NAVAJO CASE STUDY

Mr. Begay, aged 78, lives with his wife in a traditional Navajo hogan. He has lived in

the same area all his life and worked as a uranium miner until the government closed

the mines. His hogan has neither electricity nor running water. Heat is provided by a

fire, which is also used for cooking. Lighting is obtained from propane lanterns. Water

is hauled from a windmill site 20 miles away and stored in 50-gallon steel drums.

Because the windmill freezes and the roads are often too muddy to travel in the winter,

sometimes he must travel an additional 10 miles to the trading post to obtain water.

Because Mr. Begay does not own a car, he must depend on transportation from

extended family members who live in the same vicinity.

Mr. Begay has continually experienced shortness of breath, and it is getting

worse. He has been hospitalized with pneumonia several times as a result of the

uranium poisoning. He had a cholecystectomy at age 62. His diet is traditional and is

supplemented by canned foods, which are obtained at the trading post.

All health care is obtained at the Public Health Service Hospital in Shiprock.

Neither Mr. Begay nor his wife obtains routine preventive-health care. He was admitted

from the clinic to the hospital with a diagnosis of pneumonia.

Mr. Begay shows clinical improvement after initial intravenous antibiotic

therapy. However, his mental status continues to decline. His family feels that he

should see a traditional medicine man and discusses this with his physician. The

physician agrees and allows Mr. Begay to go to see the medicine man. Several

members of the nursing staff disagree with the physician’s decision and have requested

a patient-care conference with the physician. The physician agrees to the conference.

Study Questions

1. Identify three physical barriers Mr. Begay must overcome to obtain health care.

2. Discuss the benefits of Mr. Begay’s seeing the traditional medicine man.

3. Identify some potential negative outcomes of Mr. Begay’s seeing the traditional

medicine man.

4. Identify culturally relevant interventions to reduce the potential for the recurrence of

pneumonia.

5. Identify at least two major health risks that the Begays face, based on their current

lifestyle.

6. Discuss potential outcomes for negotiation during the conference.

7. Mr. Begay’s diet is described as traditional Navajo. What foods are included in this

diet?

8. Because of his continued need for oxygen, what services do you anticipate for Mr.

Begay when he returns home?

9. What might the nurse do to encourage preventive-health measures for the Begay

family?

10. Identify at least three types of traditional Navajo healers.

11. Identify contextual speech patterns of the Navajo Indians.

12. Distinguish differences in gender roles among Navajo Indians.

13. Identify two culturally congruent teaching methods for the Navajo client.

14. Discuss the meaning of the First Laugh Ceremony for the Navajo.

15. Identify two culturally congruent approaches for discussing a fatal illness with a

Navajo client.