The battle of culture and beliefs versus nursing profession
The nursing professional is consistently challenged with science and cultural beliefs of patients. A patients set of religious and personal beliefs could interfere with the nurses’ empirical and scientific knowledge (Ammouri, et al. 2015). In a culturally diverse globe, many beliefs act as barriers in performing necessary medical interventions. Nurses may play a crucial but minimal role in such cases of cultural and religious belief. In emergency care and life-threatening situations, some religions do not permit for medical procedures which puts the attending nurse in a dilemma between cultural beliefs and ethical conduct. However, in most cases, nurses are bound to respect the patient’s consent. Thus, cultural beliefs have always been a barrier in the ethical conduct of the nursing profession (Ammouri, et al. 2015).
Cultural beliefs and religion act as barrier not only in life threatening situations but also have a major impact in daily routine within the healthcare system. For instance, some religions forbid blood transfusions which may provide benefit to the patient. However, a series of ethical questions arise on the nurse’s role in such cases (Ammouri, et al. 2015). The ethical dilemma nurses face through with a series of questions such as ‘Is it the nurse’s job to convince the patient?’, Is it right for the nurse to support and respect the patient’s consent and decision?’, Is it unethical and unprofessional to opt for a life threatening decision in spite of alternatives?’, Is it right for the nurse to make full use of their power and instruct the patient to follow suit irrespective of consent in order to save one’s life?’, Are nurses eligible to make a decision on behalf of the patient or family member in a life threatening situation even if the patient’s beliefs or culture does not permit?’ In a fast growing culturally diverse globe, nurses play a critical role in day to day nursing practice (Ammouri, et al. 2015).
In the nursing fraternity, the ethical dilemma of human rights and cultural belief and respect over medical interventions would conventionally grow. Is there a solution?
Analysis of patient culture/belief: Pros and Cons in nursing ethics
Patient culture although considered as a barrier in providing healthcare interventions may in some cases help psychological and psychosocial wellbeing of the patient. Some religions have varying concepts on modern medicine and interventions but can act as a mediator in the emotional well-being of the patient (Rassool. 2015). Based on current evidence, cultural beliefs may act as a medium of conflict among nurses and nurse care interventions. However, in a few rare cases, these barriers were found to benefit the patient (Rassool. 2015).
In end-of-life care, medical interventions may not be successful in providing quality of life. However, respecting and abiding by the patient’s belief and cultural affections may provide a positive attitude in a critical state (Rassool. 2015). For example, a patient in a vegetative state who has a life expectancy of no more than 90 days should be respected for his/her cultural belief. If the patient would like to consume holy water (from the Ganges) as observed in Hindu religion, most nurses would permit such forms of act to respect the religious belief. When all medical and scientific interventions fail, nurses deal with the ethical dilemma of cultural and religious beliefs in order to increase patient satisfaction (Rassool. 2015).
In a few studies, wherein nurses provided access and respected to certain beliefs of patients, the overall health outcomes and patient satisfaction increased significantly. For example, patients who are disabled showed preference to nurses who showed interest in their culture (Ammouri, et al. 2015). Elderly patients develop a sense of trust and faith for nurses who respect and abide by their cultural beliefs. The rate of stress, anxiety, and depression among patients in long-term care was reduced when religious sentiments and beliefs were respected. Nurses prefer to provide comfort to their patients but due to medical and regulatory ethics, they are bound to follow guidelines and protocols. However, it can be considered that cultural belief and religious sentiments act as a positive factor in patient satisfaction (Rassool. 2015).
Patient culture and beliefs may have limited advantages in nursing practice within healthcare. In most cases, culture is considered as a barrier to healthcare delivery and nursing practice. Based on current evidence, some of the key barriers wherein patient belief and culture has impact healthcare and the nursing profession are listed here below:
Patient Education: Most patients prefer to learn in their local or regional language without interference from external resources. Nurses play a key role in the development of patient education. However, varying culture and competencies of patients, make it difficult for nurses to communicate effective learning modules. Most patients would not prefer or accept a medical or scientific concept thus creating an ethical dilemma (Turunen, et al. 2013)
Medical Interventions: Some religions do not permit surgical procedures or common medical practices. For example, some religions do not permit blood transfusions or surgical removal or transplant of an organ (Turunen, et al. 2013) In such cases, convincing patients is not only difficult but puts nurses in a state of dilemma in order to proceed or put the patient in a life threatening state. In some cases, patients are not permitted to have a haircut which reflects poor hygiene and increases risk for infections.
Life threatening situations: In rare and serious cases, patients are not comfortable in consuming animal-derived medications that are life-saving (Turunen, et al. 2013). Some religious beliefs do not permit the use of artificial ventilation or life support. In such cases, the concept of euthanasia and medical ethics plays a key role among the nursing fraternity.
Critical care: The use of saline, blood transfusions, intravenous medications, antibiotics, vaccine, and donor organs are forbidden by some cultures. In such cases, nurses have no option but to respect the patients consent and proceed with non-medical and ineffective strategies that could lead to serious complications and even death. Thus, patient belief and culture act as a major barrier in healthcare and nursing practice (Turunen, et al. 2013).
Conclusion
Patient culture and nurse practice have played a critical role in the healthcare industry. It is one of the most debated topics since it has a significant impact on healthcare delivery, health outcomes, and patient satisfaction. Patient belief and culture have acted as a major barrier in nursing practice. It accounts for over a major proportion of healthcare disparities owing to modified protocols, unsound medical interventions, and discrete opinions on medical conduct. As per current evidence and personal experience, patient culture has affected healthcare systems in critical care, end-of-life care, geriatric care, special needs care, emergency care, and life threatening situations. Nursing staff and healthcare professionals involved in patient care delivery face a major issue with respect to daily routine. Some patients are reluctant to change owing to culture beliefs and often create an unhygienic and antisocial environment. Patient education is a major issue among nursing staff since patients are reluctant to change their belief and switch to modern medicine (Bahrami, et al. 2004).
Based on current evidence, patient education, nurse training and education, coupled with healthcare professional and regulatory guideline modifications can help improvise the ethical issues pertaining to healthcare delivery and patient culture (Bahrami, et al. 2004). Patient education and communication is the sole and ultimate means to provide a platform to educate and make patients aware on the usefulness of medical interventions. The educational programs should incorporate cultural beliefs and provide a scientific rational against such beliefs and cultures in order to bring about patient awareness. Thus, patient culture and religious beliefs although a major ethical dilemma among nurses can be prevented and controlled though effective communication and educational strategies (Bahrami, et al. 2004).
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