1. Cultural Diversity: Russians
By: Jaden Johnson

2. All about Russians
Russians are an East Slavic ethnic group native to Eastern Europe.
The majority of Russians inhabit the nation state of Russia, while notable minorities exist in Ukraine, Kazakhstan, and other former Soviet states.. Russians are the most numerous ethnic group in Europe.
The Russians share many cultural traits with their fellow Eastern Slavic counterparts, specifically Belarusians and Ukrainians as well as with certain Southern Slavs such as Bulgarians, Macedonians, and Serbians.
They are predominantly Orthodox Christians by religion.
The Russian language is official in Russia, Belarus, Kazakhstan, Kyrgyzstan, and Tajikistan, and also spoken as a secondary language in many former Soviet states

3. Common barriers while caring for Russians
Many Russian immigrants are unfamiliar with the cultural etiquette of American medicine and may expect more compassion and emotional closeness with their physician - seeking a professional, yet close, relationship with providers.
Rather than appreciating the privacy and autonomy of the American medical culture, patients may complain about the quality of medical treatment they receive and question the physician’s ability to understand their problems.
Russian immigrants may be distrustful of physicians, and reject health recommendations, such as refusing to take medications as prescribed or combining medications and therapies with home remedies and treatments
Practices associated with physical examinations in Eastern European countries are different from those in the American medical culture.
In Russia, hospital gowns are not provided during examinations. Most patients are examined in their undergarments; nudity is not considered shameful
In addition to not being used to American healthcare systems, Russians may also experience language, transportation, and lack of insurance barriers

4. How to overcome these barriers
Stay informed, and try to accommodate any cultural norms
Specifically for Russians, try to spend longer with them, to help them feel cared for
Try to help them trust you, and ask them if there is anything you can do to improve their stay/experience

5. How does Russian culture influence their views on medicine and diagnosis?
When a Russian person is ill, family members and friends are expected to visit in order to provide support to the individual and immediate family
Bad health news is not given to a person who is ill or disabled. The family does not want the person to become anxious. It is commonly believed that the individual needs to be at peace so physical and emotional conditions do not worsen
The family prefers to receive the news first, then decides whether or not to tell the patient of the condition and prognosis
To ensure a more peaceful death, many families believe that a loved one should not know that death is imminent. The moment of death and the patient’s last words are especially significant.
They may ask a rabbi, priest, or others to pray for the patient

6. How should a healthcare worker proceed if they have a Russian patient?
Take a minute to orient your patient, and answer any questions they may have about how the system works
Explaining the Causes of Illness and Disease
Your patient and his or her family may believe that illness is caused by weather or social experiences, such as stress from the living situation or because of arguing with the family.
Ask your patient if they have experienced stresses or strains recently.

7. How should a healthcare worker proceed if they have a Russian patient
How should a healthcare worker proceed if they have a Russian patient? (continued)
Making Decisions About Health Care
Decisions are made by the parents or the oldest child.
The elders are respected
There are no major gender issues; decisions could be made by the mother, father, or eldest son or daughter.
Ask your patient about whom they want to be included in medical decisions. Then meet with the identified family members to strategize how to communicate the medical news. If the patients do not want to make medical decisions for themselves, let them know they need to prepare a Durable Power of Attorney for health care

8. How should a healthcare worker proceed if they have a Russian patient
How should a healthcare worker proceed if they have a Russian patient? (continued)
Managing Medical News
Bad medical news is often shielded from the patient by the family in the belief that telling the patient will only make the patient’s condition worse
If the patient consents, meet with the designated persons to strategize how to communicate medical news so that you are sure of the patient’s informed consent for treatment

9. How should a healthcare worker proceed if they have a Russian patient
How should a healthcare worker proceed if they have a Russian patient? (continued)
Understanding Norms About Touch and Body Issues
Direct eye contact with your patient is acceptable
A handshake is welcome from the health care provide
Explaining Touching
Before touching your patient, always explain what will be done and why
Your gender as the health care provider is not likely to be an issue for your patient when doing perineal-care or assessing urinary catheters
Your patient may prefer that opposite gender family members leave the room. Find out if this is the case for your patient
Female patients may prefer a female OB Gyn
Ask your patient to learn about her preference

10. How should a healthcare worker proceed if they have a Russian patient
How should a healthcare worker proceed if they have a Russian patient? (continued)
Understanding Concerns About Hygiene and Health
When sick, your patient may prefer sponge baths to daily baths or showers
Your patient may not wash hair as frequently when sick, especially when in the hospital, for fear of catching a cold or headache
Your patient may prefer to keep the room warm and the window shut
Hygiene may be performed by the patient, family, or with the help of a nurse or aide
Maintain modesty and privacy issues with patient’s opposite-gender family members present

11. Conclusion Russians are very close with their physicians
There can be many barriers with caring for Russians in American facilities, but with patience and perseverance, you can overcome many of them
Always ask your patient of their cultural, religious, and personal preferences
Most of all strive to make your patient as comfortable as possible, and always be polite