Muslim, Orthodox Jews, Mennonites; How to care for female patients of "modest" faiths

[sunnyjohn]

Hello everyone,

I have a situation and would like some opinions.

I have a friend who went to an ER the other day. She had fallen and hurt her leg and knee. She is a Muslim and wears a hijab (headscarf) and long dress. Her hijab covers her hair, neck and ears are but not her face.

She first asked for a female doctor. Anyway, there was no female doctor on duty, but she did not have a problem with seeing a male doctor as they offered her a female nurse in the room.

They asked her to take off all her clothes, including her headscarf and any underwear so they could examine the leg. Then they asked her to wait in a small waiting room as they might have to wheel her down to radiology

She had worn no bra or metal clothing, a pair of easy remove bike shorts and a flowing caftan so she would only have to lift up the hem and take off the shorts so she would be nude under her caftan. They could see all the way up to her pelvic bone or take x-rays if neeeded.

She said they did offer her a paper hospital gown, but when she asked for a second hospital gown and to keep on her headscarf to preserve her modest, the nurse told her they did not have any. She said she explained as best she could her need for modesty to the nurse and tech who first saw her, but they were not very nice. She left without being treated.

My Muslim girlfriend is a college educated American and was raised in the US. She was not raised a Muslim and reverted about ten years ago. Of course she is quite familiar with American culture and healthcare, so I do not think that was the problem.

Of course I understand and emergency is an emergency and if you have to cut the clothes of a trauma victim to save their life, you do what you must.

Curious, do hospitals have procedures to deal with members of very modest faiths like the Mennonite, Amish, Muslims or Orthodox Jews?

[fergus51]

I think it's just common sense to allow people to maintain their modesty as long as it doesn't interfere with patient care. I have looked after women in L&D and seen very little, because we kept everything covered right up until delivery. You certainly don't need to take off a head scarf to examine a leg and I think her healthcare workers were very inconsiderate.

[RosesrReder, BSN, MSN, RN]

I think it's just common sense to allow people to maintain their modesty as long as it doesn't interfere with patient care. I have looked after women in L&D and seen very little, because we kept everything covered right up until delivery. You certainly don't need to take off a head scarf to examine a leg and I think her healthcare workers were very inconsiderate.

I agree :)

[CHATSDALE]

you run into inconsiderate people all the time. unfortuneately

[Aneroo, LPN]

1- I don't think the pic is appropriate for the OP and is in no way related. Please remove it.

2- I believe they were just being totally inconsiderate and blind to her requests. There are ways to accomodate wishes like that. Shame on them for not respecting them, good for her for sticking her ground. Maybe they need a nice little cultural refresher?

[Bipley]

Talino...

That photo is gross.

[Daytonite, BSN, RN]

I've worked in two Jewish hospitals. Orientation included a crash course on kosher laws for those who were not Jewish. The hospital kitchen was a site to behold because it was totally kosher (dairy and meat basically had their own kitchens and service). The facilities also had several doors that were not electronic. Since kosher food is usually the biggest problem Jewish patients will encounter, most dieticians are aware of the kosher food laws. The non-electric doors were for people who were leaving after dark on Sabbath or if a morgue needed to remove a body during the night.

The Mennonite and Amish have never been a problem. I have always asked them if there is something special they need to observe with regard to their dress and I haven't had a problem.

You didn't mention nuns or priests/brothers. Not a problem. Some of the nuns may be shy more than anything, but they have no special problems of dress.

I've had a couple of Muslim patients and keeping totally covered was not a problem. For one woman, we would wrap a towel around her head if she wanted and cover her with bath blankets.

[tvccrn, ASN, RN]

.....The facilities also had several doors that were not electronic.....The non-electric doors were for people who were leaving after dark on Sabbath or if a morgue needed to remove a body during the night.

Totally off topic, but what is the purpose of the non-electric doors in a Jewish facility? Please don't think I'm being a smart@ss (don't you just hate how you can't convey confusion well in an electonic forum), I am genuinely confused.

[fergus51]

Totally off topic, but what is the purpose of the non-electric doors in a Jewish facility? Please don't think I'm being a smart@ss (don't you just hate how you can't convey confusion well in an electonic forum), I am genuinely confused.

It has to do with the rules about not doing work on the Sabbath I believe. I worked in a hospital like this too. It was explained to me that observant Jews can not operate machines or even turn on or off a light switch for the same reason. We also had a "Sabbath elevator" which just stopped on every floor, opened for a few seconds and then went to the next. That way people didn't have to push the buttons. It was fine unless you forgot it was the Sabbath and got on by accident... It took a long time to get to the 16th floor!

[sharann, BSN, RN]

Observant Jews do not engage in any type of "work" on Sabbath. Included in the defenition of work are use of any electronic equipment,phones,computers, driving a car(or being a passenger),writing(no signing papers)or carrying things outside a specific area(I am serious!).

Of course, there are varying degrees of observance. Usually people will bend the rules for the sake of saving a life(those who do not are fanatical people).It is actually a Jewish law to do anything needed for the sake of saving a life including eating on a fast holiday.

[MarcusKspn]

I agree that you have to uncover someone to examine the injury. But if you knew that it was an isolated leg injury you only need to uncover the leg to examine. You can do a "feel" exam through the rest of the clothing to check from head to toe for crepitus and see if any other injuries are present. I always try to leave the patient covered up as much as possible. Even during a bath I don't leave my patient laying there naked. They have a bath blanket and I will uncover one arm-wash-cover up, other arm-wash-cover up, chest-wash-cover up, private parts-wash-cover up. There is no point in having a patients breast uncovered if you are washing her feet, and vice versa.

[Dayray, RN]

That was way out of line. Asking her to remove her head covering and not allowing her a second gown had nothing to do with providing her care. This was a blatant refusal to honor her beliefs. Your friend should write letters to administration.

Cultural sensitivity is not an option in hospitals today it is a JACO objective. Any letters she writes will be read by JACO on their next full visit.

I work L&D at a hospital that often has both Muslim and Orthodox Jews. We do what we can to accommodate them. In cases where we can’t accommodate them they are respectfully told that we can't accommodate them and offered alternatives. Sometimes that comes down to accepting the care provider that is on shift or leaving AMA. Not because we don’t respect their wishes but because we can't change the call schedule of the OB they selected or because we cant call in a female anathesiologist to do one epidural. It rarly comes to that and I have never had any unreasonable requestes based on cultural or spiritual belifes.

It sounds to me as if the female nurse she was provided had an issue with meeting this patients requests. I hope she remembers her name so she can mention it in a letter.