Pts abusing "cultural/religious" practices to manipulate RNs - page 4

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... Read More

  1. by   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.
  2. by   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.
  3. by   caroladybelle
    Quote from tntrn
    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.
    Last edit by caroladybelle on Dec 5, '06
  4. by   PANurseRN1
    Quote from caroladybelle
    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.
  5. by   firstyearstudent
    Quote from ChayaN
    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.
  6. by   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.
  7. by   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.
  8. by   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.
  9. by   Quickbeam
    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.
  10. by   NursShar1
    The reaction of feeling manipulated by this patient is natural and justified. However, it seems that being personally offended may be interfering with the nurse looking at the entire picture. I am not Jewish, but have worked in a heavily populated Jewish area and am somewhat familiar with the culture. I do not think that feeding a child is against the Sabbath practice, and if someone sat down with this woman and had a heart to heart talk, I am sure that she may admit it eventually as well. What needs to be done, is to look beyond the feelings of manipulation, and see what is at the heart of it all. If it is a first child, she may feel overwhelmed and need some time. Is it a 3rd or 4th or 5th? She may just want the rest that she knows she will not get when she goes home. This is no reason to call child services. People are entitled to feel overwhelmed or need some rest. Is she being pressured into breast feeding by a family member? If so, she may be using this as an excuse or justification to the family for not breast feeding, and then perhaps say "the baby won't take to the breast - they bottle fed her in the hospital...". What ever the reason, of course this patient is not going to come clean and and give the real reason up front. IT is easier and less embarassing for her to hide behind an excuse.

    Remember what we all learned in nursing school however many years ago, and do not take things personally, and especially do not let it interfere with looking at the big picture. Yes, this person probably manipulated the nurse by using a cultural practice excuse, but it does not excuse us from digging deeper.
  11. by   GardenDove
    I wouldn't feel manipulated by a pt who made up a fib to get me to take care of her baby so she could sleep. I would maybe think that she was not too smart to make up one like this, since Orthodox Jews don't neglect and starve their children just because it's the Sabbath, it's totally obvious it's a fib.

    I can't believe people think she needs therapy and intervention because she made up a fake excuse to get the nursing staff to let her rest. Are OB nurses that judgemental? Hey, this is coming from me, the original Earth Mama, I'm very in favor of breast feeding. I also, however, believe strongly in pt rights, which include them choosing how to manage their own health.

    I also think that the OP's OB dept needs to wonder why pts feel like they need to lie to get taken care of. Are they too domineering with these women? People are very vulnerable when they give birth, they need to be totally defered to and given control over their own healthcare. If they want things a certain way, within reason, they should be made to feel unjudged and safe. Asking for a nights unbroken sleep after giving birth is entirely reasonable.
  12. by   caroladybelle
    Quote from 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
    I disagree. If you know much about Orthodox Jewish women, you know that culturally that they work VERY hard, to maintain their household according to kosher law. That is not easy, and much more difficult to do than handling a nonkosher household. And as Kosher (Kashrut) is involved in all aspects of the Orthodox life - from cleaning house, cooking and raising children - it is substantially more onerous than what I see in Christian households.

    There is a derogatory stereotype - Jewish American Princess - used to describe very privileged and self absorbed Jewish women. I have never met a Hasidim or an Orthodox female that fell into a "princess" category. They work to hard.

    Though all wives of all religions deserve to be treated as "princesses".

    And why do you refer to her as a "little girl"? There was no age mentioned. While Orthodox do often marry young, this could have been a later pregnancy in a much older woman.
    Last edit by caroladybelle on Dec 6, '06
  13. by   Retired R.N.
    So why should any nurse get upset if a patient asks that her baby be fed in the nursery? Has anyone considered that perhaps this patient has been brow-beaten into saying that she will breast feed, but she really doesn't want to? If she knows that she will be going home to trying to keep a kosher household, she knows that she has her work already cut out for her. If she fears will have no support for not wanting to breastfeed when she gets home, why can't you graciously allow the woman a few nights of uninterrupted sleep so she can rest and regain some strength?

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