Indian and Australian Dying Practices from the Nursing Perspective - Essay Example

?Indian and Australian Cultural beliefs and tradition on Death and Dying Practices from the Nursing Perspective Introduction: “Death is an inevitableoutcome of every person’s life but each individual’s experience of death is unique.”(Clark and Phillips, 2010). However, how people approach death, the pain and the life after death is mainly influenced by the culture, and other spiritual beliefs. In Indian culture, the spiritual aspects influence the thinking about the end-of-life concepts. Thus, in Indian culture or in particularly the majority Hindu culture, death is not only viewed as the end of life but also the beginning of a new cycle. On the other hand, in the Australian culture, or in particular the culture of the Christians, death is viewed as the beginning of everlasting life with God. Though different concepts about death and the process associated with dying prevail, birth and death are the two aspects of life which will happen to everyone. Thus providing the medical care for the patients as they step into the final stage of their life is a stressful and at the same time heart breaking situation for the families. Under such drastic circumstances, medical personnel particularly the nurses play a major role in providing a comfort level for the patients and the family members associated with them. It is also considered to be one of the prime responsibilities of the nurse to balance the emotional feelings of the patients with their complex medical needs at the dying stage. Generally people who are in their death beds need the end-of-life treatment by the critical care nurses. “Critical care nurses provide care to patients who fail to respond to treatments offered to support and prolong life.” (Efstathiou and Clifford, 2011). Critical care nurses are the nurses who attend to the dying patients, apart from nursing those patients they also handle the other aspects such as the patient-family centered decision making, emotional and spiritual support to the patients and the family members, communication, continuity in caring the patients, and supporting the physicians to make appropriate decisions. While analyzing the role of nurses in caring the dying patients, it becomes a vital to focus light on the cultural and traditional beliefs of the people about death and the dying. This paper will discuss the Indian and Australian cultural beliefs regarding death and the events associated with dying from the nursing perspective. It will also include how understanding the culture and the traditional beliefs can support the nurse to render a palliative approach to the people who are dying and for their families. Comparison of the cultures and accordingly the nurses’ role: Although, Indian culture is diverse as India is home to number of religions and their related culture, with Hindus being the majority, their culture is viewed as the common thread of the Indian culture. In most of the families following the Indian culture, the basic healthcare decisions are made by the senior most member of the patient’s family. Thus, it would be better for the nurses to approach that particular individual, when decisions have to be taken regarding crucial medical as well as personal issues. People in Indian culture are mostly family oriented, having strong relationships with a extended family circle and so the patients may have constant flow of visitors at any given point of time. Nurses have to understand this tradition or practice, and take steps to allow the patient visits by the relatives and friends, without affecting the treatment or even the comfort of the patients. In addition, the nurse who cares for the Hindu patients at home or at hospital to assist the relatives in the way of singing, chanting, praying, reading from holy books, etc. Importantly, the patients themselves would always want their family by their side and so the nurses who attend to the dying patients should encourage the peer groups for the patients and the families for coping with the eventuality. Above all, they should empathize for the pain and suffering of the patients and try to communicate with them as well as their family members, in line with their cultural beliefs. Thus the nurses who take care of the dying patients should be able to “deal with the mental anguish and fear of death, try to respond appropriately to patient’s needs by listening carefully to the complaints.” (Frankd). In the Australian Culture the nurses can treat the dying patients either in the hospitals and at home, and the decision is taken by the patients themselves, unlike in the Indian culture where the eldest ember of the family decides upon where to treat the dying patient. “Australia is a multicultural society yet its dominant ethical paradigm is firmly placed in the western philosophical tradition.”(Chater and Tsai). As in the Western cultures, the individuals can make their own decisions and it is up to the patients to accept or reject the medical treatment. Thus the patient’s decisions will be based on the individual’s right to be informed all the details about the treatment. In the Australian culture the nurses strictly stand by the ethical issues and principles. They are restricted from revealing the nature of the disease to a dying patient unless the patient insists them to do so. Thus the process of autonomy where the patients can take their own decision and to exercise independent action is being respected by their family members and health professionals. And in this situation the patient’s self determination is much appreciated by his/her relatives and the physicians. Thus the nurses in the Australian culture follow the ethical behavior which is base on the western bioethical framework. The above were some of the culturally competent nursing care in death and dying. The next concept to be discussed would be the Reflection of the cultural and traditions which can support the nurse towards the palliative approach in dealing with the people who are dying and their families. The first and the foremost traditional approach would be the “Developing creative partnership with the patients, healthcare professionals, policy makers, and others to make care of the dying a priority.”(Rushton). The imminent death is mainly defined by the physical signs and symptoms that can indicate that death will occur within few hours or days. Some of the common practices that the nurses follow would be constant checking in the breathing patterns and the pulse rates of the patients, checking the body temperatures, reducing body temperatures is one of the alarming symptom of occurrence of death. All the above mentioned concepts are followed by the critical care nurses irrespective of the cultures and traditions. “Death is a universal experience. No matter what our culture, our religion, our race, or our country of origin, we will all die one day.” (Thrane 2010). Regardless of the cultural background some of the common themes that have been identified as vital elements before dying, includes the comfort level of the patients, good communication between the patients and the doctors, which is often effected by the nurses, honoring the spiritual beliefs, framing plans and even the process of saying good bye. All the above factors are affected by critical care nurses “Palliative care is known for its provision of a comfortable environment for dying or terminally ill people.” (Chater and Tsai). Thus the palliative care nurses should understand the beliefs of the patients and their family members about the treatment plan. “Patients –centered approach emphazises the collaborative, reciprocal nature of nurse-patient-family interactions as participants mindfully create and adapt to shared meaning.”(Wittenberg et al., 2010). Moreover the decision making with the End of Life process by the family members is often effected by the palliative care nurses in Australian culture. Many ethical dilemmas will be faced by the nurses while working in the palliative care environment. As discussed earlier effective communication, clear explanations about the situation to the patients and to their family members can assist the nurses to handle the circumstances effectively. Moreover in Indian culture, people may hesitate to reveal the nature of the diseases to the patients for example in the case of cancers. In such cases the nurses should be able to deal with the patients without disclosing the truth to them. Thus most of the patients would be able to understand the prognosis, treatment options and the possible outcomes which they may discuss with the nurses, in such situations the critical care nurses should be able to balance the situation. Another vital aspect to be discussed is the family members reactions towards the patients. It is the prime duty of the nurses to assist the family members in making decisions like selecting the places, mode of treatment and other activities related. They critical care nurses should take time to understand the patients unique cultural beliefs and ethical views and facilitate them to have a dignified death. Above all continuous care should be provided to the patients. The palliative care nurses expertise in symptom management where they have the assessment of the severity of the problems, constant checking of the patients, Using the relevant therapies for the chronic symptoms, evaluating the results periodically. Basically this activity falls under the symptoms management category where the patients are kept under periodical check. Thus from the above concepts one can clearly understand the cultural and traditional aspects having an impact on the role of the nurse towards the palliative approach of the dying people and their families. Summary and Conclusion: From the above explanations it is clear that when curing becomes impossible; the dying people basically need good nursing care. This is mainly because the nurses are able to understand the plight of the patients all throughout the dying process and can render a helping hand to the complex needs at the end stage of the patients. Especially in the critical units usually the patients have a shorter life span may impose greater demand on nurses in providing the effective end of life care to the patients and their families. Thus the critical care nurses should be mentally strong enough to handle the situations with the dying patients where the patients can reveal various emotional feelings like anger, feeling of exhaustion and stress etc. Apart from the patients the family members related to the patients should also be effectively handled by the nurses so that they deal with the situation effectively. The nurses should have a holistic approach in handling the dying patients. Reference: Chater, Keri and Tsai, Chun-Ting. Palliative Care in a Multicultural Society: a Challenge for western Ethics. Australian Journal of Advanced Nursing Vol. 26, no. 2, pp. 95-100. Thrane, Susan (2010). Hindu End of Life, Death, Dying, Suffering, and Karma. Journal of Hospice and Palliative Nursing. Vol. 12, no. 6, pp. 337-342. Efstathiou Nikolaos, Clifford Collette (2011). The Critical Care Nurse’s Role in End-of -Life care: Issues and Challenges. Nursing In Critical Care. Vol. 16, no. 3, pp. 116-123. Rushton Cindy Hylton, “What Role can Nurses play in improving the care of Dying?. Before I Die, the issues opininons: Essays, n.d . Web. 28 March 2012. http://www.wnet.org/bid/es-nurses.html. Clark, Katherine and Philips Jane (2010). The Importance of Culture and Ethnicity. Australian Family Physician, Vol., 39, no. 4, pp. 210-213. Frankd, Victor E, “Care of Dying and Dead”. Nursing Reviews , 22 April 2011, Web, 28 March 2012. http://currentnursing.com/reviews/care_of_dying_and_death.html. Wittenberg, Elaine, Goldsmith, Joy and Ragan, Sandra (2010). The Comfort Initiative: Palliative Nursing and the Centrality of Communication. Journal of Hospice and Palliative Nursing, Vol, 12, no. 5, pp. 282-292. Read More