Diversity in Faith-Based Hospitals - Essay Example

Running Head Diversity in Faith Based Hospitals Diversity in Faith Based Hospitals Introduction Faith-based hospitals represent uniqueorganizations aimed to support local community and deliver quality medical services to diverse customer groups. The health care system in the United States has been in a state of crisis for some time. An obvious problem is the cost and apportionment of medical care. A more subtle problem that is beginning to receive attention involves the cultural gap between the medical system and the huge number of ethnic minorities it serves. Religion is rarely a topic of conversation in hospitals, but religious beliefs and practices are common sources of conflict and misunderstanding even in faith-based hospitals. The need for change is caused by diversity problems, lack of administrative support and strict policies adopted by faith based hospitals towards patients, medical services and medical staff. Workforce diversity is one of the main issues in faith-based hospitals. Since a large number of interpersonal and inter-group problems are related in some way to job maladjustments, culturally successful organizations provide an environment conducive to identifying and utilizing different ways of doing things. Fogel and Rivera (2004) admit that: 'the expansion in size and influence of religiously-controlled health systems is impeding patient access to comprehensive health services, including reproductive health services, patients' end of life decisions, and patients' access to research involving emerging medical technologies" (p. 725). The main problems identified by research literature are that faith-based hospitals fail to address diversity problems and manage cultural diversity. During the research, it was found that the large number of faith-based hospitals fails to employ diverse medical staff while some other hospitals fail to meet cultural differences and expectations of their patients (Leininger and McFarland 2002; Fogel and Rivera, 2004; Tangenberg, 2005; Tammeus 2006). Medical Staff In faith-based hospitals, the majority of medical staff does not belong to any religion, including the values and traditions of the faith-based community. On the one hand, this strategy allows hospitals to employ professional staff in all areas of work and deliver quality services to diverse patients. On the other hand, faith-based hospitals set strict policies for medical staff and medical care provided to patients. In faith-based hospitals, religious differences are of vital importance in the workplace. It is possible to say that religious diversity has the greatest impact on human relations than any other diversity issues. Fogel and Rivera (2004) underline that some hospitals set religious restrictions which become "a significant obstacle for patients and physicians because of the size of religiously-controlled health systems. Five of the ten largest health care systems in the United States are Catholic" (p. 275). Religion determines the way of thinking and value system, beliefs and traditions followed by faith-based hospitals. Lack of training and cultural knowledge creates communication difficulties and conflicts between medical staff and administration. The change is vital in this sphere because lack of communication and cultural misunderstanding worsen service quality and image of the hospital. It was found that: "some hospitals have outlived their mission and their usefulness in a particular community; others, through mismanagement, the departure of key personnel, or lack of resources have lost the ability to provide an adequate and competent level of service to their patients and the community" (Jennings et al 2002, p. 4). In faith-based hospitals, gender differences have a great influence on employee relations and interaction, behavior patterns and promotion. Despite many gains, women are still grossly underrepresented in professional and managerial jobs than male executives to be assistants to high paid professionals, and they are disproportionately overrepresented in special staff jobs that have no line responsibilities (affirmative action officers, diversity officers, community relations specialists). But when opportunities are factored in, the differences are greatly reduced (Leininger and McFarland 2002). In other instances, female workers are performing the same duties as men for significantly less pay (Dreher and Macnaughton 2002). More females and minorities than white males hold low job expectations. For faith-based hospitals, gender diversity should be a core of staff relations and medical service. In many religions, female purity and modesty are major values, and for this reason there is a need for faith-based hospitals to employ female physicians. Another problem is that nurses, realizing that the physician may be unaware of the American health care system, act in a less confrontational manner. Behavior which is seen as normal in one culture may be interpreted as deviant in another; not all "deviant" behavior may be a result of mental illness, but rather an expression of cultural traits. For example, in many cultures, visions of the recently deceased are common and normal; they should not be interpreted as signs of mental illness in the absence of other symptoms (Leininger and McFarland 2002). These differences are comparable to those of ethnic minorities, who may be different because of skin color, language, hair texture, physical features, and religious beliefs. Individuals who accept definitions of themselves as abnormal usually try to minimize contact with "normal" people or hide their deviance to avoid intruding unnecessarily into social relationships. Inability to do this will cause the manager to misinterpret a worker's movement, to attribute meaning that was not intended. This caution notwithstanding, it is true that Christians in particular, more frequently than do non-Christians, perceive the environment and respond to it with movement. Diversity management and careful planning are important for medical staff, because religious differences are closely connected with cultural traditions of a country or religious community (Leininger and McFarland 2002).. For instance, diversity problem are typical for Seventh Day Adventist and Baptist hospitals which "do not provide abortion services, and stress "abstinence only" practices rather than contraception and condom distribution to prevent pregnancy and transmission of HIV/AIDS" (Fogel and Rivera 2004, p, 275). In this process, medical staff should learn culturally appropriate worldviews and beliefs which, in turn, validate their sense of cultural identity and lend credence to their role identities. In every society, in most situations, there are special forms of words, or types of conversation, which are thought to be appropriate. In the workplace, the tension is created between low and high social classes, low and middle social classes. The key to the employment relationship is that it enables management to decide detailed work assignments after workers have been hired. Given the huge difficulty of anticipating the problems to be resolved in providing customers with the goods and services they desire, such flexibility is a formidable advantage (Kellhofer, 2001). Much of the debate about productivity and healthcare quality has focused on how to keep workers as fully occupied as possible, but it has neglected the other problem, of how to be sure that the necessary workers will be available when new customer orders arrive. This is addressed by the employment relationship which builds on workers' agreement to be available to undertake certain types of work as and when their employer directs (Sullivan and Decker 2005). Patients In faith-based hospitals, cultural and religious diversity has a great impact on patients and their recovery process. For this group, service quality means progressive and innovative methods of treatment and confidentiality, effective diagnostic methods and fast recovery, additional services and effective communication. "Religious restrictions on access to care are rarely disclosed to consumers before the time of service, creating significant barriers to fully-informed consent and effective decision making" (Fogel and Rivera 2004, p. 275). Routine sexual segregation is a common practice in many cultures, it is important for health care providers to realize that, in some religious contexts, it is not just a preference but a mandate. If that rule is to be violated in any way, such as allowing a woman to work the x-ray equipment, this should be discussed beforehand. Second, it would be a good idea to go over all possible complications to discuss any rules in that regard. Recognizing that rules for religious leaders may be much more stringent than those for others, and ascertaining them in advance, will avoid most of the problems (Sullivan and Decker 2002). Ideally, a staff member would have talked with a patient about her faith, emphasizing that God works through doctors and nurses as well as the patient directly. In this case, medicine could not offer a patient a certain cure; it offered only the possibility of symptom relief and life extension. Someone could have suggested that if a patient prayed and had enough faith, God would see to it that the operations were successful. Cultures develop norms, values, and behaviors that are suited to these conditions. Over time, they take on the strength of tradition (Kellhofer, 2001). Even when circumstances change, traditions often do not. In some instances, knowledge can prevent problems from occurring, as in the case of dietary taboos or preferences. In other cases, merely understanding why patients act the way they do may help hospital personnel be more compassionate and experience less frustration. Although at times it may appear that a patient's sole goal is to make things difficult for nurses and doctors, this is rarely the case. The patients are merely behaving in ways they were taught were appropriate or that were successful at other times in their lives (Leininger and McFarland 2002). The primary task of faith-based hospitals is to achieve and maintain maximum positive differentiation over and above the competition in the eyes of customers. The lower-level provisions are considered to be dependent on the customer's final requirement (Dreher and Macnaughton 2002). Given a measure or forecast of the total number of customers requiring the provision of the system, the demand at lower levels can be obtained (Kennedy and Bielefeld 2002). Faith-based hospitals need planning techniques and cultural competent staff to deal with diverse clients. Self-care, a medical goal for patients, is often ignored. The family will often take over feeding and grooming the patient. This may be an important way for family members to demonstrate their love and respect for the patient. It may also be a way for a male patient from a hierarchical culture to demonstrate continued control over his family, despite physical weakness. If self- care is necessary for recovery, as in the case of burn patients, give the family tasks that will not impede the patient's progress (Sullivan and Decker 2005). If the staff's emphasis on self- care is primarily a reflection of the American value of independence, do not insist but allow the family to continue caring for the patient (Galambos et al 2006). Some families may be particularly demanding of hospital staff and services. Often, the best way to handle them is to spend a few minutes talking with them when the patient first checks in, and then a few minutes in conversation each day. Future Growth Lack of cultural and religious training for medical staff and a gap between the actual diversity and skills of the staff will lead to dissatisfaction and low service quality provided by faith-based hospitals. The differences mentioned above show that part of the administrator's dilemma is that he or she must be sufficiently detached from subordinates to exercise sound judgment and at the same time have enough rapport with and concern for aggrieved employees to provide sensitive, empathic support. It is possible for an administrator to suppress on the conscious level emotional responses while counseling diverse subordinates (Tangenberg, 2005). Within the service area, religious diversity plays a crucial role in service quality and customer satisfaction. For this group, quality means patient safety and control of information, effective report system and orders fulfillment. As the most important, quality means "the lowest complication rate". Faith-based hospitals require that nursing staff and doctors must be ready to cope with difficult situations and patients demands. Effective managers recognize that what they know is very little in comparison to what they still need to learn. The ability to motivate and inspire employees is closely connected with personality of the managers and employees' perception. Health Care environment produces difficult situations where the role of individuality, perception and attitudes becomes increasingly important (Tangenberg, 2005). The need for change is explained increasing role of nursing staff and physicians in faith-based organizations. The role of the nurse within the health care delivery system is an important one, whether assessed in terms of in or out patient care, of hospital or community care settings. Both society and the medical profession have recognised the integral role which professional nurses play within the health care service model and, within the context of the stated recognition, actively encourage students to select a nursing career. Mmotivation can be described as goal-directed behavior and ability to contribute to a solution (Tammeus 2006). Faith-based hospitals should deliver special programs based on efforts to motivate workers, and the approaches employed, e.g. providing clear objectives, participation in decision-making and positive feedback on performance, are established principles which nave widespread use in medical applications (Fogel and Rivera 2004). By now it should be clear that it is hard work to communicate with patients from different backgrounds. Managers frequently are unaware that their subordinates verbally say one thing or "nothing" while their bodies communicate the opposite. The most insidious prejudices are negative attitudes directed toward groups of people. They take the form of assumptions or generalizations about all or most members of a particular group. This kind of in-group versus out-group hostility disrupts work unit interactions and subverts organization effectiveness. Diversity-related attitudes are learned mainly from people who have high or low prestige (Fogel and Rivera 2004). The superiority or inferiority of a group is not obvious; not many casual observers can perceive significant group differences. Besides, there are more differences within racial or ethnic groups than between them. Most employees bring their racial baggage (hatred) to work with them, bags packed by other people. When discipline is necessary, it should be based on objective standards with penalties being consistent among all employees (Fogel and Rivera 2004). Conclusion Strict policies and diversity problems identified in faith-based hospitals create obstacles for patients to obtain healthcare services. It is of utmost importance that medical staff involved in diversity activities always keeps in mind the injunction to avoid labeling, stereotyping, generalizing, categorizing, and rationalizing unique human beings who defy the reduction and simplification provided by their records and reputations. It is important for organizations to include diversity as an aspect of career progression. For faith-based hospitals, it is equally important that people are elevated to the same level of importance as inventory and equipment. The phenomenon of the process of intercultural communication relates to the interconnectedness of actions, events, states, and relations of the persons, objects, and abstractions associated with them. Successful diversity policies can facilitate the interdependence of the human resources in an organization. References 1. Dreher, N., Macnaughton, N. (2002). Cultural competency in nursing: foundation or fallacy Nursing Outlook, Sep-Oct; 50 (5), 181-6. 2. Fogel, S.B., Rivera, L.A.(2004). Saving Roe Is Not Enough: When Religion Controls Healthcare. Fordham Urban Law Journal 31 (3), 725. 3. Galambos, C., Vourlekis, B., Zlotnik, J. (2006). Improving Psychosocial Care in Nursing Home Settings: The Next Challenge. Health and Social Work, 31 (2), 83. 4. Jennings, B. et al (2002). Ethics and Trusteeship for Health Care: Hospital Board Service in Turbulent Times. The Hastings Center Report 32 (4), 1-6. 5. Leininger, M. M., & McFarland, M. (2002). Trancultural nursing: Concepts, theories, research, and practices. 3rd edn. McGraw-Hill. 6. Kellhofer, J.M. (2001). The Misperception and Misapplication of the First Amendment in the American Pluralistic System: Mergers between Catholic and Non-Catholic Healthcare Systems. Journal of Law and Health 16 (1), 103-110. 7. Kennedy, S.S., Bielefeld, W. (2002). Government Shekels without Government Shackles the Administrative Challenges of Charitable Choice. Public Administration Review 62 (1), 4-11. 8. Sullivan, E.J., Decker, Ph. J. (2005). Effective leadership & Management in Nursing 6th ed. Pearson Hall. 9. Tammeus, B. (2006). Healing ahead -- Religion-based hospitals serve as ministries despite secularization of health care. Retrieved 25 November 2007, from http://www.religionandsocialpolicy.org/news/article.cfmid=4258 10. Tangenberg, K.M. (2005). Faith-Based Human Services Initiatives: Considerations for Social Work Practice and Theory. Social Work 50 (3), 197-200. Read More