Our society is increasingly a rich melting pot of cultures, religions and ethnic groups. As a registered nurse, you need a culturally diverse knowledge base to provide personalized, patient-centered care. Not only do you need to know your patients' cultural and religious beliefs, but you also need to understand the logic behind those beliefs as they can influence your patient's treatment plan.
The goals of expanding your knowledge base on cultural and religious diversity are to reduce the frequency of poor patient outcomes, increase overall patient satisfaction, and improve the quality of care, all using best practices. Reading this article can help you achieve those goals. Of course, this is just a start, although this article will provide a brief overview of five of the world's major religions (Buddhism, Christianity, Hinduism, Judaism, and Islam) and other religions (such as Christian Science, the Church of Jesus Christ) and Latter-day Saints , the Church of Scientology and Jehovah's Witnesses) you can see there are many other religious groups as well as numerous sects within these groups and variations of beliefs within each sect. I encourage you to research specific religious practices for your patient population to optimize your patients' healthcare experience.
Determination of patient preference
During the admissions process, we typically ask patients about their cultural or religious preferences. Ideally, we use this information by including it in the care plan where appropriate.
On the other hand, we should also not make assumptions based on the patient's answers about religious preferences. Many patients adhere strictly to the beliefs of their religion, while others have modified their beliefs from those of their religion.
Be sure to ask patients about their religious preferences in a private area where family or friends are not present if possible. This prevents the patient from feeling coerced or unduly influenced by potentially conflicting views from family and friends.
While most patients turn to their personal clergy, Buddhist patients traveling far from home may require critical care services at a healthcare facility. If these patients do not have their own chaplain available, you can contact your health center chaplain. He or she may be able to help patients by reaching out to a minister of the patient's religion.
Buddhist patients are often humble, and many have an aversion to animal meat products, including those used to make certain medicines. Ask patients if they have any special dietary or treatment needs to ensure you are providing culture-sensitive care.
Buddhist patients may refuse painkillers because mental clarity is very important to practicing Buddhists. Non-pharmacological interventions are often preferred for pain management, such as meditation and relaxation techniques. Buddhists emphasize mindfulness and peaceful meditation in times of illness and crisis. If possible, try to create a calm and peaceful environment for the patient and their family to facilitate meditation.
Buddhist parents can seek advice from a Theravada Buddhist monk on naming and blessing their newborn child. Buddhist names are often associated with the child's day, month, season, and zodiac sign.
At the end of life, families can sing or pray aloud and ask for incense or candles to be lit. Whenever possible, provide privacy for the patient and their family to participate in these practices. If certain religious practices, such as B. lighting candles, are not allowed for safety reasons, because z. B. If oxygen is nearby, tell the patient and family why.
Death is seen as a moment of transition. If possible, minimize interactions with the patient so as not to interrupt their concentration or cause distractions; Nursing interventions should be grouped to allow for minimal disruption during meditation.
After the patient dies, try to keep the body as still as possible when moving and do not remove jewelry, such as jewelry. B. a rope worn around the neck or on the wrist. Buddhists believe that after death the body is not immediately emptied of the spirit. For this reason, many families may not be open to organ donation. Because many Buddhist families require the body to be available to them for several hours after death to perform religious rites, consider transferring the patient to a facility in your health center with a low patient turnover that can maintain this practice.
An example of a common discrepancy in religious practice that you might encounter is that while most Catholics generally do not support the use of contraception, many Catholics do use contraception. Because some Catholic patients use contraception, you should ask the patient at discharge after delivery or during the first 6-week assessment if she would like to discuss contraception options.
When caring for a practicing Catholic patient, remember that childbirth techniques, the use of painkillers during childbirth, breastfeeding, circumcision, and vaccinations are all matters left to the discretion of the parents by the Catholic Church.
If a patient has N.P.O. , get permission from the healthcare professional before the patient receives Communion. If possible, the patient will want to carry a crucifix or rosary with them during an operation or medical procedure.
Most Catholics believe that patients or their family members can request a Catholic priest to perform the sacraments, last rites and blessings if they realize they are in danger of death during a medical procedure. Baptism may be required, especially for a dying child.
No special physical preparation is required after death. The Catholic Church advocates burial rather than cremation, but no longer prohibits the practice. The Church requires that cremated remains not be scattered, kept at home, or divided into other containers, as this would be considered profanation. Burial at sea is permitted if the remains are kept in a heavy, locked container.
Christian Scientist Patients
The essence of Christian Science is that the true reality is a spiritual world; the material world is just the mind's distorted view of reality. From a health perspective, Christian Scientists recognize that infections are bacterial in origin, but believe there is an underlying spiritual aspect that requires healing through prayer. Christian Scientist patients are not always opposed to medication as a treatment, but they believe that medication has no real power or value. Christian Scientists generally avoid alcohol and caffeinated foods like coffee and tea.
For the healthcare professional, the focus should be on treating the patient's physical symptoms and not on the cause and effect discussion as this can be a point of contention. Many Christian Scientists oppose surgery in favor of prayer. Many prefer to be treated at home, but go to the hospital if necessary.
Christian Scientist patients are generally comfortable with hospital delivery and medication during labor, but may prefer a midwife and holistic approach. Christian Scientists allow mandatory infant and child vaccinations.
Christian Scientists believe that death is a transition into the spiritual realm. Postmortem care for women should be provided by female caregivers. Christian Science has no specific doctrine for ultimate rights regarding death, burial, or mourning rites. Cremation is often preferred to burial, but is not prohibited. Autopsies are not preferred whenever possible. Christian Scientists do not believe in donating their bodies to science because medical experiments on humans are not considered ethical.
Indian patients have strong modesty concerns and may prefer same-sex caregivers. The husband can request to be present when his wife is receiving urogenital care, particularly during pregnancy, childbirth and postpartum.
Many Indian patients are strict vegetarians who refuse medications containing animal by-products; others refuse only pork and beef. Fasting is a common practice in times of crisis.
Because Hindus believe the right hand is clean, some use the right hand for eating, with or without utensils. The left hand is for dirty tasks like going to the toilet. Be sure to shake hands with your right hand so as not to show any signs of disrespect.
Although devout Hindus prefer to die at home, religious jewelry, such as e.g. a lanyard around the neck or wrist, if a Hindu patient dies in your facility, do not remove it without the prior permission of the patient or his/her family. That the family washes the body and constantly helps the deceased and even accompanies the body to the morgue.
Patients of Jehovah's Witnesses
Many Jehovah's Witnesses strictly refuse to personally receive blood in the form of transfusions, medicines, blood products or food. This prohibition also applies to the transfusion of blood that you have stored yourself. The Patient Self-Determination Act was passed in 1991. It gives every competent and knowledgeable person, including pregnant women, the right to accept or refuse any form of medical treatment.
In principle, organ donations and transplants are permitted. Many Jehovah's Witnesses carry a medical card listing their religious preferences for emergency care.
Caring for Jehovah's Witnesses patients can be emotionally frustrating for caregivers because we are trained to save lives by administering treatments such as blood products. Be careful not to project your personal or religious beliefs onto the patient. If the patient is a minor and refuses life-saving or life-sustaining treatment, such as blood products, consult the health care team and your ethics board to ensure the decision to refuse this treatment is made with parental consent and complies with government regulations. and federal laws.
Jehovah's Witnesses do not believe in life immediately after death. Health professionals should refrain from saying things like "He's in a better place now" to comfort the family.
Death is a time for celebration, not sadness. Funeral practices are similar to those of other Christian religions. However, cameras and recording devices are generally not permitted.
Observant Jewish patients will follow the strict rule of not working on the Sabbath, which lasts from sundown Friday to sundown Saturday. They may be prohibited from using tools or starting the flow of electricity. Flicking a light switch, pressing a call button, using a patient-controlled analgesic pump, or adjusting a motorized bed can all be considered labor-intensive.
Make sure all practicing Jewish patients' needs are met before leaving the room and check in with them regularly to make sure they are still comfortable. If possible, avoid scheduling medical procedures and discharges on a Saturday. Work closely with the patient, family, health care team and discharge nurse to coordinate the patient's discharge needs in advance if a Saturday discharge is unavoidable.
Jewish law regards a woman who is about to give birth on the Sabbath as a seriously ill patient. Saturday Rules may be suspended during this pop-up period. Breastfeeding a child after birth also falls into this category. Male babies are circumcised at 8 days of age.
Observant Jewish men usually wear a kippah or kippa (cap) at all times. Orthodox Jewish women often wear wigs to cover their hair; other practicing Jewish women may also wear kippahs. Orthodox Jews pray three times a day. You can facilitate this by ensuring that interventions are not scheduled and that there are as few disruptions as possible during these times.
Observing Jewish patients will request a kosher diet. You can help a devout Jewish patient meet their dietary restrictions by ordering specific diets based on religious preferences. Also, consult the facility's nutritionist and nutritionist about the patient's dietary preferences.
Families may wish to speak to a rabbi about end-of-life care when death is expected. After death, burial must be expeditious, usually within 24 hours, and embalming is not preferred. Although practicing Jews prefer to avoid autopsies, they are permitted if ordered by a coroner. Any amputated limb that was surgically removed shortly before death may also be claimed for burial. Family members can ask for a group of 10 people (called a minyan) to pray for the deceased. For Orthodox Jews, this is a group of 10 men; for other observing denominations it may be a group of 10 men and women. To accommodate the spiritual needs of the Jewish patient and family, ensure the group has privacy for this if possible.
The Church of Jesus Christ of Latter-day Saints discourages the use of alcohol, tobacco, illegal drugs, and caffeine (any substance that is physically addictive). Although Mormons discourage alcohol consumption, medications containing small amounts of alcohol, such as certain cough medicines, may be permitted.
Mormons believe that in times of illness or childbirth, two elders can pray for the patient and anoint her forehead with oil as a blessing for healing and well-being. If possible, try to provide privacy during this prayer time.
Mormons believe that death is the separation of the soul from the body. Since all infants and children under the age of 8 are believed to be sinless, baptism is not required for this age group even if the child dies. A Mormon bishop or priesthood holder can bless a dying child and even name a child if necessary.
The Church does not encourage or discourage autopsies and organ donation. These decisions are left to the families. Taking life support away from a dying patient is often contrary to church teaching, but that choice is also left to each family. Burial over cremation is recommended. Those who have already received their temple endowment (or church dedication) may be buried in church-issued white temple robes. Many Mormons have a brief vision of the open coffin before the burial.
Muslim patients are often very modest and full nudity is a problem for practicing Muslims. Women can cover their whole body with clothes and veils.
Muslim patients may prefer to be cared for by a same-sex caregiver. Ask patients if they prefer male or female caregivers, and accommodate their request if possible. Many practicing Muslims avoid casual physical contact with members of the opposite sex; even shaking hands or making eye contact can be discouraged.
When bathing, many Muslims require water to be poured from a pitcher. According to observations, Muslims generally wash before and after meals and before prayer, which is performed five times a day. You can help Muslim patients meet their spiritual needs by praying regularly throughout the day and ensuring that interventions, treatments, or interruptions such as B. the administration of medication, if possible not take place during these times.
Muslim patients can refuse medicines containing gelatin, pork products or alcohol. Find out what medications or vaccines your patient has in these products so you can provide complete information. If the ingredients are not listed on the drug or vaccine label, ask the pharmacy staff. Muslim patients can then make an informed decision before accepting any such medication or treatment.
Immediately after birth, a Muslim mother may want to recite a prayer in the newborn's ear. The placenta, considered sacred and an integral part of the body, may be requested by the family for burial. Circumcision is performed on young boys. Shaving the baby's hair is a Muslim practice that can also be done up to 7 days after the baby is born.
Muslim tradition advises against stopping or refusing life-sustaining treatment. The family can ask an imam to help them with end-of-life decisions. The family may request amputation of family members for burial. When death approaches, families want a family member to be present so they can whisper a creed into the ear of the dying patient.
After the patient's death, the family may wish to wash the body and turn their loved one's face towards Mecca. Families rarely allow an autopsy, and the burial should take place as soon as possible after the body has been transferred.
Protestant Christianity is the largest religious group in the United States, so you're probably fairly familiar with these beliefs by now. Christianity has many denominations, but most share the same basic belief system. Most denominations do not have specific policies regarding birth style, medication use, breastfeeding, circumcision of young boys, medical care, or other specific hospital needs. Protestant Christians believe that life begins at conception, and many are pro-life.
Many Protestant Christian patients carry a symbolic cross for peace, comfort and strength and can keep it with them during medical procedures. A pastor or church elder may visit the patient to pray with them or to read the Bible during times of illness. Family members can also pray. Most Protestant Christians have no special dietary restrictions, but some may prefer to fast at certain times to strengthen themselves spiritually.
Most Protestant Christians believe that baptism is an individual decision made at a responsible age. Some denominations, such as the Church of Christ, may consider baptism a condition of salvation. Designations vary according to burial practice; Some may choose cremation. No special autopsy care is required before the body is transported to the morgue or funeral home. Organ donation is a personal decision. Memorial services and funerals are usually conducted by a pastor or church elder.
The Church of Scientology opposes psychiatry and psychology and the use of any medication that alters the psyche or physical sensations. Although Scientology patients do not prefer the use of painkillers, they can be used short-term. Scientologists promote physical fitness and mental health, and tobacco use is discouraged.
Ask what specific treatments or medications the patient is willing to accept. Like all religions, Scientologists may be loosely affiliated with the Church of Scientology or dedicated to adhering to all Church policies.
Observant Scientologists believe births should be silent (no words are spoken); The Church does not endorse epidurals and other drugs commonly used during childbirth or breastfeeding.
Scientologists believe that the human soul passes from one body to another at the time of death through reincarnation. The process is automatic without soul judgment. No rituals or prayers are required before death. Funerals are usually short and for the attendees rather than for the deceased. No specific church teaching restricts organ donation, and both burial and cremation are accepted practices.
Celebrate our differences
In order to provide religiously practicing patients with culturally sensitive care, you should first find out about their personal religious views. Never impose your religious beliefs on the patient or his family as this can cause great emotional distress.
By expanding your knowledge of religion-specific nursing, you can better meet the spiritual needs of patients and make their healthcare experience more enjoyable.
When your patient's religious beliefs differ from yours
- Avoid imposing your personal beliefs on the patient; This can lead to emotional stress.
- You can politely inform the patient that they are not allowed to discuss religion or personal beliefs while at work.
- Because many patients are non-religious or agnostic or atheistic, be culturally sensitive when discussing religion at length.
- All patients, whether observant, nonobservant, agnostic, or atheistic, should receive culturally competent and compassionate care.
- Whenever possible, you may request an alternate assignment if you are asked to assist with a treatment or procedure that goes against your personal beliefs.
did you know?
Likeagnosticis a person who has no firm belief in the existence of God. OneAtheistis a person who believes that God does not exist. You will likely see patients who have no particular belief in God, or who do not believe in God at all. You're also likely to find patients who describe themselves as spiritual but don't affiliate themselves with any particular religious group (18% of Americans have no religion, according to a 2012 Gallop poll).
You are caring for a 16-year-old patient who sustained traumatic intra-abdominal injuries in a car accident. His diagnostic tests show a torn liver and contused kidneys. Your parents indicate your religious preference as a Jehovah's Witness in their registration papers. The child's hemoglobin fell from 9.2 to 5.9; she is pale and has tachycardia. As the ER nurse attending to this patient, you know that she will need emergency surgery and replacement of blood products, such as packed red blood cells and platelets, to stabilize her condition. He asks the patient and parents for permission to give her red blood cells and platelets to stabilize her for emergency surgery. Although some Jehovah's Witness families allow their children to receive blood products in an emergency situation, the parents of their patients do not consent. They consult with the healthcare team to identify other options that meet both the patient's medical needs and religious preferences. He then asks the patient's parents if they would be okay with the health team treating their daughter with plasma expanders since they do not contain blood products. The parents agree and they manage to stabilize the patient for the operation.
What should you do if a patient and family refuse treatment? You may contact your facility's ethics board and legal team to ensure care is being provided in accordance with state and federal guidelines. Subject to state consent laws, a child may provide medical consent for treatment that is contrary to their parent's religious preference. In some states, if there is a high risk of death or complications, the state can take legal action and suspend parental rights.
They are caring for a 28-year-old Catholic patient who is 22 weeks into her second pregnancy. The generally accepted age of fetal viability is 24 weeks gestation. This patient was diagnosed with placental abruption, is bleeding profusely, and is becoming hemodynamically unstable. As the labor and obstetrician attending to this patient, you face imminent death and stillbirth if you do not agree to a cesarean section immediately. The patient refuses because she knows the child will not survive. You will consult with your institution's ethics board and chaplain to ensure that this patient's wishes for medical and spiritual care are being followed. If the patient is healthy, she can make her own health care decisions, even if those decisions may result in complications and/or death. However, if the patient is incapacitated and unable to provide guidance or consent in the situation, medical decisions must be made by the patient's attorney or next of kin in accordance with state and federal law.