Applying Culturally Sensitive Care
M2D1: Applying Culturally Sensitive Care
Mike, a 35-year-old, was brought via ambulance to the emergency department after collapsing on the street. He was diagnosed with appendicitis and the surgical team was alerted to the potential surgery. The physician prepared to obtain informed consent and began discussing the simple effective surgery and the treatment with the patient. The RN was present at the bedside. The patient stated he did not want surgery. Based upon his beliefs as a Christian Scientist, it is against his practices. He requested a Christian Science practitioner. The patient rated his pain as 9 on 0-10 verbal pain scale so the RN prepared the narcotic analgesic to relieve the patient’s pain. The patient declined the medication. The RN believes the patient should accept the pain medication and have the surgery thinking “If it were me I would proceed with the surgery and treatments proposed by the surgeon.” The surgeon can be heard speaking to a colleague about how to go about changing the patient’s decision.
Initial Discussion Post:
Address the following:
1.State and discuss the legal and ethical considerations occurring in this scenario. Include supporting citations.
2.How can RNs support the patient’s decision when the beliefs of the patient are contrary their own? List three (3) interventions, with supporting rationales, the RN would perform to ensure the delivery of culturally sensitive care.
3.Identify one (1) additional major religion, in which the same circumstances might also require the RN to advocate for the patient’s refusal of surgery. Describe the beliefs behind why the identified religion could pose a moral conflict for a similar patient.
Legal and ethical consideration
In this case study, there is conflict between the nurse ethical responsibilities to her patient, legal responsibility to her employer and legal duty to the physician; which exposes the RN to professional risk. This is a challenging situation as there is inadequate guide in resolving such kind of dilemmas. For instance, the nursing standards and law are vague about rights to ethical decisions made by RNs. The code of ethics does not offer legal protection to RN who works as patient advocate (Hunt, 2013).
In this case, the role of the nurse is to remain cultural competent. The RN must respect the patient decision even when the patient’s decision is irrational or wrong. The RN should advise the patient about their clinical opinion without putting pressure on them to accept the RNs advice. While doing so, the RN should be careful not to use words and actions that disrespect the patient values and beliefs (Hinkle & Cheever, 2013).
RNs support to patient decision
The RN can offer support to patient’s decision by (Taylor, Lilis, LeMone, & Lynn, 2011);
- Being an active listener
This is important as it helps establish mutual relationship and trust to the RN. It is a way for RN to show their concerns to the patient. The RN should ask the patient about their understanding of the health condition, which will help RN to address any misconceptions.
- Explain medication detail
Most of the healthcare medical terms are jargons to ordinary people. It is important to discuss all the details associated with the medication, his risk level and programs which could help with the patient cost management and coping strategies.
- Explore alternative approaches
Some of the patients could be comfortable to seek alternative medication such as herbal remedies or traditional healers. The RN must be thoroughly informed about the alternative medication because some of the treatment could be harmful. If considered as an alternative, the nurse can refer the patient to a certified practitioner. In Some cases, religious rituals such as prayers can be integrated into practice.
Example of major religion
An example of a religion that could possibly be holding similar doctrines is Muslim religion. Devout Muslims can reject medication containing alcohol such as those used during the peri-operative procedures, or medications made from pork derivatives. In medical situations which are not of emergency, the RN should educate the patient, but help them preserve their values and believes (Smith, 2013). This includes exploring other beliefs that do not contradict to their beliefs. These small accommodations could pay off the patient emotional well-being. Therefore, to remain culturally competent care, the RN must perform cultural assessment in order to understand their perception of illness and wellness (Kee, Hayes, & McCuistion, 2015).
Hinkle, J., & Cheever, K. (2013). Brunner and Suddarth’s textbook of medical-surgical nursing (13th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Hunt, R. (2013). Introduction to community based nursing (5th ed.). Philadelphia, PA: Lippincott, Williams and Wilkins.
Kee, J., Hayes, E., & McCuistion, L. (2015). Pharmacology: A patient-centered nursing process approach (8th ed.). St. Louis, MO: Elsevier.
Taylor, C., Lilis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of nursing: The art and science of nursing care (7th ed.). Philadelphia, PA: Lippincott, Williams and Wilkins.
Smith, L. (2013). Reaching for cultural competence. Nursing, 43(6), 30-38.
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