Agencies offer jobs, culturally sensitive care for Latinos

GATES — Carlos Hernández and Ismaray Valdés continue to live out the American dream.

Recent immigrants from Cuba, they have become home health aides with a goal of becoming registered nurses. As part of the health industry, the couple is among an increasing number of Hispanics employed in that field locally and nationally while also helping to address that population’s health disparities.

Information from the federal Bureau of Labor Statistics indicates that health-care jobs have staved off unemployment for thousands of people around the country, as nearly 600,000 jobs in that industry have been added nationally since the start of the recession. The bureau expects another 65,000 registered nurse and home health aide jobs to become available over the next decade.

According to a 2007 Centers for Disease Control and Prevention survey, there is a growing shortage of home health aides to serve the increasing number of patients in hospices and private homes. Meeting that need is one reason why Home Care of Rochester embarked on its Project ¡ÉXITO! research initiative in 2008 to determine how the agency was meeting the needs of its Hispanic patients. Research results were published this fall in Nursing Outlook , said Ismari Martínez, a human-resources associate for HCR who supports the agency’s Hispanic programs.

HCR’s research showed that by taking into account a patient’s culture when determining an individual’s care — called transcultural care — the agency has seen a dramatic 24-percent reduction in acute hospitalizations, noted Juanita Rodríguez, senior clinical manager for the agency’s Hispanic team. Patients also are better adhering to their medicine regimes and making fewer unnecessary trips to hospital emergency rooms, she added. Improved case management between the agency and doctors also has been a huge benefit, Rodríguez remarked.

The agency’s Hispanic patients "now have a basic understanding that the emergency room is just for that — emergencies, not for blood sugar being low or having a headache," she added.

Other agencies also are discovering the importance of cultural training. Lifetime Care, for example, is currently assessing its staff and hiring more bilingual and bicultural staff, said Alfredo Gonzalez, the agency’s cultural-diversity manager. Diversity training will be added at all levels, he added.

"We want to look at how can we be more culturally competent in terms of all races, not just Latinos," he said. "We are also looking at how to assess cultural values. When someone walks in a house and they see an altar with candles and (statue) figures, we want to make sure staff understand and really reflect on the values and beliefs that family has. If they don’t understand that, they may not (provide) proper care."

HCR’s Project ¡ÉXITO! focused on creating the transcultural-care model, which considers the influence of culture on an individual’s beliefs about health, illness, medical care, and diagnosis and treatment expectations, Martínez said. As a result, over the past year the agency increased its number of Hispanic or Spanish-speaking employees by 25 percent. That staff also has put into practice better modes of communication with patients’ physicians, another key factor in the improvements the agency has seen, Rodríguez noted. The agency now employs 202 workers for its Hispanic-care team, including an additional social worker and physical therapist, and the number of home health aides in that group has grown to 173.

Home health aides like Carlos Hernández and Ismaray Valdés are striving to provide that kind of culturally competent care through such means as providing diabetic meal plan booklets that include traditional Latino foods. The couple arrived in Rochester this past spring through a parolee visa obtained for them with assistance from Catholic officials in Venezuela, where they had lived in hiding after leaving Cuba as health workers. The U.S. Conference of Catholic Bishops arranged for their travel to Florida, and Catholic Family Center welcomed them when they arrived in Rochester in March.

After settling into their new community, they wanted to find work in the health field. Both worked in health care in their native country — Hernández as a radiology technician and Valdés as a laboratory technician.

The couple learned about Home Care of Rochester after befriending other Cuban immigrants here. Hernández said that he and his wife were immediately impressed not only by the Spanish-language training HCR offers for home health aides but also by the agency’s dedication to addressing health disparities for the Hispanic population.

"No enmarca la persona el mismo trabajo para siempre," Hernández added about the potential for employee advancement. "Estamos interesados en superarnos."

They underwent their training in September with the help of parishioners at Our Lady of the Angels Parish, who drove the couple to their nightly classes. Since that time, they both have received their driver’s licenses and purchased a car, and now work opposite shifts.

"Gracias a ellos, pudimos tomar ese curso tan importante para nosotros," he said.

Hernández spoke about his experiences at the Gates apartment of his patient, Luis Zuñiga, a Chile native who has lived in Rochester for the past 18 years. He suffered a fall over the summer that dislocated both of his shoulders. Following two surgeries, Zuñiga was provided with aides from HCR as well as a physical therapist. He said that Hernández has been a blessing.

"Es como nuestro hijo," Zuñiga remarked. "Es una excelente personal, muy profesional."

Hernández said that he also is impressed that a company such as HCR would recognize the needs of ethnic groups in the community — not just Hispanics but also African-Americans, Ukrainians and other immigrant groups — and create training programs to meet those groups’ needs. And instead of exploiting immigrants as other industries do, HCR provides them with dignified employment and a chance to improve their lives, he noted.

"Me siento orgulloso por el respeto de la dignidad de la persona de que se trata," Hernández said, adding that his work as an aide also helps him live out Jesus’ call: "El que quiere ser el primero, tiene que ser el último. Jesús nos llama a vivir (como) el a través del servicio … al enfermo."

Zuñiga said that it makes sense that health care is helping provide employment to thousands, particularly Hispanics who have been hard hit by the recession because of the lower number of jobs available in lesser-skilled industries.

"Menos han sido afectado porque no hay falta de enfermos en el sistema de salud," he said. "Los enfermos siempre hay de una manera ó otra."

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