Diversity Skills

1. Diversity Skills Seminar Baylee Smith Rebecca Fields Whitney Bailey Caroline Willett Bridget Bordelon Emily Savage

2. 4920 Outcome Ability • Demonstrate a wide range of knowledge, skills and attitudes including cultural awareness, humility, sensitivity, and competency. • Incorporate holistic assessments, awareness of values and spiritual beliefs in the delivery of quality patient and family centered, evidence-based care of diverse and vulnerable populations.

3. Please fill out your assessment tools!

4. Cultural Competence

5. How to be Culturally Competent • Be aware of impact of culture on a client’s view and understanding of an illness • Unique cultural perceptions exist regarding the cause of illness and treatment. Nurses should respect these views. • Coining • Hmong culture • Rubbing heated coins over area until red marks are seen. • Illness can be removed from body • Illness is due to Karma • Hindu • Meditation for treatment of illness • Hindu • Hot and Cold theory (“Yin and Yang”) • Based on the imbalance of four humors • Pregnancy is a hot state. Hot foods such as animal products and chiles are not eaten.

6. Barriers to Culturally Competent Care • Prejudice • Language Barrier • Always call for an interpreter when necessary! • Always speak directly to client even when using an interpreter • Ethnocentrism • A tendency to hold your own beliefs as more superior to another’s • Stereotyping • Not all Hispanics are Catholic etc.! Don’t make assumptions! • Lack of Knowledge • When in doubt, ASK THE PATIENT!

7. Impact on Nursing Practice • Value diversity by understanding and respecting cultural differences • Learn about major differences • Be nonjudgmental! • Assess your own beliefs and values! • Respect differences!

8. Common Diverse Groups • Ethnicity • White • African American • Native American • Asian • Pacific Islander • Religion • Christian • Jewish • Muslim • Hindu • Jehovah’s Witness

9. Remember… • It is impossible to understand every aspect of all cultures and religions • The best thing you can do is to involve the patient and their family in their care! • If needs cannot be completely met, try to find an alternative method that is acceptable to the culture • Keep an open mind and continue learning about different cultures!

10. Diversity in the Workplace • Respect co-workers’ beliefs and practices • Nurses are not ever required to care for patients if procedures go against their own personal beliefs • Catholic nurse is not required to participate in an abortive procedure • Jehovah’s Witness not required to hang blood products for patients

11. Meet Ellen Savage!

12. Ethnic Diversity in our Population • The aging population is becoming more diverse! • Between 2000 and 2030… • Hispanics expected to increase 328% • Asians 285% • American Indians 147% • African Americans 131% • An article from the American Association of Critical Care Nurses projects that by 2080 the white population will be a minority group!

13. Native AmericanNCLEX Question • A nurse is bathing a hospitalized Native American client of the Navajo culture and notes that the client avoids eye contact during the procedure. The nurse makes which interpretation about the client’s behavior? • A. The client is depressed • B. The client is displaying disrespectful mannerisms • C. The client is displaying behavior that is a common cultural action • D. The client is humiliated because of the need to be cared for by someone else

14. Answer: • A nurse is bathing a hospitalized Native American client of the Navajo culture and notes that the client avoids eye contact during the procedure. The nurse makes which interpretation about the client’s behavior? • A. The client is depressed • B. The client is displaying disrespectful mannerisms • C. The client is displaying behavior that is a common cultural action • D. The client is humiliated because of the need to be cared for by someone else

15. Skit- Considerations for Native American Clients

16. Native American Clients • Native Americans must bury all body parts with them • Native Americans practice burial rituals in which they paint the face of the deceased.

17. Religious Diversity in our Population • Hindu • Muslim • Jehovah’s Witness • Jewish • Catholic

18. Hindu ClientNCLEX Question • A practicing Hindu patient is dying, but has orders for a full diet; however, the patient will accept only soups. The nurse should order which of the following from the diet kitchen? • A. Beef broth with bits of tomatoes and potatoes • B. Pureed tomatoes, carrots, celery, and potatoes in a vegetable stock • C. Chicken stock with rice, noodles, and celery • D. Finely chopped roast beef and mashed rice with vegetable broth gravy

19. Answer: • A practicing Hindu patient is dying, but has orders for a full diet; however, the patient will accept only soups. The nurse should order which of the following from the diet kitchen? • A. Beef broth with bits of tomatoes and potatoes • B. Pureed tomatoes, carrots, celery, and potatoes in a vegetable stock • C. Chicken stock with rice, noodles, and celery • D. Finely chopped roast beef and mashed rice with vegetable broth gravy

20. Skit- Considerations for Hindu Clients

21. Remember… • Men are not allowed in the room while a Hindu woman is in labor • Hindu women can become upset if the newborn is removed from their sight for long amounts of time • Hindu women do not leave home for 40 days following childbirth

22. Muslim ClientNCLEX Question • A nurse is about to examine a Muslim woman who is fully clothed in her native garb. The nurse touches the client on the arm to indicate that the client needs to remove that particular piece of clothing. The Muslim client is extremely offended and denies compliance with the nurse’s instruction. In the context of intercultural communication, what did this nurse do wrong? • A. The nurse should have asked the client about her religion before touching the client • B. The nurse should have asked the client’s permission before she initiated any physical contact • C. The nurse should have touched the client on her leg instead of the arm • D. The nurse should not have touched the client at all

23. Answer: • A nurse is about to examine a Muslim woman who is fully clothed in her native garb. The nurse touches the client on the arm to indicate that the client needs to remove that particular piece of clothing. The Muslim client is extremely offended and denies compliance with the nurse’s instruction. In the context of intercultural communication, what did this nurse do wrong? • A. The nurse should have asked the client about her religion before touching the client • B. The nurse should have asked the client’s permission before she initiated any physical contact • C. The nurse should have touched the client on her leg instead of the arm • D. The nurse should not have touched the client at all

24. Skit- Considerations for Muslim Clients

25. Remember… • Muslims face Mecca during all prayers and during the process of dying • Practicing Muslims pray to Mecca 5 times a day. Ritual cleansing is performed before prayer. • When a Muslim patient dies, they are not to be touched by any non-Muslims. A family member of the same gender prepares the body. • The eyes and mouth are closed, feet are tied together, and a sheet is placed over the body. The body is cleansed with water and perfumed leaves. • The left hand is considered unclean • Ask permission before touching Muslim clients

26. Jehovah’s WitnessNCLEX Question • A nurse is preparing a plan of care for a client who is a Jehovah’s Witness. The client has been told that surgery is necessary. The nurse considers the client’s religious preferences in developing the plan of care and documents that: • A. Religious sacraments are important • B. Medication administration is not allowed • C. Surgery is prohibited in this religious group • D. The administration of blood and blood products is forbidden

27. Answer: • A nurse is preparing a plan of care for a client who is a Jehovah’s Witness. The client has been told that surgery is necessary. The nurse considers the client’s religious preferences in developing the plan of care and documents that: • A. Religious sacraments are important • B. Medication administration is not allowed • C. Surgery is prohibited in this religious group • D. The administration of blood and blood products is forbidden

28. Skit- Considerations for Jehovah’s Witness Clients

29. Remember… • Jehovah’s witness do not accept blood transfusions under any circumstance. They believe that doing so will result in excommunication and damnation. • In the case of a minor, the doctor can overrule the parent’s decision in situations where the child would die without a transfusion

30. Catholic ClientNCLEX Question • A newly married Catholic couple comes to the nurse in the family planning clinic. They are not yet ready to start a family but wish to abide by their religious beliefs. The nurse decides to teach the couple about natural family planning (NFP). Which statement if made by the couple would indicate the need for further teaching? • A. “Natural family planning does not involve the use of artificial substances or devices.” • B. “If we use natural family planning it will also be useful in helping us to plan a pregnancy.” • C. “Natural family planning is free, safe, and acceptable according to our religion.” • D. “If we have intercourse during the fertile days, this is known as natural family planning.”

31. Answer: • A newly married Catholic couple coems to the nurse in the family planning clinic. They are not yet ready to start a family but wish to abide by their religious beliefs. The nurse decides to teach the couple about natural family planning (NFP). Which statement if made by the couple would indicate the need for further teaching? • A. “Natural family planning does not involve the use of artificial substances or devices.” • B. “If we use natural family planning it will also be useful in helping us to plan a pregnancy.” • C. “Natural family planning is free, safe, and acceptable according to our religion.” • D. “If we have intercourse during the fertile days, this is known as natural family planning.”

32. Skit- Considerations for Catholic Clients

33. Remember… • Catholics view abortion as murder and will not receive one even if the fetus has serious congenital abnormalities. • If a newborn is critically ill and is nearing death, a Catholic priest should be notified to perform Baptism and Last Rites. • Catholics do not believe in contraception

34. Skit Bloopers

35. Questions?

36. References • Comprehensive nursing care. (2010). Retrieved from http://wps.prenhall.com/chet_ramont_comprehens_1/40/10409 /2664869.cw/content/index.html • Potter, P. A., & Perry, A. G. (2009). Fundamentals of nursing. (7th ed.). St. Louis, MO: Mosby.