Cultural Awareness for Hindu Patients

Cultural Awareness for Hindu Patients
Cultural awareness and competence in nursing practice has gained significant importance in the last few decades. It’s no longer enough to understand and respond to patient’s needs, but also important to recognize and respect his or her cultural traditions and beliefs. As a 1st year nursing student I’ve learned this myself through the experience of providing care to Hindu women in our local hospital. The Hindu culture was not close to me at that time. We didn’t have any “cultural competence” classes yet, so except for its geographical location I knew nothing about India and its traditions.

One time, on my 4th day of practice at the hospital we had an emergency call and soon there came one of our ambulance cars with a Hindu woman who had a massive heart attack and was unconscious by the time she was placed in one of our wards. I’ve noticed that the ambulance car was accompanied by couple of others and later learned that the whole family was at the hospital waiting for diagnosis and further recommendations. I thought it was very nice when there is a whole family to support you, but I was surprised that all these people (there were seven or eight of them, including children) left all their urgent tasks and came to the hospital.

I was assigned to accommodate the woman in one of our wards. Although it was already time to give medications to my patients and there were two other male nurses available to do this task, I was told that they cannot perform this procedure. So, with no time to ask other questions, I have accompanied the patient to her ward and started preparing her for the bed. Although none is generally accepted to the ward at the emergency situation, the woman’s husband has insisted to enter the ward and I couldn’t afford wasting more time to argue. When I started to take off the woman’s clothes, her husband has drawn the curtains, although there was none except us and two other female patients in the ward. Finally, when I was about to take off the jewelry, the woman’s husband started talking to me loudly in Hindu and preventing me from removing any piece of jewelry from her wife.

At first the situation seemed quite strange for me. When the doctor came, I’ve explained what had happened and she said everything was fine and that I didn’t have to worry. Later we had a talk and she had explained why the man was acting that strange. The matter was that treatment of Hindus as well as some other nationalities was different from the commonly practiced standards. It was very important, though, to recognize the cultural differences of people with different ethnical background, since otherwise some action could make a serious offense to the person and his or her family. That was exactly the case when I tried to take off the woman’s jewelry.

In Hindu culture jewelry not only has a decorative value, but also represents a religious and cultural significance. A woman’s brooch (mangal sutra), for example, is given to a woman when she marries. She is supposed to wear it as long as her husband stays alive. If someone tries to remove it from the woman, it causes a big distress. Hindu boys often wear a “Sacred Thread” around their body and over the right shoulder, which is not supposed to be removed, unless there is a really urgent need for it. Thus, before removing any jewelry, a prior permission should be granted by the patient to do so and once it is removed, all items should be kept clean and later retained to the patient (Miller, 1999).

Another feature about Hindu culture, which I was wondering first about, was that the whole family came to the hospital with that woman. The doctor has explained that all it was important for all of them to be there, especially for the senior members of the family, since any decisions regarding treatment should only be taken by elder people in the family rather than by the patient herself. The family members may expect to visit the patient any time they choose, as well as help treating the patient by washing and feeding him or her. Thus, it is important that medical staff discusses all issues with the patient’s family and works out the most appropriate behavior. Any Hindu patient may have many visitors, who will bring gifts and national food to aid healing. Religious ceremonies may also be performed by Hindu patients together with their family. These may include blessing a sick relative with holy water, reciting hymns or tying a symbolic string of jewels around arm, neck or body (Miller, 1999).

While talking to the doctor, I remembered that there were other nurses available to handle the accommodation. I asked why they chose me to do that. Was it something about my age or gender? The doctor replied that female Hindu patients prefer to be treated by other women. Besides, they feel themselves particularly uncomfortable in the mixed wards, so unless there is a case of emergency, they should be accommodated to the same sex wards. If there is a situation, when a female doctor is not available, the Hindu women are likely to request the presence of their chaperone, if not accompanied by a senior family member. Hindu men are also reluctant to be treated by female personnel. Both genders may want to expose only that area of their body, which is being examined, while keeping the rest covered (Miller, 1999).

Most Hindus are vegetarian, and that is why it is important to check what kind of medicines they are prescribed, since some of them may contain animal products, such as beef derivatives. The Hindu culture places obligation not to be responsible for the death of animals or any living creature, and that is why it is important to work out the most appropriate alternative or discuss the treatment, if there is none (Miller, 1999).

It is also important for medical staff not to interrupt Hindus during they prayer, which takes place three times a day: at sunrise, noon and sunset. Such items, as candles, religious icons, food and bell should be allowed to be next to the patient’s bed and should be treated with respect (Lynch, 1992).

Another thing that all staff, especially nurses, should know is that Hindus use water to wash after they go to the toilet. If there is no bidet available in the ward, the patients should be provided at least with a bowl of water. Same gender staff assistance may be required if the patient is bedridden. Hindus also prefer to take a shower rather than a bath, since they consider bath unhygienic (Lynch, 1992).

When preparing for surgery, most Hindu women must obtain permission from their husband to cut the hair and are generally reluctant to do so. The permission should also be obtained from a husband or father before signing a consent form. The male Hindu are not likely to remove their jenoi (sacred thread) during the surgery and are very concerned about this thread contacting with body fluids during the operation (Miller, 1991).

Finally, when clinical history is taken from a Hindu patient, it may take plenty of time, since it is considered disrespectful to rush a patient when he or she is given an interview. The Hindus have a tradition of approaching serious subjects indirectly. Therefore, before asking Hindu patient personal questions about his or her health, it is important to talk about general issues beforehand, otherwise by most Hindus it will be considered extremely rude (Morse, 1989).

That was a very valuable talk for me, because for the first time I have realized how important it is to know the customs and traditions of other nationalities. Something that could seem ordinary for me (such as taking off a necklace or a brooch) could mean a real disaster for a person with different ethnic background. Now that I know a little bit about Hindu culture, I can tell what makes sense for me and what doesn’t. I guess it’s only a cultural prejudice, but I don’t fully agree that patient should be consulted as to whether or not he/she will take the medicine, if it has some animal products in it. I personally think that if the patient comes to a hospital, he is expected to follow the doctor’s prescription, otherwise doctor should not be held responsible for the patient’s health state. Another feature I believe to be wrong about Hindu customs is that the patient cannot make decisions about health treatment, while this right is granted to senior family members. I understand that this is a part of the family tradition, but each individual should have a right to decide what to do with his/her own life.

However, I don’t believe these prejudices of mine will be serious obstacles in providing a competent health care. Now that I’ve learned about importance of cultural differences in providing nursing care, I will definitely study this subject more thoroughly and will do my best to apply all my knowledge in practice. I think that the only way to provide a culturally competent care to the patients is to treat them with respect to their traditions as long as these traditions do not interfere with saving a life of a patient or improving his or her health condition. Thus, I believe that in order to ensure the culturally competent environment all existent and future nurses should be trained about ethnic and cultural differences and also some actions should be taking on a legislative and regulatory level.

Cultural Awareness for Hindu Patients 8.9 of 10 on the basis of 4471 Review.