Introduction
Various ethnic and cultural groups may have distinct communication styles that are not understandable to others or create barriers in the interaction between these specific communities with people of different ethnicities. Indeed, as the cultural contract theory states, communication is the foundation of the process of identity negotiation (Castle Bell, 2019). For example, black people are known to have a unique way of communicating (Castle Bell, 2019). The distinctive communication style among African Americans allows us to recognize them among other races, but historically-formed biases about black-and-white relationships create issues that impede effective interaction between the two. This paper will discuss interaction methods that pertain to African Americans, biases these communities have when communicating with individuals of other ethnicities, barriers to interacting with them, and strategies for overcoming these obstacles for clinicians.
Views and Practices of Communication Among African Americans
Overview and Examples from Literature
African American culture is unique for historical reasons when black slaves were abused by white plantation owners but continued to work hard and create music. Many black people, living in English-speaking countries, especially in the United States, are considered to have an accent because their pronunciation deviates from the one that most white native speakers have (Adebayo et al., 2020). Moreover, African American rhetoric is extraordinary because they often change standard words and pronounce them differently (Steele, 2018). For example, black bloggers altered the term bourgeoisie to bourgie to describe people from the upper-middle class (Steele, 2018). Notably, this term refers only to people of color born in low-income families, but they could improve their financial situation by obtaining an education and becoming successful in their careers (Steele, 2018). This habit of changing pronunciation, shortening words, or tweaking terms came from black slaves who used a distinct language likely to avoid being understood by white people or to simplify intragroup communication. Indeed, it is nearly impossible to confuse African American verbal interaction styles with other cultures.
Assumptions and Biases of African Americans
Since black people developed a generational trauma from the period of slavery, they formed specific assumptions and biases about white people. For example, according to Castle Bell (2019), black individuals may view whites as those who categorize themselves as privileged and entitled. Since the instances of micro-aggression towards people of African descent in the form of verbal and non-verbal expressions are not rare, black people have a legitimate reason for maintaining a distance from other races and ethnicities. Furthermore, technologies that are primarily developed by white individuals are still imperfect in the facial recognition of black people, resulting in more unnecessary arrests (Bacchini & Lorusso, 2019). This technical problem reassured African Americans in their belief that white people were biased toward the black race.
Strategies for Communication with African Americans
To reduce this gap between people of different ethnicities, specific strategies can be used to improve communication. These techniques are instrumental in healthcare, where black patients may need a unique approach or additional support. Firstly, it is essential to emphasize the importance of individual decision-making because, in black communities, families often play a traditional role in forcing patients to make specific choices (Sanders et al., 2019). Secondly, when establishing a rapport with African American patients, clinicians must consider their religious beliefs because spirituality often plays a vital role in these communities (Sanders et al., 2019). Other than that, the treatment of these people and healthcare workers’ attitudes should be identical to patients of other ethnicities and cultures.
Specific Communication Strategies
Family and religion are two essential things that need to play an orientational role for clinicians when establishing a rapport with African American patients. Even though there are exceptions, most people in black communities have strong bonds with relatives and are spiritual (Sanders et al., 2019). It is recommended to always explore individual goals, values, and beliefs in a respectful and empathetic manner, especially if a patient is diagnosed with a terminal illness (Sanders et al., 2019). If an individual emphasizes the importance of religious beliefs and family in one’s treatment or palliative care, then clinicians should offer the patient’s close relatives to be involved in these processes as much as possible. Moreover, it is critical to implement the usual verbal and non-verbal communication methods that healthcare workers are trained to use.
Implication for Nurses
Nurses are the central workforce of any healthcare organization; thus, they have the power to raise patients’ trust in clinicians. According to Adebayo et al. (2020), “trust can be established by nurses through empathetic communication, warmth, and most importantly, the practice of self-reflection and reflexivity to minimize personal, implicit biases” (p. 402). Due to historical reasons, health literacy remains low in these communities; hence, minimizing medical jargon and providing printed information for patients can improve patient outcomes (Adebayo et al., 2020). Overall, nurses should be aimed to develop genuine relationships with hospitalized individuals from black communities because it will allow them to raise trust and make people feel heard and understood.
Barriers to Communication with Black Communities
General Barriers
In English-speaking countries, usually, there is no problem in communication between different ethnic, racial, or cultural groups. However, generational trauma from slavery and racism that were more prominent in the United States may create a barrier in communication with black people (Castle Bell, 2019). Therefore, clinicians may face challenges connecting with these patients, resulting in worse health outcomes among individuals of African descent, especially if they come from the U.S.
Barriers to Effective Communication
Unfortunately, the uniqueness of communication in black communities sometimes creates obstacles for other groups to interact with them. Indeed, according to Castle Bell (2019), “fear, prejudice, and racism create communication barriers between Black and White individuals, which complicates interracial communication” (p. 1). Since these biases are usually bidirectional, the problem of friendly or effective, for that matter, communication between people of African descent and other groups still exists.
Impediments in Communication for Nurses
Nurses may also experience difficulties interacting with patients from black communities because the latter has an overall mistrust of all healthcare workers. Communication is primarily preverbal, which means that people build their conversation with a new person based on their previous experience and knowledge about those similar to this individual (Castle Bell, 2019). If a patient of African descent encounters white people with racial prejudices, one is likely to be suspicious and reserved when communicating with white nurses.
Overcoming the Barriers
Despite the existing challenges in communication, it is essential to overcome the current barriers between health practitioners and individuals of color. The strategies that nurses can use are for different ethnic groups using such non-verbal and verbal techniques as eye contact, supporting tone and gestures, and asking confirmatory questions. These techniques can help reassure patients of African descent that the clinician has no racial prejudices and hence is prepared to provide necessary aid with empathy and compassion.
Conclusion
Black communities, specifically African Americans, have distinct communication methods due to the uniqueness of their historical and cultural background. Many of them possess what is perceived by native English speakers as an accent. Furthermore, they have firm reliance on their religious beliefs and family bonds. These peculiarities and expectations of racial bias often create barriers to interacting with these individuals in the healthcare setting. Hence, nurses should strive to improve communication with patients of color by building trust through a caring and genuine attitude.
References
Adebayo, C. T., Walker, K., Hawkins, M., Olukotun, O., Shaw, L., Sahlstein Parcell, E., Dressel, A., Luft, H., & Mkandawire-Valhmu, L. (2020). Race and blackness: A thematic review of communication challenges confronting the black community within the U.S. health care system. Journal of Transcultural Nursing: Official Journal of the Transcultural Nursing Society, 31(4), 397–405.
Bacchini, F., & Lorusso, L. (2019). Race, again: How face recognition technology reinforces racial discrimination. Journal of Information, Communication, and Ethics in Society, 17(3), 321-335.
Castle Bell, G. (2019). “There’s difference between Black people and n******”: A cultural contracts exploration of interracial communication barriers. Communication Quarterly, 67(3), 243-270.
Sanders, J. J., Johnson, K. S., Cannady, K., Paladino, J., Ford, D. W., Block, S. D., & Sterba, K. R. (2019). From barriers to assets: Rethinking factors impacting advance care planning for African Americans. Palliative & Supportive Care, 17(3), 306-313.
Steele, C. K. (2018). Black bloggers and their varied publics: The everyday politics of black discourse online. Television & New Media, 19(2), 112-127.