, this is gonna be exciting. You sound like you live in one of the most beautiful places ever.

0:04:31.7 Teresa Romero: To me, actually, it is one of the most beautiful places to live in. That’s for sure. Thank you, Latrina.

0:04:39.2 Professor Walden: That’s… Very much. You’re very, very welcome. You’re very, very lucky, ’cause I definitely don’t get that where I… Just don’t get me wrong, but it’s definitely not that. But we are so excited to have you here, and to kind of start this conversation for our Spanish-speaking population, and for the NPs who are going to learn a lot just by being here with you. So thank you so much for joining us.

0:05:05.4 Teresa Romero: Thank you so much for having me. It’s great for me to be here.

0:05:09.4 Professor Walden: Fantastic. Fantastic. So what I’m gonna do is, I’m gonna bring up your PowerPoint. And with that being said, Ms. Teresa, take it away.

0:05:17.5 Teresa Romero: Okay. Thank you very much. So, thank you everyone for being here. Thank you for having me. I’m so excited to be here with you, and have this opportunity to talk to you about Latin American culture, and some important values and concepts of this culture, of this group. And as Latrina said before, this is something that I think everybody, little by little, should start learning and hearing more about, because if there is something for certain about Latin Americans in the United States, it is that this population is only about to grow. And it’s already a very important part of groups, culture groups, in the United States, so therefore it’s definitely important to learn about it.

0:06:13.6 Teresa Romero: So, okay. Oh. I…

0:06:21.7 Professor Walden: As we did it again. Good thing, we didn’t get right into it. Right. So we… She has clicked out of her PowerPoint, but she’ll be right back. She always does. We did a little practice run and that happened before. So no worries, guys. She will be right back. She just went to clicking and popped right out. But again, she is coming to us from the Mexican hillside. So this is exciting. And she is ready to give her Spanish culture information to us all. So, Hey Lucy, I’m so glad you could join us. This is gonna be great. I’m just waiting for her to pop back in as she kind of disappeared on us. So it’ll be okay. She’ll be back in 2.2 seconds as well. So this is gonna be good, but I was actually just speaking with her about where she lives and kind of the atmosphere and what she does. She’s been doing this for over 30 years. She’s been speaking to us, so this is going to be really good. I’m really excited.

0:07:37.7 Professor Walden: And you guys, I’ve taken a peek at her PowerPoint presentation. It’s wonderful. Okay. It’s wonderful. So get ready to be wowed. Okay. Just waiting on her to pop back in here as she will. So no worries there. All right guys, whenever she is back, other than that, how are you guys doing? How’s everything going while we’re waiting for her? Everybody okay? As you can tell, I have a little bit of… Or you probably can’t tell, I have a little bit of some germs, yay, germs so I have a little bit of some germs, and but it’s non-COVID. Don’t worry. I’m gonna be fine. So we are doing this, and then we are going to, you know, get back in there And there we go. Hey, Veronica, I see you. We’re gonna get back in there and just handle business like we usually do. Right? Everyone else doing okay though? I’m gonna assume yes. Just waiting on her to come back. Of course. There she is.

0:08:58.5 Teresa Romero: I’m so sorry…

0:09:00.4 Professor Walden: No worries.

0:09:01.4 Teresa Romero: I was disconnected.

0:09:04.1 Professor Walden: No worries. No worries.

0:09:05.7 Teresa Romero: Sorry guys. I kept you there waiting for me when I finally realized that I was just talking to the air. I’m so sorry.

0:09:17.8 Professor Walden: That’s okay. That’s okay. We were waiting for you to come back. No worries.

0:09:22.3 Teresa Romero: Okay. Sorry. All right, so let’s try to do that again. Let’s…

0:09:27.9 Professor Walden: At least you weren’t like in the… It was just the beginning, so it’s okay.

0:09:33.2 Teresa Romero: All right. Okay.

0:09:34.4 Professor Walden: There we go.

0:09:35.4 Teresa Romero: So then let me see, let’s start with the… Where we are here. Well, we were at the beginning right here, right? So that this was the only thing you saw, right?

0:09:47.3 Professor Walden: That was the only thing I saw. So go ahead.

0:09:50.4 Teresa Romero: Okay. All right. So yes. Guys, thank you for that, for your patience. Thank you for not disconnecting. I’m gonna start again with my name, Teresa Romero Maya. I go only with Teresa Romero because it’s shorter, and it’s easier to remember and to pronounce for everyone. I don’t know why this is moving. So this is moving so fast. I don’t know why, it shouldn’t be go that fast. Okay. Are we still seeing this, Latrina?

0:10:29.4 Professor Walden: Yes, we are.

0:10:30.2 Teresa Romero: Okay. Let me see. I don’t know why it’s going so fast. It should just stay where and wait until… Oh my goodness. I’m using a new… This famous Canva presentations, and they don’t work as usual with the PowerPoint, my God. Okay. So let’s see. How do I make this larger and… Why does it move at a faster pace as the one that I wanted to move? Why doesn’t it move? Okay, so I’m gonna try to… Oh, because it’s in automatic, right. Okay. It should be right now.

0:11:25.2 Professor Walden: Okay.

0:11:26.1 Teresa Romero: Okay. Sorry. Here it goes again. I already said my name. I’m Mexican. I have 28 years of teaching languages in three different continents and five different countries where I have lived and worked as a teacher, teaching languages, Spanish, French, and English. Those are the three languages that I am certified on. And for the last three years, I started focusing on working with healthcare providers in the US.

0:11:57.4 Teresa Romero: I realized there was a great need and interest of healthcare providers who regularly see Latino patients and who struggle to communicate with them. And I took that as an opportunity, then the pandemic hit, and it just confirmed that it was the best thing for me to do at that point because I could do it online and everything went online. So everybody was being served well by me doing this work now with them. So I became a Latino cultural coach and a Spanish language instructor for this community. And I have a 12-week Spanish for Healthcare program that I used to share information about Latino culture and some Spanish, so that more healthcare providers can communicate and establish a better rapport with their patients.

0:13:02.3 Teresa Romero: So I have this picture of Nelson Mandela and one of his quotes, to set the tone of this presentation, and it goes like this, “If you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart.” And I think this is so important to understand that when you talk to people in their language, right, you are really touching their heart, you’re communicating with them in more directly, in a more emotional and more important way.

0:13:42.5 Teresa Romero: So let me talk about Latin America a little bit. So I’m gonna share these four aspects or these four tips, bits of information about Latin America. There are 33 countries that compose the whole Latin America area or space, but only 21 of those countries speak Spanish as their main language, right? So all of these, people coming from all of these 33 countries would be considered Latinos, but only 21 of people coming from 21 of these countries are Spanish speakers or native Spanish speakers.

0:14:21.0 Teresa Romero: Another point that I think it’s very important also to address is the fact that Latin America is multi-racial, right. It’s composed by White people, Black people, Native American people, Mixed people, so there is, I think, a generalized perception that Latin America is mainly Brown, that people who come from Latin America are Brown, but in fact, we have all kinds of races, right.

0:15:01.3 Teresa Romero: So, the last bit of information that I wanted to mention is a question that a lot of my students ask me about… Many people wonder whether the term Latino and Hispanic are the same, and the answer is yes, or yes and no, because Latino would qualify or would address people that are from these previously mentioned 33 countries of Latin America, but not all of them speak Spanish and Hispanic refers to people who use Spanish as a language, so that includes as well, Spain, that is not part of Latin America, right? So Hispanics are all of those who speak Spanish and whose culture is related to Spain, including obviously Spain. Spanish people are also Hispanic, but they are not Latinos, alright.

0:15:54.4 Teresa Romero: Okay, well, so we’ll continue with some key values and concepts that I would like to discuss. I usually discuss these topics with my students, but because I find these are some of the most important topics and relevant topics to discuss and to learn about Latinos, because they have implications in their medical practice, right?

0:16:20.6 Teresa Romero: So, here, I included six of them that I usually go through with my students, as I mentioned before, but today, because of time constraints, we will only review half of them, so the first three, right, hoping that later, if we have a chance later on in another session or if any one of you is interested in learning more about this, we could do it on a one-on-one session or sessions in my program. So we’re gonna go then with the first, I’m gonna read all of them and briefly describe what they are, so the first one is family, the value of family.

0:17:14.1 Professor Walden: We can’t see that slide, I don’t think…

0:17:16.1 Teresa Romero: Oh, you cannot. I’m sorry. Okay, let’s see.

0:17:19.0 Professor Walden: We’re still on…

0:17:19.9 Teresa Romero: Why we didn’t change, it didn’t change?

0:17:24.4 Professor Walden: We’re still on Latin America.

0:17:30.3 Teresa Romero: Okay, why isn’t this moving? Yeah, this is… Okay. This is the one that you saw before, and why it’s not moving to the next one. Because Latin America and key values and concepts. Can you see it now?

0:17:48.5 Professor Walden: No.

0:17:52.5 Teresa Romero: No. Okay, but did you… Could you see the slide with the Nelson Mandela’s quote?

0:18:00.8 Professor Walden: No.

0:18:00.9 Teresa Romero: The one I mentioned before? Only the one with Latin America?

0:18:08.1 Professor Walden: Uh-huh.

0:18:10.2 Teresa Romero: Okay, I don’t know why this is not moving. Okay, did my name… No. Okay, I stopped the sharing. I’m gonna try to share it again to see if it works better this time. Okay, can you see the screen now?

0:18:53.5 Professor Walden: We see key value.

0:18:53.9 Teresa Romero: With the key values of concept?

0:18:57.8 Professor Walden: Yes.

0:18:58.2 Teresa Romero: Okay, alright, so I don’t know from this… Why is it not moving, like one by one? It should be moving as I move it now with my arrows. So I have the arrows here, and I click the arrows, but it doesn’t move. All right, so I will read this one, and then if I have to share one by one, like maybe get out and then get in again, that’s how I’ll do it because for some reason, it’s not working for me. Okay, so as I mentioned before, key values and concepts. The number one is family, family is one of the most important values in Latin-American culture. Personal relationships as well, so this is how we relate with them, not only with our family, but with the people around us and in other spheres where we relate with people and how we relate with them. The third one is deference or respect, and this is related to levels of hierarchy and gender roles, that’s number three. That’s, sorry, number four, point number four.

0:20:13.5 Teresa Romero: Religion and spirituality, of course, these are very important values and some of the concepts related to religion and spirituality and how we understand these two aspects and how they play in our lives are very important to understand because they do have some effect on our behavior or our daily actions, and obviously that will reflect on how we do things when we are, for example, in a situation where we are sick and we have to go see a doctor or seek for healthcare. And the last one, it’s… The word is in Spanish, it’s fatalismo, and it refers to the belief and the perception and concept that we have of fate and destiny, and that also plays a very important role in how we behave and what we expect of life and the results of our actions. So as I said before, I’m gonna change again because I cannot seem to be able to change the slides directly here, and then I’m gonna share again. So we’re gonna start with the first one. And there is family. Okay, so when it comes to family, the key word here, or the key phrase here is family first.

0:22:00.2 Teresa Romero: Now, there are three aspects that I’m gonna mention here that are very important in the way we relate with our family, and we understand family relations, one of them, the first one is that it is common to live in a household with many family members, extended family, living in the same household, it’s a very common thing. So you will find grandparents living with their children and children who are already married and already have their own children sharing all the same household, and even sometimes even more members of the family. So that’s very common. Another thing that is characteristic of the way we see family and how we behave and things that we learn in our families, that interdependence is encouraged over independence. So we relate very interdependently. So we make decisions and we take actions based on our relations many times with our families, and not in a very independent way or just self-centered or focus more on our needs and what we want of our life.

0:23:18.3 Teresa Romero: Cooperation, our competition is also encouraged, so we are encouraged to cooperate with other members of the family rather than compete with them. And another factor that is important in relation to family is the economical contribution to the family household is expected. And so how does these… How do all of these concepts and values may play out in the medical context, and what can you expect? I think this is probably the most important thing that you would like to learn. So often you will find that your patients show up accompanied by one or more family member, and they commonly ask for them to be allowed in the consultation room. So we spend a lot of our time and long periods of our lives, probably all our lives, accompanied by, in one way or another, by our families, and obviously the medical scene is no different. So that serves in many ways, and one of them would be that maybe your Spanish patient is not very fluent in English or cannot understand English at all, and maybe one of the family members does. So that person would be expected to serve as a translator, even if you have a translator institute.

0:25:00.1 Teresa Romero: It’s not ideal, of course, and nobody really wants that, but that’s how they feel comfortable in talking to somebody in the family who understands them and who could properly translate. You can also see that… And you should understand that one of the things that they ask other family members to be allowed in the consultation room is that this other family member will be another set of ears to what is happening, and another set of eyes to what is… Eyes and witness to what is happening and what is being said in the consultation room.

0:25:39.0 Teresa Romero: So, that means that they can later discuss at home what was said and confirm if what they understood was right, right? If the other person understood the same thing. So the medical decisions are made with the family, right? That comes obviously, from the interdependence and the cooperation, right? That we are used to carry out and take into account of everything we do. It is unlikely then for your patients to agree to the recommendations or procedures that you recommend, by themselves, right? So, that means that it’s very unlikely that they will agree to something that you say or that you ask them if you need them to make a decision or follow something or maybe buy some medicine or equipment, they will not agree, most of them will not agree before they have a chance to consult it and decide with the family. Economical support is expected as well from family members, and that will be also another reason for your patients to wait until they get back home and talk and discuss about the situation they are in. And together with the family decide what would be economically available for or possible for all of them, right, to cover, okay?

0:27:25.2 Teresa Romero: All right, so I’m gonna change again with the next slide. Okay, alright so the second point, it’s about personal relationships, and this is how Latinos relate to other people that are not inside the family group. So this means the key word here is amigos, right? That means friends, and this is how people relate with others, right? That others means neighbors, coworkers, friends, obviously classmates, and you would be, at some point, also a part of this group of people that Latinos get in contact with, right? So when it comes to relations and how we relate with others two factors or two things that are very important for us in developing relationships with other people, are trust, developing trust, and confidence, right? And we do these trying to become little by little become friends with others, right, with other people. Of course, there are different levels of friendship, right, but this is something that Latinos tend to do with everyone they know. No, they try to start a friendly relationship that will eventually, if it’s possible, become a friendship, right?

0:29:17.1 Teresa Romero: But the part of trust and confidence is very important to develop in relationships for Latinos. Building and maintaining close interpersonal relationships is common as well for Latinos. So Latinos try to make friends fast and the personal close interpersonal space is very short, right? And that’s the way we are. We are used to be close physically to other people.

0:29:54.4 Teresa Romero: And so… And I understand that this is something that for the Anglo culture, is not very comfortable because your personal space is larger or bigger than ours, right? Also warm and friendly greetings, yes, Latinos, tend to greet in a very friendly way and a very warm way. And physical demonstrations of affection and gratitude are common practice among Latinos. So when I say physical demonstrations of affection, I don’t mean necessarily kissing, right? But although kissing a friend, it’s a common thing to do, right? As well as hugging, or holding hands or patting somebody on the shoulder or on the back and hugging, right? All of these are common demonstrations of affection that take place almost anywhere and in any scenario. And it would be no exception in the medical scene, right? So they will not obviously, try to do that with you immediately, right? Because they first have to build trust, and they have to build confidence, and they have to little by little construct or build this relationship, right? But once it’s there, it’s common, right? So how this may play out in the medical scene? Well, they will, for example, from them, this is something very important for Latinos, and I think it’s important for every culture, in fact, that somebody talks to you in your own language, right?

0:31:48.7 Teresa Romero: I think that if you were in a foreign country and you could find someone speaking to you in English, you would feel so relieved, so much more relaxed and confident. And especially if you’re sick, and if you’re in a hospital or in a clinic, and if you find someone who speaks to you in English, it would be, “Thank God.” Of course, it’s the same thing with Spanish speakers. And so they will create a feeling, and it will start building trust. They will trust you more if you do the effort to speak a little bit of Spanish with them, because they will feel that you’re putting that effort, that you’re caring, that you care about what they feel, who they are, their culture, that you see them and that you hear them, that you’re willing to do that, even if your Spanish is not perfect, and that makes a very, very big difference. Interpersonal space is closer than in an Anglo culture, as I mentioned before. So don’t take it personal, don’t think that everybody is trying to hit on you if they are getting closer to you. It’s just that that’s the space that we are used to have with other people.

0:33:13.5 Teresa Romero: And another thing is that Latinos like to give or to show their appreciation with little tokens, little things or gifts. If you do something good for them and they appreciate it and they are thankful with you, they are grateful, they will probably come back and give you some little something. It’s possible. And if the policies in your workplace allows that, it would be nice for you to take the little gift. Now, that very commonly is food, because Latinos are very food-oriented. We are very food-oriented, and we like to give food as tokens of appreciation. And then when it comes to the physical part, I mentioned here that a pat… Obviously this is if you are comfortable. So a pat or a comforting touch on the shoulder of one of your patients will be very welcome and very appreciated, because we are very physical. We like to touch each other a lot. So that touch is… Especially if it’s a touch with this intention of comforting, it is very, very appreciated especially in this kind of situations, when people feel sick, when they feel bad.

0:34:40.2 Teresa Romero: Okay, all right. So this is what I find is very important in relation to personal relationships that you will eventually build with your patients, with your Spanish-speaking patients. All right, so I will share the next slide. Okay. All right, so we have on this point is the point of deference. This is a concept and a very important value because it dictates a lot of our behavior, and it would… For you to understand it, to know about this one and to understand it a little better, I think it would tell you a lot about how Latinos think and how they behave, and some of their values. So this point of deference is one that I divided into two, because there are two main parts of this aspect of deference, this concept. And the first one is Hierarchy. So the key word here for this aspect is hierarchy. And this speaks of the way we relate and how we show deference and how we expect deference or respect from others, so how we show our respect and how we expect to be respected or to be shown that we are respected.

0:36:33.8 Teresa Romero: So this relationships are based on one’s hierarchical place, based on gender, age and authority. So these three aspects, gender, age, and authority get mixed and combined to know what is our place in society. We have to also remember that Latin American cultures are very patriarchal, and especially with conservative groups, it’s even more patriarchal, because if you compare it to maybe some other groups that are a bit more modern, then this privilege of male starts… Slowly but surely, it’s starting to lose power or to lose force. Still there, of course, but it’s starting to slowly go and lose power, and females are starting to gain a little bit more of a higher level in that hierarchical ladder. So, what I wrote here is a list of authority figures that we immediately recognize as people that we should show respect.

0:38:07.0 Teresa Romero: So the first one is older people. So older people are people that we should always show respect to. Males, so men over women, as I mentioned before with the patriarchal society. Doctors. That is… So if you are a healthcare provider, and I know that here, I think in this group, there are not real, there are not doctors, most of you are nurse practitioners or nurses. And you’re still in this group because you are in the medical air field, which is very admired, and it has a very high position in that hierarchy. Also your boss, of course. So if you’re in a situation where you are the employee and you have a boss, you obviously need to show respect to your boss, religious leaders, people with university degrees, so academics as well, police force and government representatives.

0:39:22.1 Teresa Romero: All of these are positions or roles in our society that hold a high hierarchy level. And to them, we usually show more respect, or immediately, without questioning, we show more respect. Now, I would like to talk to you about how this respect of this or this deference may show when it comes from the part of your patient. So if you are the healthcare provider, if you’re the doctor, if you’re the nurse, they will look at you with more respect, of course, because as I mentioned before, you are in this field, in the field of medicine, and what happens is that one, these are… What I mentioned here are these three ways that Latinos show respect. Avoid prolonged eye contact. So you might notice that your patients don’t look at you directly in to your eye for very long, and they tend to look to the other side.

0:40:33.9 Teresa Romero: Even if they’re listening to you or they’re talking to you, but they will avoid eye contact. This is a show of the respect. We are taught, since we are very little, that we should not stare. We should not look directly into the eye of someone that we respect. We don’t ask questions, and we don’t question what the doctor says. In this case, you being the nurse as well and giving recommendations and prescribing things, we don’t question, and this is a sign of respect. But not because we don’t have questions. Of course, we do have questions a lot, but we are… We have been taught, since we are little, that we should not ask. That means we should not make questions, and we should not question what the doctor says or what any of these authorities say.

0:41:28.9 Teresa Romero: So what you do, these are my recommendations to you. First of all, try to break the eyes with a smile, and make them… Your patients comfortable and ask them if they have doubts. Note if they have any question, because if when you say, do you have any questions, they would say, no, no questions. Remember we said, no questions. So maybe if you ask if they have doubts, if there is something that is not very clear, and if when you smile to them, you are preparing them to make it very clear to them that it is okay to ask. This is encouraging them, encouraging your patients to go ahead and ask by telling them explicitly that it’s okay to do that. And then if it doesn’t seem to work very well, still you have this other resource, that is, you should ask them to repeat the information that you gave them.

0:42:32.8 Teresa Romero: So if you have already shared with them the prescription, you have already recommended something, that you have instructed them to do, or to follow a certain treatment, for example, or if you have given them… I don’t know, an appointment or a date for a later appointment at a later time, and you wanna make sure that they have that clear, don’t ask if they have questions. It’s better to say, okay, could you tell me back, can you repeat to me the information that I just gave you? And in that way you can confirm what you… What the information you gave them, and if they got it right or not. So this is about some of the things that might happen in your consultation because of this respect, this aspect of respect. And the next one is gonna be, the second part of this… Okay. So I’m gonna stop sharing, and I’m gonna reshare again. Okay. I think I’m doing it faster now. Okay. And so this last one.

0:44:08.3 Teresa Romero: The key word here is respect, right? So what we were talking about before, your patients respect you a lot, and they will not ask, they will not look at you directly in the eye for a long time. Even if they have a lot of questions, they won’t question what you say because you are the authority and you should know that there are certain things, that what you’re saying is correct, right? There’s this other aspect of deference that is respect and how we show respect, and what is the direction of this respect. And in this case that I’m gonna mention that this is also based in gender, age, and authority. And when it comes to the direction of respect, we also, because of if we are in this ladder of hierarchy, obviously the lower levels need to show respect to the higher levels, right? And so in what direction does that go? Well, younger people should show respect to older people, of course, females to males, lower to higher hierarchy levels, of course, so for example, students to teachers or employees to bosses, and any kind of situation where there is a difference in this hierarchy it is supposed that the lower level will show respect to the upper level.

0:45:37.3 Teresa Romero: Now, in your case being a doctor, being a healthcare provider, you are at a high level, but there are these other aspects that you have to take into account, so your authority is high because you are in the medical field, but because of your gender or your age, you might, let’s say, lose points, right? So you will go down on that hierarchy level. If you’re a female or if you’re young, right? So it depends on what or who your patient is, of course, so if you have a patient who is an older male, you will be expected to show respect to him, and that doesn’t mean that that allows him to be disrespectful to you, but what that means is that since you’re at that lower level, you could not become or you cannot address that person in a friendly way, for example, because in a friendly way, it’s a way that we use only with people who are at our same level on that ladder or lower, of course. So you have to be respectful with them, for example. So I would like to mention some of these things here about how it may play out in your medical context.

0:47:02.1 Teresa Romero: So your patients, they will have preference over you or other healthcare provider or other nurse in this case, because they will have more preference and more respect for male practitioners or male nurses or male healthcare providers, if they prescribe, that means if these are people who are prescribing, who have the knowledge, the capacity to prescribe medicine, that puts them already at a higher level, because they are… It is understood, or people understand that you have more knowledge and more knowledge means you’re at a higher level, right? And at the same time, people would prefer, and they would have more respect for female healthcare providers, if they are carers, that means… What I mean by this is that if these are people or providers who do the tasks of taking care, not necessarily prescribing, but taking care of the patient. And if that is your role, if this is mostly what you do, then they will prefer to have you as their nurse if you’re a female, because it’s… For some reason, this care or disability to care better and in a better way, is attached to the female role and the knowledge and the capacity is attached to the male role, and so they will prefer… They will show this preference and respect to you depending on your gender and also on your age.

0:49:08.2 Teresa Romero: This is the other aspect that for hierarchy and showing respect, so if you’re young and you’re a female, you will get less credit, unfortunately. I think that that could go also in other cultures, is not just the Latino culture, but in the Latino culture, it’s very persistent, it’s a very persistent perception or concept. So what does that mean? If you are… This part here is about how you show your respect to your patients, you should address them formally in every situation until you have created some more friendly relation with them. And you should address them with your staff. For those of you who already know some Spanish, you might know that in Spanish, we have you with two forms, one informal and one formal, so you should use the formal one, and you should use it with everyone except with people who clearly are younger than you, and you can use titles, senor or senora, plus the family name to address your patients as well, except if they are very young people, of course, where you don’t need to use any title. So this is basically the last part of my presentation. I just want to show one last final remark that is related to the fact that not everyone is the same. We all have differences and there are many things that are different even if we share one culture.

0:51:02.0 Teresa Romero: So, the points that I described before are obviously generalisations, and they are intended to offer a broader perspective of Latin Americans and what we share in common. But it’s important to bear in mind for you that there are many differences and there are many aspects based on country, on region, on level of education, on religion, on social status, and all of these aspects have impact in an individual’s culture, so in every person and how they experience their culture. So, at this point, this is, Latrina, what I prepared for today.

0:51:51.0 Professor Walden: Fantastic, you’re getting… So a lot of us interact with the culture, Spanish-speaking culture, on a daily basis, and there was a lot of commentary about how we just… It’s all making sense as to the experiences that we’re having. Excuse me. One of the students was explaining that she notices when she smiles more, that she gets more information out of them.

0:52:20.7 Teresa Romero: Absolutely.

0:52:21.3 Professor Walden: And so when you kind of mentioned it, it was like, Well, that explains the smiling, who knew? And probably when you think about it, how difficult this was during COVID.

0:52:31.7 Teresa Romero: Absolutely, absolutely, yes.

0:52:34.9 Professor Walden: Yeah, because we just could not… You can see your eyes smile, but it’s a very big difference when you…

0:52:41.8 Teresa Romero: Yeah, when you involve all of your face, not only the smile, but your face. And I had a student who told me, “Well, during COVID, I was trying to but obviously wearing my mask and wearing all that equipment… ” and I said, “Well, try to smile with your eyes, at least.”

0:52:57.9 Professor Walden: Yeah, yeah.

0:52:57.9 Teresa Romero: That can be a smile, can be perceived through the eyes, but of course…

0:53:01.2 Professor Walden: Exactly.

0:53:03.0 Teresa Romero: Yes, it’s difficult in these circumstances and in these times.

0:53:07.0 Professor Walden: Yeah, and again, I guess it just made sense because I’ve noticed that in my practice… Like you were talking about space and bubble. So I’m a big person about giving people their space and having that adequate distance between us, but I do notice that my Spanish-speaking community likes to get right up next and close to me, which is…

0:53:32.6 Professor Walden: Which for me is an adjustment because again, I’m used to my own space, so like you said, in America, it is very much… We have bigger spaces and bigger bubbles.

0:53:44.1 Teresa Romero: Absolutely, and this is… I just want to make sure that everybody understands that this is not necessarily because they are trying to hit on you like… But it’s… We’re just used to be close to other people, and it’s just that measurement of space is different and we are used to that, so we are getting close to everybody, and we are very touchy as well.

0:54:07.5 Professor Walden: Yes.

0:54:07.7 Teresa Romero: Of course, that doesn’t mean that you should allow anything that is not comfortable, that you don’t feel comfortable with, but at least you could understand it, you can understand where it comes from, and that makes a big difference.

0:54:20.9 Professor Walden: Absolutely. Well, I am so excited that you did this. And guys, this is just the first of many, so thank you Ms. Teresa. Hang out with me one second, and we’ll chat with you.

0:54:28.6 Teresa Romero: Thank you, thank you, guys, of course.

0:54:29.0 Professor Walden: But guys, this is the first of many. So Ms. Teresa will be back with us, we’ve got to get her back on the schedule because we had to do a little background first before we dive right into the Spanish. So I needed you guys to understand kind of the culture that we’re dealing with, and understand the background to that, but when she comes back to us, now we’re gonna do the language. So we’re gonna be talking, and she’s going to be teaching us, and using some of the Spanish-speaking language, some of the Spanish, so that we can all learn and hopefully take it back to our clinics and start utilizing it and practicing it.

0:55:15.9 Professor Walden: So we’ve got all of that worked out for you, so you will see her on the schedule very, very soon. So we’re very excited about that. So that one should be great. But with that being said, this was great, I again… We all know that we’ve studied this in school as nurse practitioners, we looked at the cultures, we studied the different cultures, but for some reason, I feel like there was a few things that were missing that Ms. Teresa said that we did not get in school, which now makes it… All makes sense for us, ’cause I think there was a lot of, “Oh, this is why they’re doing that.” So I’m excited to see the light bulbs go off in your eyes and as well as in mine.

0:56:04.8 Professor Walden: So she’s gonna be back, that’s all I can say, and I am excited about that. So she will be back, and we’re gonna be doing the language, and that’s gonna be exciting. So you guys, start practicing, get your tongue rolls ready because we are going to be utilizing them and saying them with her, okay? So you guys, as always, gonna keep it super respectful of your time, and we did it, we did it. I will absolutely be letting you know when she’ll be back, and then we can get started on speaking Spanish and being really comfortable with it. So alright guys, you can catch me over in the Slack if you have more questions or anything to that nature, and I will catch you over there. Have a good evening. Talk to you soon. Bye.