1. Transcultural Nursing Care
Meeting the spiritual needs, and religious differences of your patients.

2. Spirituality and Religion
A person’s spirit: is the very essence of the person, the life force, and includes the beliefs and values which provide strength and hope for that person
Religion tries to make rules and capture the experience of spirituality into a defined system

3. Providing Spiritual Care
Involves helping patients develop awareness and maintain the following:
Inner strength
Self awareness
Life’s meaning and purpose
Relationship to others
Relationship to higher power

4. Identifying your patient’s spiritual care needs
Crisis situations often arise in acute care areas.
Patients beliefs and values affect how they respond to these crisis, their attitude towards treatment and their rate of recovery.

5. Nurse’s should be alert to the following when assessing for spiritual needs
Hospitalization
Patients who are in pain
Patients with chronic or incurable disease
Patients who are dying
Families who have experienced the death of a loved one
Patients who are facing an undesirable outcome of illness, such as amputation
Patients who have lost control of themselves

6. Spiritual Care Interventions
Ask open ended questions
Actively listen to the patient, sit beside the patient and maintain eye contact
Be nonjudgmental of patients and their responses
Avoid giving advice or a lecture to patients
Be aware of nonverbal messages from the patient
Expect to learn from patients

7. Spiritual Care Interventions
Understand the feelings of your patients but avoid adopting those feelings for yourself
Stay with patient after the person has received an unfavorable diagnosis
Assist the patient to participate in desired religious/spiritual rituals
Protect the patient’s religious/spiritual articles

8. Western Religions in the United States and Canada
Judaism, Christianity, and Islam are common western religions that patient’s often practice

9. Judaism Oldest faith to have belief in one God.
The Holy Books of the Jews are the Torah and the Talmud
Followers of Judaism are called Jews
Jewish clergy are called rabbis
Jews worship in buildings called temples or synagogues

10. Judaism The major divisions of Judaism are the following three:
Orthodox Judaism – follow the traditional faith and strictly adhere to rituals, including kosher diet and keeping of the Sabbath, they do not completely integrate into modern society, Jewish identity is passed on through the mother
Conservative Judaism – follows most traditional practices but adapt traditions to modern world

11. Judaism
Reform Judaism – stress the ethical and moral teachings of the prophets and autonomy of the individual. Rituals are performed which will promote a Jewish God filled life. Allow Jewish identity to be passed on from the fathers side as well – largest and fastest growing segment of Judaism

12. Judaism General beliefs Believe in God but not in Christ
Avoid references to heaven and Jesus
Sabbath is from sunset Friday until after sunset Saturday if observed.
Dietary rules are Kosher – separate utensils for preparing and serving meat and milk dishes

13. Judaism
Meat may be consumed a few minutes after drinking milk, but 6 hours must pass after eating meat before drinking milk
Some Jews will avoid eating pork, ham, Canadian bacon, eel, oysters, crab, lobster, shrimp, or eggs with blood spots

14. Christianity Belief that Jesus Christ is the Son of God
Followers are called Christians
The Bible is the sacred book and is divided into the Old and New Testament
Baptism is the rite of admission to the Christian community and may be performed if an infant is felt to be near death by anyone with the right intention

15. Judaism
Dying patient – family and friends may want to be with the patient at all times
Some do not believe in autopsies, embalming, or cremation
Some Jews will not want the nurse to touch the body of a dead Jew and will want the Burial Society to complete the preparation
If nurse must touch body wear gloves

16. Christianity Three major divisions: Catholicism Protestantism
Clergy are called Priest
Protestantism
Clergy are called ministers, pastors
Eastern Orthodox
Clergy are Bishops, Priest, and Deacons

17. Roman Catholic Baptism is necessary for salvation
Dietary Restrictions: if 14 years of age or older are to abstain from meat on Ash Wednesday and all Fridays during Lent. Catholic from 14 – 59 are to fast (eat one full meal and two lighter ones on Ash Wednesday and Good Friday
Fasting and abstaining is excused during hospitalization

18. Roman Catholic
Death – patients may wish to receive the last sacrament of the Christian, in addition to the anointing of the sick by a Priest
Cremation and organ donation are allowed

19. Eastern Orthodox Baptism is necessary for salvation
Dietary restrictions: abstain from meat and dairy products on Wednesdays and Fridays during Lent. Ill Patients are excused from this requirement
Dying patient – Last Rites are obligatory and performed by Priest, preferably while patient is conscious.
Autopsy and organ donation are not encouraged
Euthanasia and cremation are discouraged

20. Protestant Old Order Amish Assembly of God Baptist Episcopalian
Lutheran
Methodist
Presbyterian
Quakers
Seventh Day Adventist
United Church of Christ

21. Protestants
Emphasize individual responsibility and conscience over following tradition or religious authority
Follow the Bible
Food is individual choice
Death – Personal choice of patient and family, clergy my visit. Organ donation, autopsy, burial, and cremation individual choice

22. Islam Muslims believe in one God called Allah Holy Book is the Koran
Muslims pray in Arabic and worship in Mosques
The Imam is the leader of the Muslim population

23. Islam Follow the Five Pillars of Faith
The Profession of Faith – verbal pledge that there is only one God, Allah and that Muhammad is the messenger of Allah. (Muslims mothers may whisper this pledge into a newborn’s ear.)
Prayer – called to prayer 5 times per day
Almsgiving – annual payment of a certain percentage of a Muslim’s wealth and assets and is distributed among the poor
Fasting – During Ramadan, the 9th month of the Islamic calendar, adult Muslims abstain from dawn to sunset from food, drink and sexual activity
Pilgrimage – adult Muslims who are physically and financial able are expected to perform pilgrimage to Mecca at least once in lifetime

24. Islam
Pray to Allah 5 times per day (after dawn, at noon, in mid afternoon, after sunset and at night
If patient request to face Mecca, bed or chair may be positioned in a southeast direction from the United States
If the Koran is in the room do not touch it or place anything on top of it.

25. Islam
If Muslims wear writings from Koran on a black string around the neck, arm, or waist, these writings need to be kept dry and remain on the patient
Rules of cleanliness may include eating with the right hand and cleansing self with the left hand after urinating and defacating

26. Islam
Dietary – some Muslims will not eat pork and pork products, eel, oyster, crab, lobster, shrimp, and meats from animals that have not been bled to death by a Muslim

27. Islam Death practices:
Women may be barred from the room of a dying family member
Family may pray for dying member and Imam usually reads from the Koran for the patient after death
After death family washes the body including all orifices
Nurse may touch body only after donning gloves
Body is wrapped in white cloth for burial
Family may not permit organ donation, autopsies, or cremation
No embalming after death
Try to bury the dead within 24 hours

28. Important points on other various Religious groups
Christian Scientist –
No clergy – but may request a Christian Scientist practitioner to give treatment with prayer
No baptism
Consider the Lord’s Supper a spiritual communion with God and may sit quietly during this time.
No smoking or drinking alcohol
Do not accept blood transfusions or surgery
Feel studying Eddy’s book and the Bible will heal them

29. Jehovah Witness Baptism necessary for salvation
Beliefs based on the Bible
No ordained ministers
No churches but worship in Kingdom Halls
Publications include Awake and Watch Tower
Refuse blood products including plasma, will accept blood transfusion alternatives
Alcohol and tobacco are discouraged
Believe soul dies at death
Autopsy decided by family
Cremation is acceptable
Organ transplants personal decision – must be cleansed with non blood solution

30. Mormons The Book of Mormon is considered complimentary to Bible
Worship in temples and tabernacles
No ordained clergy
High priests are members of the Church and form the Council of Twelve and exert spiritual leadership
May avoid alcohol, tobacco, coffee and tea
Baptism is necessary for salvation
No restrictions on blood, or medications, may use herbal medicines, organ donation permitted
Promote dignified death, organ donation personal choice, autopsy permitted with consent of family, burial in temple clothes

31. Eastern Religions in the United States and Canada
Buddhist
Illness result of Karma (cause and effect)
Foods – extremes are to be avoided –many do not eat meat
No restrictions on blood or medical therapy, organ donation is allowed
Death – body is shell(treat with respect), autopsy and burials are personal wishes – burial and cremation allowed, ensure calm and peaceful death – it is important for family members to relate that patient had calm and peaceful death

32. Hindu
Some may wear a thread on the torso that should not be removed except in annual ceremony
Daily bathing but not after a meal
Most are vegetarians
Right hand used for eating, left is used for cleansing
Medication, blood and blood products, donation, and receipt of organs acceptable

33. Hindu Patient should be allowed to die peacefully Believe in rebirth
Autopsy and organ donation acceptable
Immediately after death priest may pour water into mouth of corpse and family may wash body
Cremation common, ashes disposed of in holy river
Priests unlikely to be involved with illness