wk 3 Assignment
Reply to at least two of your classmates(below) using at least two references for each reply. In your responses, you should compare and contrast your experiences with differences in race, cultural background, or sexual identity (gender identity) between you and your patient with your colleagues’ experiences.
Article 1 # MM
When I worked as a NICU nurse (Neonatal ICU) and then as a Nurse Practitioner for the Department of Pediatrics, Jewish parents (Hasidic Jews in this case) would let the staff know that they (the family – the baby and mother) must be discharged and be home before sundown. This was an issue for the nurses, especially if the baby was going home on a Friday. Everything was a rush, rush, rush predicament, and away they went out the door before sundown. The Department of Pediatrics had made some accommodations, especially when a baby is scheduled for discharge on a Friday. My colleagues and I would wish each other “good luck” when giving instructions to them because they had “weird and unusual” questions, and their questions almost always involved what their Rabbi might or would say. We would shrug our shoulders and say,” ask your baby’s pediatrician.” We had a Jewish colleague who could answer their questions during discharge instructions and connect with the Hasidic family; however, she does not work on Fridays.
The Jewish community that I have come to know is observant of Shabbath. Hasidic Jews are considered Ultra-Orthodox Jews and strictly adhere to all religious laws. There is a biblical correlation to this cultural practice because they must do this religious observance weekly. Their lives revolve around Shabbath since it is the most ancient continuing weekly ritual involving the family. The Jewish Sabbath begins at sundown on Friday evening and continues until sundown on Saturday evening. Shabbat (also Shabbos or Sabbath), meaning “rest” in Hebrew, is the seventh day of the week. God labored for six days in the Jewish sacred text of Genesis to create the world. On the seventh day, God rested and commanded the Israelites to refrain from working. Since antiquity, many Sabbath laws, observances, and traditions have developed, including lighting candles, making challah (bread) and eating special foods, studying the scripture of the Torah, and praying (Marks et al., 2018).
According to the Staircase self-assessment model by Kersey-Matusiak (2019), “recognizing the anxieties, biases, and frustrations is the first step in preventing barriers to communication between patient and the nurse” (p. 73). In the NICU situation, the staff nurses experienced being uncomfortable expressing their frustrations and were not fully engaged with the discharge instructions. There was a disconnect between the nurse and the family because there was a breakdown in providing effective, understandable care compatible with the needs of the Hasidic family. A culturally competent nurse must start with a complete assessment during admission, including the patient’s spiritual and cultural practices, demonstrating respect and a non-judgmental attitude. Can the Hasidic family benefit from an in-house Rabbi for consulting and spiritual guidance? How can this Hasidic family receive appropriate and sensitive cultural care? Is there another source of emotional and spiritual support? Is the mother a primigravida? Perhaps there is another Hasidic patient on the floor that she can connect with? Patient safety was compromised due to nurses’ attitudes and biases, and infant safety was jeopardized because of possible pertinent questions regarding infant care that the parents could not ask due to the nurses’ dismissive attitude.
This maternal-child health case scenario can be replayed at other institutions and yield different patient experiences. Is the patient safe? Or is there potential or actual patient harm? Can this happen to an African American teenage mother from an underserved area? When caring for a patient whose cultural background differs from ours, stereotyping and prejudices must be avoided. Each patient is unique, and nurses must treat and assess all aspects of their cultural preferences on an ongoing basis.
Articles #2 LE
As a relatively new Licensed Practical Nurse, this nurse once cared for a patient with Cerebral Palsy. “Cerebral palsy is a group of permanent disorders affecting the development of movement and causing a limitation of activity,” (Hallman-Cooper & Cabrero, 2022). It is a common misconception that all individuals with cerebral palsy suffer from an intellectual disability, and while that may be the case for some, it is not the case for all. While caring for this particular patient, this nurse noticed that numerous staff members made flippant comments regarding the patient, and treated them with less patience than they typically had for our other physically disabled patients. This patient was bed bound and required total care, including feeding, all of which was out of the patient’s control. Though anytime the patient required assistance, the staff assigned to the patient would almost always have some verbal resistance to entering the room. This nurse once asked a staff member why they disliked entering the room and they stated it was because they could not understand the patient. This nurse then asked the staff member, “Can you imagine how frustrating it must be for the patient that we all struggle to communicate with them?”
Integrate Cultural Competency
In a study that was conducted out of Canada, it was discovered that young individuals with cerebral palsy experienced great impacts to their ability to engage in living meaningful lives. After the study was completed, it was concluded that improvements are needed to create the ability for individuals with cerebral palsy to live fuller lives in society (Hanes et al., 2019). If programs were to be initiated to allow for a multidisciplinary adult health team, as well as community services, it might afford various members of the interprofessional healthcare team the ability to interact with and provide greater care for this vulnerable population. In allowing further interaction with these particular individuals, the interprofessional healthcare team may gain more knowledge about these individuals, helping to combat the stigma that these individuals are severely neurologically impaired, when they in fact are not. Engaging in advocacy for this particular population not only enriches their lives overall, but it vastly aids in improving upon their health and wellness, ensuring longer lives with less health related complications.
Impact on Patient Safety and Outcomes
It was noted in the study conducted out of Canada that patients with cerebral palsy experienced an impact on their overall wellness and the longevity of their lives. Without certain considerations being made to address individuals with cerebral palsy’s limitations, they were not able to live as fulfilling of a life as they desired, especially as it related to their ability to work. The benefits of going to work such as having a purpose in life and having social interactions, were not something individuals with cerebral palsy were experiencing. “Social connections have potent influences on health and longevity, and lacking social connection qualifies as a risk factor for premature mortality,” (Holt-Lunstad, 2021). By not providing programs for individuals with cerebral palsy that allow them to live a high functioning life, including having a healthy work-life balance, their overall wellness is being severely compromised. In addressing this limitation, we as the interprofessional healthcare team have the ability to positively impact the mental wellness and overall health of individuals with cerebral palsy. And in advocating for this vulnerable population, it provides further interaction with this specific population, providing the ability to gain more knowledge about them, and helping to remove the stigma surrounding their capabilities, as well as limitations.
