I'm sorry if there is a thread about this already, but i searched and i couldn't find anything...
I was recently reading one of my nursing books and I've been really interested in cultural diversity, and as a nurse i know that it will be important to recognize different culture's values and beliefs, but some of them are difficult for me.
For example, a chinese american may nod their head and it may not be because he/she is agreeing with you or understands what you are saying, he/she is just nodding. And native americans may not look you in the eyes as you explain a procedure to them; they are actively listening.
I was wondering if anyone could give me some helpful tips to help with the cultural differences i may encounter. I want to be able to provide the best possible nursing care i can when i become a nurse.
The only one i have so far yet is one concerning hispanic americans (there is large population here). I have noticed that family is VERY important and may be the ones who want to talk to the patient for you, and would rather be the ones helping the pt to the restroom, giving a bath, and feeding. I wasn't offended but it was explained to me that i wasn't doing a poor job, it is just a cultural value.
It is not my job to argue theology or scripture of any kind. If a Muslim husband and wife present to the ER and the wife will not talk much and the husband indicates he makes decisions then we have to accomodate their requests. That is the simple truth. If we didn't then we would be labeled obstenate and not respectful of their interpretation of their religion. Damned if you do and damned if you don't it appears.
When I was fairly new at my first job on a med surge floor in a huge hospital...I had a muslim male pt post vein harvest for bipass. The wounds were a complex dressing and unfortunatly...I was a female and the patient and patients wife could NOT let me do it for religious reasons...they just said that they were sorry but they couldn't...I respected that although odd to me (hey, I don't know everything..so things are frequently odd anyway..LOL).
So instead of getting ticked, I saw he had a brother in the room and asked him if I taught him how to do a sterile dressing if he would do it. Everyone agreed! I took him into a room and taught him for a day how to do it (my day off!)...the whole shabang! He was great!!!!!!!
SO, what I did was stand outside the door with my back turned to the patient as the brother did the dressing change. He was so good! I actually think that with the continuity and my lesson that that dressing change and wound did better than anyone elses! I loved it! And they appreciated my flexibility (and the nurses appreciated that they didn't have to do it...LOL!). Total win win!
The sad thing was the MD would not lift a finger to help his patient. He was obviously done with all the roadblocks their form of the religion prohibited them to do. Guess that is why we have nurses huh?
I have dealt with many different cultures and religions in my 6 years. Japanese, Chinese, Hispanic, German, English, French, African, Russian, Indian, American Indian, Pakistani, Iraqi, Egyptian...and from Buddist to Jahova's Witness. I love finding ways of respecting and doing things accordingly to be a happy challenge that I am very suited to take...I love taking the road less traveled anyway! LOL!
It is not my job to argue theology or scripture of any kind. If a Muslim husband and wife present to the ER and the wife will not talk much and the husband indicates he makes decisions then we have to accomodate their requests. That is the simple truth. If we didn't then we would be labeled obstenate and not respectful of their interpretation of their religion. Damned if you do and damned if you don't it appears.
That's not what you said in your first post, and that's what I take issue with. No one is demanding that you argue theology, only that you not make assumptions. You made the statement that this is how you treat your Muslim patients and I am saying that to assume this is a huge mistake and would be (and may well have been) insulting to many Muslims. How about, as another poster suggested, you take things case by case and not assume that because someone looks a certain way that they want to be treated a certain way. Patients will most likely let you know if they want things done one way or another. If they do not, it's not your job to pry it out of them any more than it's appropriate to make assumptions.
Specializes in Education, Acute, Med/Surg, Tele, etc.
"Frankly, we had a few Muslim men in the ER who refused to even speak to female RN's."
The above story..all had to be translated through his wife, and he did speak English. But heck...no probelm there. As long as things were done, even if I had to stretch things a bit in a Catholic hospital (LOL..what a choice they made huh?)...it all got done :).
Would you only do this with Muslims or would you also do it if your patient looked like they belonged to some other religious group? This is a sign of abusive behavior, regardless of the culture. There is no law in Islam that states that a woman must seek any man's permission for medical treatment, quite the opposite. Protecting your health and life is one of the primary reasons almost any Islamic law can be broken. Need pork to save your life? Fine, eat it, and so on and so forth.
It is your interpretation of Islam that their is no law that states a woman must sek any man's permission for medical treatment. It appears that a subset of some Muslims have a different interpretation than you do.
We probably aren't far apart here. I think we'd agree that this should not be assumed about all Muslim patients, and that they should be treated with respect.
This is a sign of abusive behavior, regardless of the culture.
I think that's too much of a generalization. If a couple prefers that the husband makes the healthcare decisions, it isn't necessarily because they are in an abusive relationship. Some couples just divide certain areas. My dad would defer to my mother in all matters financial for instance.
I've worked with a lot of muslim women who believe Islam requires things of them that you obviously don't (though I suspect a lot of it is no doubt cultural and not religious prohibitions). If a mother asks me to wait until her husband is there to discuss their infant's health and make decisions, I respect that regardless of her religion or culture because MY culture requires it.
That's not what you said in your first post, and that's what I take issue with. No one is demanding that you argue theology, only that you not make assumptions. You made the statement that this is how you treat your Muslim patients and I am saying that to assume this is a huge mistake and would be (and may well have been) insulting to many Muslims. How about, as another poster suggested, you take things case by case and not assume that because someone looks a certain way that they want to be treated a certain way. Patients will most likely let you know if they want things done one way or another. If they do not, it's not your job to pry it out of them any more than it's appropriate to make assumptions.
I did not say this in my first post, or any post after it. I have not edited any of the posts either. In fact, I mentioned something about never assuming that all Muslim couples are this way. I referred to my own personal emotional response to a Muslim couple who did require the husband to give permission. I am entitled to that private emotional response. If you re-read my posts perhaps you will see this. I doubt we are far apart here.
Specializes in Education, Acute, Med/Surg, Tele, etc.
It isn't just cultural differences I found also! I had a patient that was in the hospital for a week post vein harvest and he was deaf, and so was his wife...no children or other family.
So everything was written on a board for them to read (I will make this short...), but I arrived as their nurse on discharge day..and something was just not right! The wife and husband looked so clueless! I took a wild stab, and wrote "Purple Monkey Dishwasher" on the board and they nodded their heads! THEY couldn't READ!
So I got a translator (took forever, red tape and a ticked off charge nurse..but whatever!), got the MD back in the room for their questions. Get this....neither of them knew why he was sent from the ER to this room for a week! They had NO CLUE! Poor souls!!!!!
I got them the help they needed :), and this was a week or two after my Muslim patient I spoke of...needless to say I was labled a rebel and wound up quitting with the harrassment I got from managment about my 'tactics'..uhg!!!!!!
But I still do it to this day...except this job I have now...They not only give me those types of patients, but ask for advice..and I am agency for this hospital! Feather in my cap for sure! I love the challenge and the happiness it gets from one simple implementation!
Specializes in Education, Acute, Med/Surg, Tele, etc.
Hey now...we all have different levels of religious beliefs so that...just like in medical anyway..nothing goes by the book! There are varieties within varieties...you just have to adapt if you are so willing to :).
My worse set of Pts were actually Constitutionalists...I didn't even know that existed! These are people that take the constitiution word for word...and I had this mans wife as a pt post hister. Everything done to her had to be checked by him, considering he felt that everything and every bit of info was going to 'the man'...and he even believed that her uterus was going to wind up in some lab for stem cell research! He told her what to do, pretty much tried with me (and failed...I quoted the constitution in regards to state laws and me being held to state law in medicine! Won that one!).
Oh man they were soooooooo odd! But oh well...not my place to judge...just to help to the best of my ability!
The other one was a male white supremist...oh man we won't even go there, but needless to say I have never heard someone call me...a white woman...so many horrid things in my life simply because I was a woman! Uhgggggg! He got his throat slit raping a child...we saved him..but what an ethical thing I went through!
If a mother asks me to wait until her husband is there to discuss their infant's health and make decisions, I respect that regardless of her religion or culture because MY culture requires it.
I do think making decisions regarding a child's health is different than one partner asking the other if it's ok to have a procedure (especially if it's life saving) done. Parents are jointly responsible for the health of their children. I also realize that couples consult one another on a variety of decisions. That, of course, is very different than having no say at all in your own medical treatment.
All of that being said, I do understand the need to cater to the needs of your individual patients. What I am concerned about is making assumptions based on, well I'm not even sure. I'm assuming that you know the religion of these particular patients because they have told you and not because they look a certain way or have certain names.
On the abuse front, however, my alarm bells are going off because I wonder if the treatment would be the same should your patient be blond Joe and Jane Smith in jeans and T-shirts. I'm not a nurse yet, and I'm not sure what kind of responsibilities nurses have to monitor for abusive behavior. I'm afraid that the abuse of a Muslim woman might more likely be dismissed as "culture" out of a desire to be respectful.
We have some Muslim pts here and when the pt is female we tell the husband/father what we're going to do first, to obtain his agreement/permission.
Sorry, Mullti I got you and Tazzi mixed up. Yes, it does appear that we agree. The bottom line for me is respecting the wishes of the patient and not making assumptions, it seems that is your bottom line as well. There is little that chaps my hide more than assumptions that because I'm a Muslim woman that I'm not capable of making my own decisions. I have been treated this way more times than I care to admit and it just :angryfire. I hear my friends complain about it ALL the time as well. Excuse my passion on the issue, I didn't mean to flame you.
Multicollinearity, BSN, RN
3,119 Posts
It is not my job to argue theology or scripture of any kind. If a Muslim husband and wife present to the ER and the wife will not talk much and the husband indicates he makes decisions then we have to accomodate their requests. That is the simple truth. If we didn't then we would be labeled obstenate and not respectful of their interpretation of their religion. Damned if you do and damned if you don't it appears.