summary with 200 words each question making 1200 words total
Enny123
NorlanderChapter11CulturalSensitivityLookingThroughDifferentEyes.pptxTo comfort always
A Nurse’s Guide to End of Life Care
Chapter 11: Cultural Sensitivity
As nurses caring for dying patients, we need to acknowledge that our views of death and dying might be different from that of our patients and their families
Chapter 11: Cultural Sensitivity
American medical practices place a high value on the concept of individual patient autonomy and the patient’s right to know what their diagnosis is
Communicate directly with the patient and tell them the diagnosis
Many other cultures value collective decision making or avoiding discussing death
We expect patients to be part of the decision making process, but some cultures rely on providers to make those decisions
Chapter 11: Cultural Sensitivity
For some cultures, discussion about death is considered taboo
Southeast Asian cultures
Belief that talking about death might bring it on
Discussion about death can be insulting to ancestors
Somali cultures
Discussion of dying is considered uncaring and disrespectful
Chapter 11: Cultural Sensitivity
Native Americans
See illness as an imbalance between the heart, mind, body and soul
Rather than looking for pharmaceutical or surgical remedies, they might look instead to a spiritual healer
Chapter 11: Cultural Sensitivity
Others might view our system with mistrust
Because of past or current experiences
United States
Historically provided less access to healthcare for African American communities in comparison with the white population
Chapter 11: Cultural Sensitivity
Understand your own beliefs
Look at your own attitudes, beliefs and practices
A number of cultural self-assessment tools exist that can help you better understand your own beliefs
Chapter 11: Cultural Sensitivity
Questions to ask yourself
“How was death talked about in my family?”
“What kind of death would I prefer?”
“What do I believe causes most deaths?”
“If I were diagnosed with a terminal disease, would I want to be told?”
“What efforts should be made to keep a seriously ill person alive?”
“What do I consider a good death?”
Chapter 11: Cultural Sensitivity
Chinese Immigrants
Choose to avoid death at home
They believe that the ghost of the person who died will inhabit the home
African Americans
Tend to prefer end of life care in an intensive care unit, hospice residence or nursing home so they will not be a burden to their family
Chapter 11: Cultural Sensitivity
Listen to the patients
Honest and active listening
Ask open ended questions
Be patient
Listen to story telling
Acknowledge the patient’s perception to the illness
Pay close attention to nonverbal communication
Facial expression
Eye contact
Touch
Chapter 11: Cultural Sensitivity
Eye contact
Can be a misinterpreted nonverbal signal
European – American society
Accepted practice to make direct eye contact when you look at people
Asian and Native American
Considered disrespectful to look directly at a person you consider a superior
Chapter 11: Cultural Sensitivity
No magical formula exists for understanding various cultures
You can find a great deal of diversity among individuals even in the smallest cultural groups
Beware of stereotyping or making assumptions based on general knowledge of a patient’s culture
Chapter 11: Cultural Sensitivity
Communication suggestions
“I am not familiar with your customs. Please tell me if I ask questions that offend you.”
“Who else would you like to have here while I talk to you?”
“Some people like to know everything about their illness. What would you like?”
“Do you make your own decisions about your care or would you like someone else to? If so, who?”
“How does your illness affect your day-to-day living?”
Chapter 11: Cultural Sensitivity
When using trained interpreters, consider the following
Prepare the interpreter ahead of time that you will be discussing end-of-life issues or using the word dying
Position yourself at eye level with the patient and speak to the patient, not the interpreter
Following the interview, give the interpreter a chance to process the interview, and ask your questions
Chapter 11: Cultural Sensitivity
Communicating with a patient or family without an interpreter
Speak in a low, moderate voice
Do not raise your voice
Use simple words
Use “pain” instead of “discomfort”
Ask direct questions
“Can you tell me about your pain?”
Give instructions in simple language and demonstrate them
Discuss one topic at a time
Chapter 11: Cultural Sensitivity
If you work in a healthcare institution
Look at your policies of your work place
Are trained interpreters available?
Do you have written resources?
Chapter 11: Cultural Sensitivity
Funeral rites in some religions
| Religion | |
| Buddhist | Family stays with and prepares the body. Death is considered a prelude to existence in another state. |
| Hindu | Cremation should occur within 24 hours. Organ donation is prohibited. |
| Jewish | Burial should occur within 24 hours of the death. The body should not be left unattended. |
| Muslin | Burial should occur before noon on the day of the death. The body should be buried with the head toward Mecca. |
| Western Christian | The funeral industry is relied upon to prepare the body and organize the rituals. |
Chapter 11: Cultural Sensitivity
Working with patients and families of different cultural, ethnic and religious backgrounds during the last steps of a journey in life is an art
It’s the art of being aware of diverse needs, the art of listening, and the art of balancing your own culture and the culture of your institution with the culture of the patient and family
