After reading this chapter, the nurse will be able to:
Identify specific communication approaches for Irish Americans that influence health and wellness behaviors.
Explain the distance and intimacy behaviors of Irish Americans and their influence on health and wellness behaviors.
Describe the traditional roles of Irish-American family members.
Identify the Irish-American orientation to time and its influence on social and psychological behaviors.
Recognize cultural factors that affect the health-seeking behaviors of Irish Americans.
Recognize physical and biological variances that exist within and across Irish-American groups to provide culturally appropriate nursing care.
Overview of Ireland
The Republic of Ireland covers approximately 85% of the island known as Ireland . It comprises 26 counties that became the Irish Free State in 1921. In 1937 the Irish Free State was given the Gaelic name Eire by the constitution. Ireland is bordered on the northeast by Northern Ireland (Ulster), which today remains a part of the United Kingdom, and by the Atlantic Ocean to the west and south. St. George’s Channel, the Irish Sea, and the North Channel separate Ireland from Great Britain by distances averaging at least 50 miles (80 kilometers).
The Republic of Ireland is primarily an agricultural country and is noted for the Irish potato. Industry is flourishing, and mining has become increasingly important because of recent discoveries of lead, silver, zinc, and copper deposits. Most of the countryside in Ireland is lowland situated less than 500 feet above sea level, and it is underlain by limestone rock. Most of the surface is covered by glacial drifts that are a legacy of the Pleistocene Ice Age. In some places in Ireland, the drifts have been shaped into distinctive landforms that form a continuous belt across the island.
Most of Ireland has a cool, maritime climate. For example, in July temperatures vary from 61° F in the south to 57° F in the north. Winters are extremely mild, with January temperatures varying from 44° F in the Valentia to 40° F in the northeast.
Ireland was colonized by settlers from Europe. For at least 5000 years, successive waves of settlers arrived from the island of Great Britain. Each group of settlers contributed to the heritage of the modern Irish nation. Even today, the Celtic influence remains dominant in Ireland. However, the eastern portion of Ireland has been particularly influenced by the Anglo-Normans, whose initial invasion in 1170 was followed by the subsequent immigration of settlers from England, Wales, and Scotland. The population of Ireland rapidly expanded during the eighteenth and early nineteenth centuries and reached a peak of 8.1 million people in 1841. However, the Great Potato Famine that began in 1845 brought a reversal of the population trend as a result of the many deaths and massive migration to the United States and Great Britain ( ). This exodus continued over the next 100 years, and by 1921 the population of Ireland numbered little more than half of the original 1845 figure.
In the early , the Irish revolted against Britain in a battle for home rule. At the Easter Rebellion in Dublin in 1916, Irish nationalists unsuccessfully attempted to throw off British rule. In 1919, the rebels proclaimed Ireland as a republic. Unfortunately, this was followed by guerrilla warfare against the British until 1921, when a peace was negotiated by General Michael Collins (Your Irish, 2015). In 1922, the Irish Free State was established as a dominion and one of six northern counties constituting the United Kingdom. In 1948, Eamon de Valera, American-born leader of Sinn Fein (meaning “our own”; pronounced/shin fayn/), who had won establishment of the Free State in 1921 in negotiations with Britain’s David Lloyd George, was defeated by John Costello, who demanded final independence from Britain. The Republic of Ireland was proclaimed in 1948 when it withdrew from the British Commonwealth (Your Irish, 2015). Nevertheless, in a claim not recognized by Ireland, the British government reasserted its claim to incorporate the six northeastern counties into the United Kingdom. In 1993, the Irish and British governments agreed on a plan to resolve the Northern Ireland issue, and in 1994 a cease-fire was announced by the Irish Republican Army (IRA). However, when peace talks lagged, the IRA returned to its terror campaign in 1996, which continued until 1997, when a new cease-fire was announced. In September 1997, Mary Robinson, the first woman president, resigned and Mary McAleese, the first northerner to hold the office, assumed the presidency. However, unrest continues to plague Northern Ireland, with periods of conflict following peace plans and a lagging hope of lasting peace in sight ( ). Since Queen Elizabeth visited Ireland in 2014, relations between the countries have improved ( ). Although discrimination is illegal in Britain, the ongoing conflict with the Irish has affected Irish who are working in Britain ( ). It was noted in that racial discrimination and prejudice against Irish nurses can be found in British health care facilities. This is not without deleterious effects. For example, it has been noted that there is a higher incidence of mental illness among Irish-born women in Britain ( ).
Over the years, music has played an important role in Irish history. In the , Irish music, including spiritual music, Irish Catholic hymns, Irish songwriter and singer Mary Coughlan, and the Irish céilí ( ceilidh , Gaelic for “party,” especially one with dancing and music) bands, and the Chieftains received national recognition ( ; ). In 2001, the band U2 was the top band in Ireland, and several Irish singers had international musical hits ( ). Ensemble performance groups like Riverdance (since 1994) and Celtic Woman (since 2004) have received international acclaim presenting Irish song and dance programs around the world. James Galway is considered one of the best flute players in the world. Ireland’s 99% literacy rate indicates that education is also valued ( ).
Research concerning health care problems in Ireland is evident in the health care literature. For example, there has been a dramatic increase in the percentage of infants born to unmarried mothers in Ireland over the past decade. For the first 50 years of the 20th century, 2% of all registered births were to single mothers. In 1975 the figure had risen slightly to 3.7%. Within 10 years, it had risen to 8.5%, and in 1990 the figure stood at 14%. In 2010, it was reported that of 18,844 births, 6205 births were registered as outside of marriage, accounting for 32.9% of all births in Ireland ( ).
Another recent health problem in Ireland is a dramatically increasing suicide rate in all age ranges. Numerous meetings and websites document the governmental initiatives regarding this issue ( ). In contrast, the undetermined death rate has fallen off. This has implications both for improving measurement procedures and for suicide prevention ( ; ; ). Interestingly, there is little information in the Irish medical literature on smoking. However, a ban on smoking in workplaces and public spaces was enacted in May 2007 ( ). Another health problem noted in the Irish medical literature relates to incontinence in the elderly. It was noted that only 33% of general practitioners studied were aware of the incontinence status of their clients over 75 years of age ( ). Research in Ireland has also suggested that self-neglect in later life, or Diogenes syndrome, may be a significant problem ( ). noted that older people in Ireland experience considerable ill health and social deprivation. Work by indicated that there may be a prevalence of teenage asthma with associated allergic conditions in Ireland. Finally, alcoholism is historically an ongoing problem, with binge drinking being the norm ( ).
Against a background of fundamental change in the Irish health care environment, conducted a survey to determine the information needs of all health care practitioners. This survey revealed serious deficiencies in access, awareness, and availability of information for both staff and clients and recommended a comprehensive national health information strategy to coordinate the future development of health sciences information services. These changes have taken place, and nurses are expanding their roles to provide appropriate information and care across departments and health care ( ) is continuing to evolve ( ). Irish nurses are recognized for their innovations; for example, Irish nurses are credited with making an important contribution in Calcutta ( ), for providing effective community public health partnerships for persons with mental health issues ( ), for uniting with American nurses in the development of advanced cardiovascular life support training in Ireland ( ), and for developing better care for the elderly ( ).
The population of Ireland is approximately 4,553,000 ). Dublin, the largest city in Ireland with 1,018,500 inhabitants, is the capital ( ). The life expectancy in Ireland of males is 75.76 years, while for females it is 81.24 years. The infant mortality rate is 5.31 per 1000 live births ( ; ). Ireland’s human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) rate is 0.2% (2800) of the population ( ). The per capita income is $31,900, with an unemployment rate of 4.3% ( ). The economy has been growing ( ), and tourism to Ireland is increasingly promoted. noted that the market history suggests that Irish Americans are the best target for promotional campaigns. Many visit family but while in Ireland are also consumers of tourism products, renting cars, and patronizing hotels and restaurants. Immigration to the United States continues to be an attractive alternative for many who are distressed by the political unrest that has so long prevailed in Ireland. However, once a country plagued with high unemployment, high inflation, slow growth, and a large public debt, Ireland has undergone an extraordinary economic transformation over the past 15 years. The “Celtic Tiger” has become a leader in high-tech industries, and recently the economy has grown as much as 10% ( ). In fact, many European economists postulate that Ireland is continuing to distance itself wisely from the debt crisis experienced by other European countries such as Greece ( ). In 2010, the yield on 10-year Irish government bonds actually closed below 8% for the first time since the EU–International Monetary Fund bailout, but the yield is now back to levels seen in October 2010, suggesting that indeed Ireland is righting its financial course.
Immigration to the United States
The large number of Catholic Irish immigrants of the famine years were not the first Irish people to immigrate to the United States. The famine immigrants were preceded by their Irish countrymen in the seventeenth and eighteenth centuries, although in smaller numbers. Many of the earlier immigrants, particularly during the seventeenth and eighteenth centuries, were Protestants from the northern county of Ulster and thus came to the United States under less dramatic circumstances than the later immigrants did. The early Ulster immigrants arrived in the United States just in time to help the Americans win independence from England. At that time many Irish-American immigrants regarded themselves as members of the Anglo-American society. This distinction was made not to deny their Irish origin but to embrace their new heritage. During the Civil War, more than 150,000 joined the Union army. Since much of the White population of the Confederate states was native-born, there was less of a drive in the Southern army to recognize heritage than there was in the Union forces, where, for example, the fabled Meagher’s Irish brigade went into battle with an emerald green flag with a golden harp in its center ( ). Meagher led Irish Americans who were recruited from among common laborers in the Twenty-Eighth Massachusetts Regiment in a daring performance to “clear the way” for brother units. One of the best-known Irish nationalists in America, Meagher used his oratorical skills in Boston’s Music Hall to whip up enthusiasm among the Irish for the effort ( ). By the mid-, Irish organizations were established in the major cities of the United States ( ). Today, Irish descendants regard their Irish extraction more as a point of historical interest than as an identification with social relevance for their lives. According to , Irish Americans, in the process of adapting to American life, began to think and behave like their American counterparts. Ethnic lines are blurred and it is difficult to tell differences between Irish and Americans ( ). Today, however, there are as many Americans descended from Irish Protestants as from Irish Catholics, so the tight-knit communities that kept the anti-British cause alive are fast disintegrating ( ). Irish Americans have become so assimilated into the mainstream of American society that today they are likely to be professionals or managers and less likely to be laborers, service workers, or factory workers ( ).
Approximately 40 million people of Irish descent reside in the United States ( ). The Irish immigrant population has been steadily increasing since the early and increased dramatically in 1994, with 14.1 million between 1971 and 1980, 32.8 million from 1981 to 1990, 20.6 million from 1991 to 1993, and 17.3 million immigrants in 1994 alone ( ). In addition, it was estimated that in 1992 there were 36,000 undocumented Irish immigrants ( ). Irish ranks as the second largest ancestry group in the United States, outranked only by German. Irish is the largest ancestry group in five states in the Northwest and ranks third (after German and African-American) for having the largest ancestry group in a state ( ). The number of Irish descendants has resulted in St. Patrick’s Day being celebrated on March 17 each year in communities across the United States by Irish and non-Irish alike ( ; Your Irish, 2015).
The official language of Ireland is Irish (Irish Gaelic). However, English is recognized as the second official language. English is universally spoken throughout Ireland, and approximately 27% of the population knows both Irish and English. Irish is more widely used in the west and is the first language of people in remote areas.
To understand the development of language in Ireland, it is essential to understand the historical significance of Celtic (usually pronounced /kel-tic/) languages. Because the Celts (/kelts/) developed a written language quite late, the people were forced to rely heavily on the oral transmission of laws, customs, religions, and philosophy; poetry became a useful mnemonic device for transmitting tradition. According to legend, the ancient heroes of the mythological cycle, which included Finn MacCool and Cuchulain, were clearly in love with the sound of their own voices. Modern-day Irish people are much like the ancient Celts; much wit and humor are part of communication ( ). suggested that, for Irish people, playing with the language provided not only a means of communication but also a portion of their enjoyment and pleasure. It should be noted that languages throughout the world that have survived from an earlier period have not only elaborate language structures but also more extensive vocabularies. The suggested reason is that spoken language needs to be more flexible and descriptive than written language.
For people in the western part of Ireland, the vocabulary is about one half as extensive as the vocabulary of the well-educated English speaker in London. It also has been noted that people who live in the Gaeltacht (/gail-tahht/) or the Irish-speaking regions in the west tend to have an extensive English-speaking vocabulary. Although a modern-day Irish language exists, the Irish language for all practical purposes was almost destroyed during the second half of the nineteenth century with the onslaught of the English language. Some phrases attributed to the Irish, such as “Top O’ the Mornin’,” are not commonly heard in Ireland, where noted that “Hi,” “Hiya,” and “Howarya!” or, in rural areas, a polite “Hello,” are the common terms. An effort has been made to increase the understanding and use of Gaelic through TV programs financed by the government, as well as schools using only Gaelic ( ).
Because many Irish persons arrived in the United States with knowledge of English, assimilation into the predominant culture was enhanced. However, despite the use of English words, some words have different meanings for the Irish. For example, the word homely , which is commonly used in the United States to describe someone who is plain and not attractive, is used by some Irish people as an endearing word to describe hospitality. An Irish guest after a dinner may hug the host or hostess and say, “Thank you for being so homely.” In Ireland it is considered inappropriate to ask for a “ride” from a cab driver. Instead, the word lift or drive is used.
Nonverbal actions have special significance for the Irish. For example, holding up two fingers with the palm facing one’s face is a hand gesture meant to be obscene ( ). In business or professional relationships, it is not considered proper to give gifts. Instead, tokens of appreciation with special significance, such as Vermont maple syrup or California wine, are appreciated ( ).
In Ireland, “Mac” before a family name describes the “son of,” and “O” is used to mean “descended from.” Gaelic names such as Brian, Maureen, Sheila, Sean, and Moria are popular first names for Irish-American children. Names are typically written with the surname. First names are commonly used in informal situations ( ).
The Irish tend to dress up rather than dress casually for business or professional events. The nurse should not be surprised if a newly immigrated Irish client comes to a health care agency very well dressed. Brightly colored traditional Irish costumes can still be seen in America by persons performing Irish dances and can be noted in Ireland at special holiday events ( ).
Implications for Transcultural Nursing Care
It is important for the nurse to understand that some Irish Americans who may be encountered in the health care system may not have an extensive vocabulary, but the words they speak may be used with exaggeration. Because language is a form of entertainment and power for some Irish people, the client may attempt to communicate needs through flowery and sometimes exaggerated words. On the other hand, some Irish tend to ignore pain and to provide no words of complaint. Therefore, it is essential for the nurse to carefully evaluate physical signs and symptoms of pain in addition to oral descriptions to accurately assess the need for nursing intervention. Because of this variety of responses, it is particularly important for the nurse to be careful to not stereotype Irish-American clients relative to pain response ( ). The astute nurse must keep in mind that the Irish-American client may tend to be overly verbose in descriptions of conditions, but this does not imply that the client is not being objective or accurately descriptive about the nature of the condition. The nurse should use a combination of open- and closed-ended questions to solicit specific information from which culturally appropriate nursing care can be planned. When assessing the client, the nurse should be aware that some Irish Americans tend to avoid saying the word “no.” Instead, phrases such as “I’ll let you know” or “we’ll see” or “perhaps” are used. It is important for the nurse to try to analyze context and demeanor to determine if the response is really negative ( ).
compared Italian Americans and Irish Americans and their descriptive methods of presenting complaints. The findings of the study indicated that when Italian Americans and Irish Americans were asked, “Where does it hurt?” Irish-American respondents were more likely to locate chief problems in the eyes, ears, nose, or throat. In a similar question, the respondents were asked to identify the most important areas of the body. Again, for the Irish-American respondents, the emphasis was on the eyes, ears, nose, and throat. Another finding of the study was that the Irish Americans more often than the Italian Americans denied that pain was a part of their illness. When Irish-American respondents were asked about the presence of pain, some of them hedged their replies with qualifications such as “It is more a throbbing than a pain,” or “It is not really a pain; it feels more like sand in my eye,” or “It feels more like a pinprick than a pain.” The conclusion of the study was that Irish Americans, through such comments, were reflecting something more than an objective reaction to their physical condition. Irish Americans were found to describe their chief problems in terms of specific dysfunctions. What appeared to emerge from the study was that Irish people limit and understate their physical difficulties, whereas Italians spread and generalize theirs.
With the increasing numbers of Irish clients, it is helpful to have health care materials translated into Irish. However, translating client-teaching materials and various assessment materials to the Irish has not always been completely successful. For example, attempted to utilize the Brief Symptoms Inventory to assess psychological distress among Polish, Filipino, and Irish immigrants by translating the form into the respective languages. It was found that the scale in its translated form was able to measure psychological distress with all three immigrant groups. However, problems with the psychoticism subscale occurred across all three immigrant groups, indicating that this subscale should be interpreted with caution when used with immigrants. Thus, although English translation to another language on written assessment materials is sometimes helpful, it cannot be assumed to be accurate.
Space is an essential component in a cultural framework of nursing because from the beginning of modern time, philosophers, mathematicians, psychologists, and ethnologists have studied the phenomenon of space. Territoriality , proximity , and personal space are all terms that have been used to describe space. The word territoriality was initially used to describe the physical area that animals claim as their own and defend from predators, but in modern times the term has been extended to describe human behavior as well ( ). coined the term proxemics to describe the use of space as an elaboration of a culture. According to , individuals by virtue of their culture have four ways of perceiving distance: as intimate distance (from 6 to 8 inches), as personal distance (from 6 inches to 4 feet), as social distance (from 4 to 12 feet), and as public distance (from 12 to 25 feet). concluded that the use of space explains communication in various cultures.
Space is a cultural phenomenon that is infrequently noted in the literature about the Irish. has noted, however, that Irish-American students often require more time to become articulate and self-confident in a high-powered academic environment and that this can be seen in the student’s spatial relationships with others. The Irish-American student is more likely to sit off in a corner for several semesters, only to be “discovered” later as having produced brilliant work, for the most part in solitude ( ). Some authors ( ; ) have also noted that Irish individuals are less likely to be physically affectionate in both their interpersonal and their family relationships.
Implications for Nursing Care
The use of space, in its simplest terms, is a means of nonverbal communication ( ). How individuals feel about their own personal space determines how much intrusion by others is considered acceptable. Because health care often occurs in what is described as an intimate zone , spatial issues have important implications for the nurse.
The personal space of some Irish Americans is limited, and they are perceived as having a past-time–oriented culture that relies heavily on extended family ties ( ). They may be accustomed to having family members close by, increasing their need for proximity of family members during illness. However, according to ), despite the closeness of the family unit, Irish-American families have a tendency to collapse the personal space inward, more so than in other cultures. It has been noted that Irish-American families have difficulty expressing love and affection. Some have more difficulty in expression with close family members than with more distant persons, creating an isolated and greatly expanded personal space. Others express feelings somewhat readily with a close group of intimates but not with persons more distant. The nurse should be cognizant of the possible effects of attitudes and values about space that may affect individuals from different cultures. One major objective for the nurse may be to assist the family in recognizing the need to convey warmth, feelings, and attitudes in order to create a supportive and nurturing spatial environment for the client that will promote recovery.
The famine years had a profound effect on the structure of the Irish-American family. As the famine progressed, the resulting experiences dramatically altered the family system in Ireland. Immigrants brought this altered family structure to the United States and formed their own ethnic societies. Most of those who immigrated to the United States from Ireland were between 15 and 35 years of age, since it was these able-bodied individuals who were most able to leave ( ).
Ireland stands alone in losing such a large proportion of its population to emigration. Even in modern times, more Irish people live outside Ireland than in it, and most Irish families have at least some members living in the United States ( ). A wide range of disparity has been noted regarding the link between Irish Americans and the family in the homeland. For some Irish Americans, there appears to be an almost mystical link between the family in the United States and the roots in Ireland. These roots often lead to a particular farm that may still be inhabited by a remnant of that particular clan. For other Irish Americans, there is almost no link remaining, except the knowledge that an ancestor originated in Ireland. The family values and ethnic traits are often transmitted to the next generation unconsciously by imitation of the parental model.
Before the famine years, families in the southern and western parts of Ireland were traditionally Irish speaking, Catholic, and subsistence farmers. The typical couple married early, had many children, and on the father’s death subdivided the land among the sons. The agricultural pattern of the prefamine years no doubt was instrumental in creating the almost total reliance of the Irish on the potato crop. However, this pattern of continuous subdividing of the land among family members also contributed to the close family bonds, as were evidenced by parental demands for respectful attention and obedience to marriages arranged by the parents. These family bonds continued even after immigration to the United States, as evidenced by the fact that it was the responsibility of many immigrants to send money back to Ireland to pay the passage for another family member to come to the United States ( ).
In the past, there was intense social pressure among Irish Americans to select mates from the Irish Catholic community. Therefore, the Irish neighborhoods in the United States often served as the social context for the meeting and pairing of the young immigrants ( ). For the early Irish settlers, marriage with non-Irish Catholics was a permissible alternative. However, these marriages generally followed a preferential hierarchy in which the early-arriving English or German Catholics were considered more suitable than the later-arriving Irish Catholics ( ). By the time of the third generation of immigrants, a tendency was noted for the socially aspiring Irish Catholic to marry a Protestant or even convert to Protestantism. These practices were generally disapproved of by other Irish-American Catholics. Even today in stable communities in the United States, intermarriage between Irish families remains one of the clearest distinctions of social acceptance and social equality in the Irish-American community.
Bachelorhood and spinsterhood are infrequent among Irish Americans ( ). The typical Irish-American Catholic woman marries at 22 years of age, and the typical Irish-American Catholic man marries at 24.5 years of age. Although this is a bit older than the American average, the practice in ancient Ireland was to delay marriage until the early 30s. The mean number of children for Irish-American families is 2.6, compared with the national mean of 2.4. As family planning becomes more progressive among Irish-American Catholics, the number of children is decreasing.
Role of Women.
One traditional view of Irish women was that they were controlling matriarchs on whom sons and husbands were dependent ( ). A contrasting view held that male dominance began as a pattern in Ireland after the mass emigrations. Women were expected to be subservient in every way and assist their husbands with what was considered “men’s work” in addition to completing their own traditionally female tasks. However, many women emigrated alone, accentuating the strength and resolve of women; today, many are involved in professional occupations ( ).
Irish-American women are more likely than their Anglo-American counterparts to view the wife–mother role as the dominant one in marriage. The findings are also suggestive that Irish-American women view the mother’s working as detrimental to children and see the role of the wife as a helper to her husband, although these views are changing to reflect more mainstream thought ( ).
Role of Men.
has noted that although Irish men, particularly when intoxicated, may spin tall tales and recite romantic poetry about their true love, in intimate relationships they often become awkward and tongue-tied and may become clumsy, if not rough, in any attempts at intimacy. The male dominance that began in Ireland as a result of the change in family structure between 1840 and 1940 is paralleled even today among Irish Americans ( ).
Children and Adolescents
investigated pretend play interactions of Irish-American children, noting that compared with Chinese children studied, specific culture communities tend to create distinctive developmental pathways. In a study of adolescents in England and Ireland, noted that the Irish adolescents had a less mature pattern than their English counterparts; however, Irish adolescents in the study admitted to having more worries. The conclusion of the study was that cultural differences are specifically reflected in adolescent experiences.
In Ireland and in the United States, the primary cultural force and national unifier of Irish culture has been the Catholic church ( ). In fact, the parish rather than the neighborhood has traditionally defined the family’s social context ( ). The Church of Ireland is an independent Anglican church found in both the Republic of Ireland and Northern Ireland, tracing its episcopal succession from the pre-Reformation church in Ireland. Christianity is believed to have existed in Ireland before the missionary activities of Patrick, the patron saint of Ireland, in the late fifth century. The early church in Ireland was monastic, without parochial or diocesan divisions or central government. If there was authority within the structure of the church, it rested with the abbot and the bishops.
In Ireland, the Catholic church has been faced with a dilemma because of the desire to preserve the Catholic moral tone. In this regard, the Catholic church has found it necessary to relegate the prevention of AIDS through the promotion of condoms and safe sexual practices to the government. Most Catholic churches advocate abstinence before marriage and avoidance of sexual behavior by some high-risk groups, such as homosexuals.
Immigrants from Ireland have contributed significantly to the development of the United States from its inception ( ). In fact, eight Irish individuals signed the Declaration of Independence, and five died in the Boston Massacre. About one third of the people in the United States can trace all or part of their lineage to Irish ancestry. It has been reported that three presidents, including Andrew Jackson, James Buchanan, and Chester Arthur, were sons of Irish immigrants. Irish individuals have been active in all walks of American life, including the formation and growth of trade unions and active service on police forces across the country, and have served admirably in the Army and in the Navy ( ).
Irish Americans have enjoyed a significant and spectacular rise in the political arena in this country, in part because of block voting in large cities, where they generally were the largest single group. This voting practice assured the Irish of political influence by the , particularly in Boston, where the first Irish-American mayors were elected. During this same period in New York, the Irish, including noted Irish-American political bosses John F. Fitzgerald, Richard J. Daley, “Big Tim” Sullivan, and James Michael Curley, controlled many political machines. The success of the Irish resulted partially from their strong sense of group solidarity, their fluency with the spoken word, and their personal charm. Historically, the Irish were known as the most successful enhancers of corrupt politics. Today, the voting patterns for Irish Americans remain about the same as that for other Americans. In addition, with the election of the first Irish-Catholic president in 1960 (John F. Kennedy), the issue of an Irish-Catholic president was resolved.
Implications for Nursing Care
The nurse must keep in mind that the one reemerging theme among Irish Americans is the significance of the family and family structure, which may be difficult for people from other cultures to perceive. Because Irish Americans are viewed as having a relational orientation that is lineal in nature (see later discussion), nursing interventions are likely to be successful only if family involvement in the care and treatment of the client is maximized.
viewed relational orientation in families as having three subdivisions: lateral (collateral), lineal, and individualistic. For families with a lateral (collateral) mode of orientation, the goals and welfare of laterally extended groups, including siblings and peers, take on paramount importance. This type of family assumes responsibility for all of its members. Therefore, the goals of the individual family members become subordinate to those of the family group. When the lineal mode is present as the major focus in family groups, the goals and welfare of the group may also have primary importance because the family members view culture and kinship bonds as the primary basis for maintaining lineage.
It is important for the nurse to seek the family’s advice and opinions on treatment for the client. In addition, since the family is perceived as being a source of anxiety and tension because of restricted family roles, it is important for the nurse to assist the family in identifying the boundaries and characteristics of each role. If the family determines that the boundaries are restricted and do not overlap, the nurse must accept this fact and recognize and appreciate that such families function with a hierarchical ranking of family roles. Therefore, lack of recognition on the part of a nurse may foster feelings of anxiety and tension on the part of those persons who are considered to be at the top of the hierarchical ranking, such as the father or the mother.
A contrasting mode held by some families is the individualistic mode of orientation. For families with this orientation, individual goals are viewed as being more important than specific lateral or lineal goals. In this type of family, each member is held responsible for personal behavior and is therefore judged according to personal accomplishments ( ).
Because Irish Americans tend to delineate roles and behaviors within the family structure on the basis of gender, it is important for the nurse not to minimize the significance of ranked ordering of behavior. For example, some Irish-American women may view their role as primary caretaker of the family. Therefore, when they are ill, their role function is greatly compromised. In this case, the client must be assisted to develop strategies to help the family meet its needs in the absence of the primary caretaker.
It also is important for the nurse to remember that for some Irish Americans, religion and religious views take on paramount importance in maintaining the social integrity of the individual. The astute nurse should solicit information on religious practices that are deemed essential to the optimal functioning of the Irish-American client. Lack of recognition of the significance of religious beliefs may augment problems and difficulties encountered with illness.