Meeting Spiritual Needs in Culturally Diverse Patients - Essay Example

Topic: Meeting Spiritual Needs in Culturally Diverse Patients Name Course Institution Date Introduction Current agitation for healthcare reforms aims at enhancing the quality of care by improving the ability of nurses to provide spiritual care to meet the needs of terminally ill patients. Consequently, the World Health Organization acknowledges that meeting the spiritual needs of a culturally diverse population poses immense challenges to nurses. A critical examination of the Greater Western Sydney reveals that nurses working in this region face challenges in the provision of spiritual care to a culturally diverse community. This paper critically discusses how to provide spiritual care to a culturally diverse population to meet the spiritual needs of terminally ill patients and their families. In doing this, the paper underpins the discussion by illustrating a clinical example from clinical learning experience and practice. For optimal care for patients suffering terminal illness and their families, several principles must be observed. One of such principles is the provision of pastoral care to culturally diverse patients and their families (Marianne and Deborah, 2009). This argument reflects growing consensus that spirituality plays an important role in human living and dying. Consequently, spirituality has an influence on the quality of nursing care and patient outcomes. According to Leininger and McFarland (2006), the concept of spirituality generates controversy nursing care. Currently, there is no universal definition of spirituality although its importance for nursing care is well documented. Esther and Rolley et al (2008) maintains that spirituality refers to the ‘relationship between self and the dimension beyond the self’. This means that spirituality emphasizes on how people create relationships and make meanings in life. Further spiritual experiences involve relationships and how individuals connect to their families, communities and groups. Generally, religion and rituals play an important role in spirituality. Similarly, caring for the spiritual needs of patients and family members requires understanding of the cultural background of the individual. For instance, suffering and ill health are important themes in spirituality and health. It is against this background that nurses should provide spiritual needs of patients and their families. The importance of culture is especially important to nurses. Differences in perceived risks posed by specific illness and appraisal of stressors are determined by cultural factors (Amanda, 2008). Similarly, nurses need to understand stress-mediating factors in individuals including the role of the family and available social support. This is especially important for dying patients and their families. Understanding the perception and sensation of each individual patient is important for a nurse caring for terminally ill patients (Lucy et al, 2008). It has been shown that functional, psychological and physical changes in terminally ill patients can be addressed by recognizing the unique expectations of the patient and family members (Downing et al, 2011). It is therefore imperative that as a nurse caring for terminal patients, reliable tools must be incorporated into daily practice to assess the spiritual, functional, cognitive and psychological status of patients and their families. In this regard, the nurse should also assess the living environment of the patient. Effective communication plays an important role in the safety and perceived wellness of terminally ill patients and their families. For instance, poor communication has been associated with poor compliance to medication, decreased patient satisfaction and malpractice (Karen and Sharyn, 2009). To address the spiritual need of a patient, the nurse should focus on addressing the factors that inhibit communication. These factors include religion and culture, language, literacy levels, hearing and visual impairment as well as health proxy and cognitive limitations. Nurses can achieve this by developing essential skills in cultural diversity. Proper knowledge of patients’ cultural and religious background enables the nurse to identify patients’ spiritual needs and thus enhances the quality of health care. Similarly, a culturally sensitive nurse is able to deliver ethically acceptable and respectful spiritual care. It is therefore imperative that nurses should focus on attaining cultural skills. These are important in influencing the perception of grief especially for patients receiving end-of-life care and their families. Similarly, as a nurse practicing in a culturally diverse environment, it is important to encourage patients and their families to develop spontaneous reminiscence and life review. This should be achieved by recognizing the role cultural heritage and related symbolic legacies. Nurses should therefore facilitate connections between present events the patient and family faces to the past hopes (Purnell and Paulanka, 2008). This can be achieved by supporting the patients’ spiritual belief system and confronting emerging conflicts such as anxiety and sense of guilt. A nurse should focus on instilling hope and a sense of wellbeing. Another strategy for providing spiritual care in a diverse context includes using eclectic approach coupled with coaching, listening and counseling. These interventions vary depending on the individual situations. As a nurse, it is important to be a dependable confidant. Cultural sensitivity helps the nurse to avoid stereotyping and premature closures of treatment and prognosis. Appropriate social, recreational and diversion activities helps patients in end-of-life care keep motivated. The role of the nurse in this regard is to suggest appropriate activities by consulting with family and peers to establish effective support system. This is also important as it avoids social isolation which could aggravate suffering and disease progression. Cultural sensitivity enables nurses to recognize patients’ attitudes, values and expectations. This reflects the argument that healthcare professionals should adopt individualized care as a standard of practice with regard to terminally ill patients. To effectively address the spiritual needs patients from culturally diverse background, it is also important for the nurse to analyze the effectiveness of social support. Community resources play an important role in maximizing function and retaining personal goals of patients and their families. This can be achieved by creating a nonrestrictive environment and maintaining independence of the patient. Similarly, it is important for the nurse to assess whether the family has the skills and knowledge necessary to deliver care to terminally ill patients. According to Khlood and Rick (2010), caring for terminally ill patients requires consideration of dietary restrictions. This is especially important given that some cultures prohibit certain foods during sickness. As a nurse, it is important to follow restrictions on food reported previously. Similarly, the nurse should inform the patient of components of drugs that may contain animal products or alcohol. Addressing spiritual needs of culturally diverse patients also requires the nurse to consider permitting prayer time. The nurse should consider the spiritual needs of the patient and visit by religious leaders. It is common practice for family members to gather around sick or dying patients. The nurse should therefore take into consideration the religious aspect and permit for prayers and visitation by the clergy. Understanding the decision making process enables the nurse to respond to patient and family needs more effectively. In some cultures, healthcare decisions are made by the family. For instance, eastern cultures tend to relegate healthcare decisions to the family (Shirley, 2011). Although the people value the nurses opinions and suggestions, it is important for the nurse to allow family members to make their contribution in the decision making process. To illustrate how to provide spiritual care to patients from diverse cultural backgrounds and their families, the following is a clinical experience that I encountered during clinical practice. A veiled woman was admitted to the hospital in an emergency incident. The usual emergency management procedures were carried out and the family was conducted. While collecting information on medical history, the family reported that the patient was a staunch Muslim. The medical personnel established that the patient had a chronically terminal breast cancer. Further investigation revealed that the patient was fasting in recognition of the holy month of Ramadan. The woman refused to be examined by male physicians and requested to attend private prayers. Moreover, the patient was uncooperative and refused to take medications. As the situation worsened, the patient asked to be seen by the local Muslim clergy although immediate clinical care had to be performed. As a nurse, the first impression was that knowledge of cultural sensitivity issues particularly about the Muslim faith and beliefs would play an important role in offering satisfactory care to the patient and her family. I understood from the beginning that most eastern cultures use collective model of decision making particularly in healthcare. The family was requested to assist in decision making. To avoid misconceptions and misunderstandings, the family members were consulted taking important note of views given by the men in the family. The action reflects the understanding that in the Muslim culture, healthcare decisions are usually made by the family members and especially the men. I also requested for advice on how much information may be disclosed to the patient. Understanding the decision making process with regard to the Muslim faith facilitated effective relationship between the family and myself as the care giver. As the patient showed temporary recovery, the family called in Muslim clerics to say their prayers. Visitation by the cleric was allowed. This reflected the understanding that the Muslim community shows its moral support by sitting at the bedside of the sick (Mohammadi et al, 2007). Although this could be misconstrued to mean obstruction or hindrance to the patient care, my knowledge of the Muslim culture and beliefs facilitated communication with the patient and the family members. Similarly, dietary restrictions were taken into consideration. For instance, adult Muslims fast during the holy month of Ramadan. The patient and the family were advised about the consequences of fasting and implications for the treatment regime. Nevertheless, prayer time was granted in recognition that Muslim faithful meet their spiritual needs through timely prayers. These actions illustrate a practical case study for a patient in the palliative care. Conclusion Research literature shows that culture, spirituality and religion play an important role in healing especially in palliative patients. Consequently, nurses and other healthcare professionals should recognize the role of spiritual and cultural values and practices in healthcare. More importantly, terminally ill patients require care that addresses psychological, spiritual and physical need. To articulate spiritual needs, the nurse should focus on delivering culturally sensitive care. This involves taking into consideration the decision making process, permission for prayer time and visitation by religious leaders and family members as well as dietary restrictions. The nurse should take the patient as a unique individual rather than a member of a community. Moreover, exploring the patients and families’ beliefs and values about illness and the authority of the healthcare professional promotes mutual understanding between the caregiver and the patient. In this regard, cultural competence should be an integral part in the training of nurses. 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