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Culturally Competent Nursing Care
Culturally Competent Nursing Care
This week you have your choice of three discussion topics! Select the one that most interests you and answer the corresponding questions completely.
Remember to reference both the book or lesson, and an outside scholarly source.
Option #1:
You are the nurse assessing an Orthodox Jewish client with peptic ulcer. The client is strictly religious and refuses to eat the food provided at the health care facility.
Describe how you would further assess and provide care for this client.
What steps could you take to increase your cultural competence, if you were not familiar with this faith?
Option #2:
You are the nurse caring for a client with Crohn’s disease. The client believes he is being punished by God. The client is spiritually distressed and cannot come to terms with the illness.
How would you respond to this client?
What are some identified risk factors for spiritual distress, and recommended interventions?
Option #3:
Describe a time in your clinical nursing practice when you have cared for a client of cultural, religious, or spiritual practices different from your own.
What were some of the challenges you faced caring for this client?
What steps did you take (or could you have taken) to ensure the patient received culturally/spiritually competent care?
Clinician: So the two of you have gotten over the initial shock of Melissa’s breast cancer diagnosis and you have decided to go for the mastectomy. How would you put into words what’s going to help you make your ways through this? Melissa: We’re in it together… I couldn’t go through this without Steve. Steve: Yea… that and our faith… we’ve kind of fallen away from church in the last few years, but we were talking about our faith always still being there and being important to us. Clinician: Your caring for each other… great. When you mention “your faith,” how is it that that is important to you right now? Steve: God doesn’t give you more than you can handle… Melissa: That and the idea that everything happens for a reason. Clinician: Is there some “reason” that you see at this point? Melissa: I don’t know… maybe it’ll make us closer… I guess it has done that… maybe it’ll bring us back to church. Steve: Closer, yea… but I’m still kind of burned out on church… for me, the main thing is just trusting God together to work this out.
This brief spiritual inquiry has established a number of points. Caring for each other is sustaining for this couple, and they hope that Melissa’s illness may bring them closer together. “Faith” is important to them, not so much in the form of institutional connections, as privately. The ideas that things happen for a reason and that God will be working things out are parts of their belief system, although just what they might mean at this point is not completely clear.
Spiritual struggles and issues Much of our exploration in this chapter has focused on spiritual resources; identifying and encouraging people in the expression of values and practices that lend meaning and spiritual vitality to their lives. What about the “spiritual issues” side? What do you say to people who are furious at God for allowing egregious suffering… the 29 year old mother of two infant children who has just been diagnosed with end-stage breast cancer, or the parents of a beautiful young child who has been disfigured in a fire? What do you say to people who are locked into spiritual desperation or hopelessness… like the aging man who feels estranged from his faith and is increasingly despondent that he may never be able to heal a decades-long rift with his son? What does “spiritual inquiry” consist of in the setting of suffering like this?