Pts abusing "cultural/religious" practices to manipulate RNs

[HvnSntRN]

This has been bugging me for a while.

A few weeks ago, we had a postpartum patient who is Jewish (Orthodox), which means that they won't do "work" on their Sabbath (sundown on Friday until sundown on Saturday). No problem. The nurse looking after her planned with her to check in every hour to see if she needed something.

I later found out that the patient sent the baby to the nursery to be bottle fed by the staff overnight, even though she was breastfeeding.

I also found out that not only did she do this on Friday-Saturday, but also Saturday-Sunday, and Sunday-Monday. She had a different RN working with her each shift and pulled the "no work on the Sabbath" routine, expecting that the nurse wouldn't be familiar with the differences between the Christian and Jewish observances of the Sabbath.

I guess I just have a hard time respecting people who misinform regarding their beliefs and cultural practices with the aim of getting what they want from other people. I mean, why not just say (like other people do) "I'm really tired from breastfeeding and I'd rather let you give the baby a bottle overnight", instead of trying to manipulate us with phony information about religious beliefs and practices? I'm pretty sure that Jewish people eat on the Sabbath; do they plan to not feed their babies on the Sabbath once they're discharged from the hospital? If that's the case, then we should be calling CPS, right?

I'm all for being culturally sensitive and respecting other peoples' belief systems. What I don't appreciate is when my colleagues get manipulated on that basis by people being deceptive about their beliefs and practices - it shows a distinct lack of respect for us and an abuse of our efforts at being culturally sensitive.

How do other RNs handle situations like this?

[PANurseRN1]

I'm sorry but I don't think walking a patient's visitors to the elevator and pushing the button for them is a part of my job. Especially in my unit where we have to go beyond the locked doors to get to the elevator. And why should I have to know this also?

I pride myself in being very tolerant, but there's a limit to what we are supposed to know about all the many differences. And again, if I, as a Protestant, were to be hospitalized in a predominantly (fill in the blank) area, would they be busting their bums to honor each and every one of my religious beliefs, not to mention already knowing about them? Seriously doubt it.

I don't think caroladybelle was saying you had to do it. She was simply relating what she chooses to do. No need to get your nose out of joint.

Why should you have to know this? I guess you don't if you're not interested in providing holistic care. But this is the problem here in this country; the majority feel no need to learn more about those who are different. Some are outright offended at the mere suggestion that they should try to do so.

As far as how you would possibly be treated at a non-Protestant facility, why should you let your assumptions affect the care you give to your patients? Whatever happened to "do unto others"? There's a basic Christian tenent for you. (Given by someone who was Jewish, no less.)

[ChocoholicRN]

Not to sidetrack too much, but just a comment on the elevator thing. We as nurses/nursing students are taught to be tolerant of the cultures of our patients and not judge them. There are things that I have had to do for patients of other cultures that was a lot more difficult than pushing the button in an elevator. True, it is a pain to have to do that for someone, especially if it is out of your way, but it is a matter of respecting anothers religion and traditions. Most Jews who observe the Sabbath don't mind taking the stairs, as it is something they have always done on this day. Other hospitals or apartment buildings have an one elevator that, on Shabbat only, will stop on every floor going up and down for the whole day, no pushing buttons!! Please just try to understand where these people are coming from, it may seem like a pain in the neck for you, but for someone who observes the Sabbath it is a mitzvah for you to go just a little bit out of your way to do this for them. And if it really is truly out of your way at that moment, as a nurse or an aide or anyone to help.

[GardenDove]

The elevator thing is a little over the top, IMO. People do have to take a little responsibility for their own beliefs. For instance, I were as a practising Catholic wanted someone to bring Holy Communion into the hospital, then someone from the Church would come. I wouldn't expect nursing staff to know all the ins and outs of all my religious needs. To most people it would seem logical that taking the elevator is LESS work than taking the stairs actually. Also, we aren't there to serve every minute need of every visitor. If they are that hairsplitting about fine points of their Sabbath law, they probably ought to stay home. Is that really true that they can't push a button on an elevator on the Sabbath, but they can take the elevator if someone else pushes it?

People have to communicate reasonable requests. But I don't think we are responsible for pushing the button on the elevator for every Orthodox Jew who visits the hospital.

[Zippedodah]

We have orthodox Jews where I work, and yes, they can't "activate" anything electrical, so we do it for them It isn't really a big deal to push an elevator button...surely a post c/s mom who is staying and boarding shouldn't be walking up and down 2 flights of stairs, so we accomodate them. No problem. Actually, most Orthodox won't be in to visit and you won't have to push the button because they can't drive from sunset to sunset.

Our hospital is very good in making sure we have inservices about the different cultures and what to expect. Maybe ask your education and training department about that.

[Yuliya3]

Orthodox Jews take stairs on Shabbos unless there is a Shabbos elevator in the hospital (the one that authomatically stops on every floor). There is IMO a problem (actually 2) to ask someone to operate elevator for then. So I do not think there are many people out there bugging nurses to press elevator buttons. If there are such visitors, they would probably ask who ever is in the elevator already to press a button for them. Personally, I think that unless one is becoming a rabbinical student, a nurse can survive without knowing details of every Jewish law(or laws of any other religion for that matter). In NYC you would see patients of 10 different religions/cultures in one day. A Muslem patient who needs a female Gyn, or a SDA patient who will not take blood products, or a diet info sheet that addresses specific needs of a Hispanic patients, or Creole translation chart for a patient who does not speak a word of English, patient is a patient. No one is a mindreader, so people should explain what they need and why, but still...religion/culture is a part of a patient nurse has to deal with.

[caroladybelle, BSN, RN]

I'm sorry but I don't think walking a patient's visitors to the elevator and pushing the button for them is a part of my job. Especially in my unit where we have to go beyond the locked doors to get to the elevator. And why should I have to know this also?

I pride myself in being very tolerant, but there's a limit to what we are supposed to know about all the many differences. And again, if I, as a Protestant, were to be hospitalized in a predominantly (fill in the blank) area, would they be busting their bums to honor each and every one of my religious beliefs, not to mention already knowing about them? Seriously doubt it.

You don't HAVE to know things and there are plenty of things that are not my JOB, but that I learn and do because it is respectful and mannerly, if I have the time to do them.

In Jewish hospitals there are plenty of accomodations of Christian/Muslim/Hindu/Buddhist patients. Most of the microwaves on the floors are not kept kosher (they could easily bar them for use in prep on nonkosher foods) , and it can be darned inconvenient to have to double wrap and slowly heat kosher food so that it doesn't burst. Autopsies if requested are done, as well as cosmetic surgery, both of which are counter to Jewish law (and yes, I do know about the number of Jewish plastic surgeons). Non kosher food is permitted in the facility, as well as religious counsel that is non Jewish. And yes, the Rabbi will bust his bum to make sure that your religion will be reasonably accomodated. For one, during Ramadan, I have seen them make arrangements for Muslim staff/patients to be able to eat well after daily fast is broken.

I routinely ask my Asian clients whether they prefer cold or warm water, and offer to heat their liquid meds (Warmth is healing, cold is associated w/ illness in many asian cultures). I honor my JW patients request for bloodless care, get orders to use peditubes on their lab draws. I ensure a vegetarian diet for my SDA/hindu patients if need be. And I get special permission for my NPO Catholic clients to have communion, and to call the nuns if requested.

I do not do this because I 'have' to - I do it because it is the way that I want my beliefs respected when I am ill.

[PANurseRN1]

You don't HAVE to know things and there are plenty of things that are not my JOB, but that I learn and do because it is polite and mannerly, if I have the time to do them.

In Jewish hospitals there are plenty of accomodations of Christian/Muslim/Hindu/Buddhist patients. Most of the microwaves on the floors are not kept kosher, and it can be darned inconvenient to have to double wrap and slowly heat kosher food so that it doesn't burst. Autopsies if requested are done, as well as cosmetic surgery, both of which are counter to Jewish law (and yes, I do know about the number of Jewish plastic surgeons). Non kosher food is permitted in the facility, as well as religious counsel that is non Jewish. And yes, the Rabbi will bust his bum to make sure that your religion will be reasonably accomodated. For one, during Ramadan, I have seen them make arrangements for Muslim staff/patients to be able to eat well after daily fast is broken.

I routinely ask my Asian clients whether they prefer cold or warm water, and offer to heat their liquid meds (Warmth is healing, cold causes illness in many asian cultures). I honor my JW patients request for bloodless care, get orders to use peditubes on their lab draws. I ensure a vegetarian diet for my SDA/hindu patients if need be. And I get special permission for my NPO Catholic clients to have communion, and to call the nuns if requested.

I do not do this because I 'have' to - I do it because it is the way that I want my beliefs respected when I am ill.

This is an excellent reply. Encapsulates exactly what caring for the "whole pt" is all about.

I do have a question, though. If pusing an elevator button is considered "work," wouldn't someone taking the stairs possibly have to open a door? Would that be considered work? I'm not trying to be dense, just trying to understand more. I'm a little confused about what is defined as "work."

Thanks to anyone who can answer.

[firstyearstudent]

Not to sidetrack the thread into a discussion of the finer points of Jewish theology, but that's not technically correct. A Jew who "apostizes" (I'm sure that's spelled wrong) by adopting another religion, be it Buddhism, Hindu, Christianity or whatever, might have to immerse in a Mikvah (ritual bath) in order to be accepted back into the Jewish fold, but they're considered Jewish all along, and a child born to Jewish parents, even if they practice another religion, is considered Jewish and is welcome back anytime without having to undergo conversion.

Only if both parents or the mother is Jewish. If the father is Jewish and the mother is a gentile, the reform branch of Judaism would consider the child Jewish if the family is practicing. However, orthodox Jews would require that the child undergo an official conversion (including a circumcision if the child is male) and might not recognize a conversion that isn't orthodox.

[rktele]

Maybe she's just a really tired new mom and used her religion as an excuse so she wouldn't have to answer any questions.

[SOREFEETEMPTYSTOMACH]

If This Little Girl Thinks That Holding A Newborn Infant And Breast Feeding It Is Work She Has A Real Awakening Coming To Her.it's Possible That Her Husband Treats Her Like A Princess But In Any Event I Agree With Everyone Recommending She Get Some Help, Even Therapy.i'm Not Sure She's Ready To Take The Infant Home. There Is A Problem.

[SmilingBluEyes]

I think it helps to know the difference between providing culturally-sensitive care and being manipulated. This comes with a lot of experience, study and time. I have several cultural nursing books that have helped me greatly through the years. And I am with the posters who say providing culturally-sensitive care may not include items IN MY JOB DESCRIPTION, but I will do what I can to accomodate, as long as safety and patient care (all my patients) are not compromised.

[Quickbeam, BSN, RN]

a SDA patient who will not take blood products

I think you meant Jehovah's Witness. There is no prohibition for SDAs against taking transfusions. Individuals may choose that, probably, but nothing in the corporate faith. My church has blood drives!

No intent to hijack here...just wanted to clarify. I am an SDA and we get confused with other faiths all the time.