Asian Culture

I love this culture because I grew up with it! I was the minority in my high school and learned from the dominant culture. The dominant culture in my area was Vietnamese. Not all Asian cultures are the same. Food, language, religion, and many more things differ. One thing that I found to be uniform from my studies is the idea of intergenerational living. I noticed many of my neighbors had grandparents, young children, and young parents all living within the same household. Grandparents would walk their grandchildren to school, while young parents went off to work. It seemed to me an effective system.

What I love most about this idea of intergenerational living is the importance each family member plays in the patterns of daily living. Each individual is important. I especially love this because often in U.S. culture, the elderly are pushed to the side. Grandparents have a purpose in Asian culture and help the success of the younger generation. As a future nurse I want to make sure that I include the entire family in the care of the patient. Family is central to this culture and we should respect their importance in our care while in the hospital.

Jewish Culture

Halakhah or “the path one walks” is the center of judaism. This guides all aspects of religious and daily observance. Keeping God’s commandments is vital to a successful life. One must be diligent in prayer and scripture study. Sabbath observance is held in synagogues where a rabbi leads and guides prayer and study. There are different rituals held in the jewish faith. One is the Bar and Bat Mitzvah or the coming of age for girls and boys. Girls are to come of age at 12 years old and boys at 13 years of age.

Other rituals are held and observed within the jewish culture. It really opened my eyes to the importance of asking what is important to different patients we care for. Being sensitive to different religious observances and finding ways for them to be practiced is important and culturally sensitive. For example, it would be important and wise of the nurse to have a dietary consult with jewish patients to be sure a Kosher diet is followed. Time for prayer should be allowed 3 times a day: morning, noon, and evening since this is an important religious observance.

I enjoyed reading more about this culture. I thought I knew enough from reading in the Old Testament, but many things I did not have a knowledge or awareness of. I think we all fool ourselves into thinking we are culturally competent. I know I do, but this class has taught me that the only way to know about someone, is to ask, research, and continue learning.

Native American Culture

I have always been fascinated by Native American culture! This week I focused on healing practices common in this culture. I learned that thanks to the Native Americans, we have over 500 herbal remedies in use today. How they discovered herbal remedies was by observing the world around them. This culture views plants as “brothers and sisters.” We are all connected from the plants, to the animals, to other humans. A large emphasis is placed on healing the mind, body, and soul.

Scientific evidence has proven that emotions can effect our physical health. Before evidence of this even existed, Native Americans made a large effort to heal the soul more so than the body. If the soul was unhealthy, than the physical body was affected. In applying this to nursing practice we should take a holistic approach with these patients. It’s also important that when doing assessments we make sure to ask any herbal remedies being used. Herbal remedies have been proven effective, however many interact with medications. Discussing this with HCP’s will ensure safe and effective medication administration.

Deaf Culture

I have always found the origin of languages to be fascinating. This culture in particular fascinates me because I can’t imagine learning how to communicate when it was a barrier to begin with. I admittedly did not know that just like we have multiple spoken languages, there are multiple sign languages. In ancient times, a deaf member of society would be persecuted. This prevented any form of language for this culture since there was no opportunity to do so.

American Sign Language (ASL) became prominent in the 1800s thanks to Thomas Gallaudet. He wanted to help his deaf neighbor Alice Cogswell. He traveled to Europe to learn how to communicate through the use of his hands. He met a deaf instructor, Laurent Clerc, who came back with him to America. They started an educational program to teach deaf Americans how to communicate. Copying some of the signs from France’s sign language, ASL was created. Schools started to spread throughout the United States and later in life Gallaudet’s son created a college for the deaf.

I amazed by the members of this culture. I find them to be some of the most inspiring members around us. I think a really great approach in nursing practice is to find an interpreter. Looking directly at the person you are speaking to, rather than the interpreter, shows interest and care toward the individual. I had an experience, not in the hospital setting but in a fast food restaurant, where the workers were not understanding a deaf man’s order. I could sense this man was getting frustrated and rightfully so. I decided to whip out my phone and type down a question as to what he wanted. I explained that I didn’t know ASL but I would be willing to help. He smiled and typed back everything he needed. Since the interpreting resources were unavailable to me, I decided to use a universal language we both knew, writing. It worked. I don’t see why this wouldn’t be appropriate in the hospital setting. Use of a white erase board or paper can help prevent barriers when an interpreter is unavailable. In my experience, it is the thought that counts. A patient can tell the effort you are making to improve the quality of their care. Trying to solve the problem rather than avoiding it is always a better approach.

Hispanic and Latin Culture

I decided to focus on this culture’s view on death and dying. Family is very important to this culture. The family may wish to care for the patient in the comfort of their own home. Doing so allows the family to resolve past conflicts and resolve issues before death.

The soul lives on after death and is very much a constant presence in the family’s lives. There are certain days during the year where deceased loved ones return to visit. In order to do so, the individual must be buried rather than cremated.

Women are allowed to express grief openly in front of others. Men are expected to keep emotions in check. As the nurse, it will be important to assess how family members are doing, especially male members. Looking at nonverbal signs and maintaining a constant presence will be beneficial.

As the nurse taking care of these families, ensure that a catholic priest may come to give the patient their last rites. This is important so the person may confess and die with a clear conscience. The priest will also anoint the patient with holy oil.

Being aware of these cultural views on death will help the nurse to be more accommodating to the family and patient’s needs. Understanding this cultures different expressions to mourn and knowing steps to take before death will help the family emotionally during such a difficult time.

Muslim Faith

This week our topic has been the muslim faith. I decided to focus on different nursing aspects to consider when caring for this culture. I feel that common NCLEX questions refer to:

– the importance of modesty
– the need for same sex HCP’s
– etiquette in eye contact (not looking men in the eye if you’re a female and visa versa)

Sometimes I feel like I have a good enough understanding to care for this culture, but the article I read proved me wrong. For example, the left hand is viewed as unclean in muslim religion. It is disrespectful to feed, give medications, and hand items to muslims with your left hand. The right hand should be used in the those situations. I’m a lefty and naturally do everything with my left hand. I had no idea that my personal hand preference could be offensive!

I also learned about Ramadan. It is viewed as the most spiritually beneficial time of the islamic year. Ramadan is a period of fasting. Fasting is exempt for those that are pregnant, ill, or frail. If you have a diabetic patient, they may still choose to participate in fasting. As the nurse, your diligence in checking blood glucose levels will be important. Diabetics are allowed to eat in periods of hypoglycemia. It is important to remind the patient that is what you will do if their blood sugar plummets.

I have always known prayers to be important in the muslim faith, but I didn’t know that they face Mecca when doing so. Mecca is a holy city where the prophet Muhammad was born. Muslims face whatever direction points to Mecca. Helping patients locate where they should kneel and being sensitive to not interrupting their prayers will continue patient-nurse rapport. Planning care around their 5 daily prayers will be important to think about as well.

I loved learning more about the muslim faith and learned that I can’t ever assume I know enough about a religion. Cultural competency requires effort and a commitment to life long learning. I’m grateful for this class because it has helped me to get into these habits earli in my career.

Catholicism

This week’s cultural topic was on Catholicism. I hold a special place in my heart for those of this religion. I nannied for a Catholic family and became very attached to the children. We prayed together. We blessed the food together. I even read verses from the bible with them. I loved learning about their use of the rosary and their thoughts on life and death. It was wonderful to unite in what we had in common, rather than disagree on differences in belief.

I feel that in nursing, we need to make sure that we are sensitive to how important these beliefs are to our patients, just as much as our beliefs are important to us. Catholics may want to attend mass while in the hospital, or want a cross or rosary at their bedside. For those dying, they may wish to have the Sacrament of the Anointing of the Sick. We need to be respectful of these wishes and be sure to accommodate to them.

I know that my religion is the center of everything in my life. I would hope that others would respect my decisions and wishes if I were in the worst physical state imaginable. If we can look at the patient holistically as a person with spiritual, physical, and emotional needs, then we can be assured our patients are receiving the best care imaginable. Often we forget that providing that care goes beyond the medical realm. There is so much more we can do to improve the overall health of our patients. I say we look for ways to do so and discovering spiritual practices is a great way to start.

The Homeless

Our topic for this week in transcultural nursing was on the homeless population. Over the summer I had the chance to interact with many patients from this culture in the ER. Often in the emergency room, we’re the only healthcare they’ve got.

I will never forget the day I helped an older gentleman with his care. I walked into the room and soon had to hold my breath due to the smell. Literal dirt was on the bed along with some leaves. I wanted to get in and get out until a humbling learning experience was given to me. The patient could probably tell my reaction to walking in his room and quickly apologized for the smell and the dirt. He wouldn’t stop apologizing to me and said he wished he was cleaner. I felt awful! I quickly decided to be the nurse he deserved that day and told him I was more than happy to help him. He quickly became at ease with me and was cooperative the rest of the time he was there.

This patient truly needed the medical attention as we ruled out his problems. Had he left due to my offending him, I could never live with myself. I’m guilty as much as anyone else for not being excited to care for those that don’t smell as good or look as good as others.

In healthcare, we need to do a better job of treating a homeless individual the same as any other patient. We need to make sure we give them the best care possible since often they don’t have access outside of the occasional ER visit. I can’t imagine how difficult being surrounded in poverty would be! I would hope to be looked at as a person, rather than a bum on the street. We need to remember that this population is victim to mental health illness, violence, and multigenerational poverty. It’s not a choice for many families and individuals to get out of this situation.

I don’t know how to fix this problem of poverty, but I do know that healthcare can join forces with political leaders to make a change. If we stand by other patients, why shouldn’t we stand by homeless patients. I think we’re just as responsible for the poverty in America as anyone else if we don’t try to do something about it. Sometimes, just being that kind nurse is a great way for homeless patients to continue seeking care when they need it. It can’t be easy coming into the hospital when everyone looks down upon you. I say we change that! I say we treat everyone the way we would hope to be treated if we were in their situation. I think the best way to change poverty is to embrace those that are in it.

Jehovah Witness

This week our topic was on Jehovah Witness beliefs. I have interacted with many members of this faith throughout my life. I’ve experienced their belief in Evangelism or door to door knocking before. I have found them to be kind people and I respect them for their diligence in sharing their beliefs. I can’t imagine door to door knocking being an easy task!

I wanted to focus on one particular topic that has caused a lot of controversy within the medical field. As I’ve said before, I respect this religion immensely, but as a future nurse, the issue with blood transfusions may pose as a challenge. As many of us know, Jehovah Witness members do not believe in blood transfusions. This belief stems from different passages in the bible and failure to follow can result in disfellowship.

I think that we nurses need to be sensitive to the fear of disfellowship that blood transfusion can cause. We should also be sensitive that this is their religious belief. I wanted to know what to do in the case of a pediatric patient whose parents are Jehovah Witnesses. There have been cases where parents have refused life saving blood transfusions for their children because it is contrary to their religious beliefs.

When researching this, I found the United States governmental stand on how to approach the situation. The Supreme Court stated that, “the right to practice religion freely does not include liberty to expose…the child…to ill health or death.” In other words, if a parent’s religious beliefs place a child’s life in danger, the state is allowed to intervene to protect the child.

Again, I think it is important to be sensitive to the beliefs of others but knowing actions to legally take in life threatening cases is also important. I think the best way to approach religious beliefs is with an open mind and understanding of the importance of these beliefs to the patient. If legal actions have to occur, we can still be civil and kind. Explaining the duty the state has to protect minors will be necessary when children are treated against parent’s will.

Article: http://adc.bmj.com/content/90/7/715

Latter Day Saint Culture

This week our class topic was on LDS culture. I personally chose to focus on LDS belief of death since I was curious to see what scholars wrote. I am LDS so this was a unique experience in the sense that I read about my culture in a non-religious text. I enjoyed it and found it insightful to see how others view my beliefs. It made me more aware and curious as to what I really do find to be truth in my life.

LDS religion teaches that there is life after death, we will be in physical bodies again due to Christ’s resurrection, and families can be together forever. Today I’m celebrating the 48th birthday of my Father-in-Law, who passed away in November of 2013. I grew up with him as a father figure in my life and miss him terribly. I think that’s why I love the LDS belief of life after death so much because I can’t bear the thought of never seeing him again. I also love to know that he’ll be my family forever!

When thinking about patients who will either face death or families who will lose loved ones, I know that my religion is important to me when it comes to those aspects of life. Reading about my own beliefs made me more sensitive to what others might feel towards death. I want to be as sensitive and as accepting of their beliefs as I hope others would be towards mine. I think being the nurse that openly accepts important beliefs on topics such as death is important because one way or another we’ll be faced with this situation and we’ll be responsible for promoting the most therapeutic environment we can.