NRSE 110 Exam #2 ⭐️

Religion

• a unified system of beliefs, rituals, practices

• latin = religare = to bind = reconnect

• what is right and wrong?

• what is true and false?

• what practices, rites, or rituals should I follow?

Spirituality

• one’s personal, conscious journey

• everyone’s is different

• where do I find meaning?

• how do I feel connected?

• how should I live

How is spirituality and religion simlar?

• belief

• comfort

• reflection

• ethics

• awe

What is spiritual distress?

• an unpleasant experience - emotional, psychological, social, spiritual

• interferes with our ability to cope

• loss of control, feeling like a burden, isolation, loneliness, hopelessness, fear of dying or pain, unforgiveness, anger

What do chaplains do?

• offer spiritual care to patients, families, staff

• respond to each person’s unique values and beliefs

• care for persons of every faith background

• help people sort through issues of meaning and value as they face crises or transitions in their lives

• off non-anxious, non-judgemental presence

Spirituality factors

• harmony with self - self-identity, wholeness, inner peace

• connectedness with others - love, reconciliation

• relationship with a higher being - God

  • hope, gratitude, inspiration

• what is scared for this person?

Spiritual care interventions

• acknowledgement of someone’s struggles and empowering one’s own journey

• creating a sacred space

• communication - active lisenting

• grief and loss counseling

• religious resources - crosses, rosaries, Bibles, booklets

• navigating through family dynamics

• prayer, rituals, ceremonies

Examples of chaplin staff support

• debriefing

• silence to honor the life of a patient who died

• weddings, funerals, memorial services

• special worship - blessing of the hands

• someone to talk to

What does culture consist of?

• food

• faith/religion

• behavior

• rituals

• customs

• language

• beliefs

• attitudes

What is the iceberg concept of culture?

2 parts of culture…

• surface culture

• deep culture

  • unspoken rules

  • unconscious rules

What is surface culture?

• above sea level

• emotional level is relatively low

• food, dress, music, arts, drama, dance, literature, language, celebrations

What is deep culture?

• unspoken rules

  • partially below sea level

  • emotional level is very high

  • courtesy, conversational patterns, personal space, rules of conduct, facial expressions, body language, eye contact, touching

• unconscious rules

  • completely below sea level

  • emotional level is very intense

  • notions of adolescence, patterns of decision-making, definition of insanity, concept of self, tolerance of physical pain

What is ethnicity?

• a shared identity related to social and cultural heritage, traditions and customs

• values, language, geographical space, racial characteristics

• Asian-American, African-American, Afro-Caribbean, Hispanic/Latino

What is race?

• a designation that is limited to biological attributes like skin color and physical features

• a socially constructed concept

• Asian, Black, White, American Indian, Native Hawaiian

How are race and ethnicity similar?

• both are social constructs

• both categorize and characterize seemingly distinct populations

What are important cultural factors a nurse should know about a patient?

• beliefs

• practices

• diets

• feelings about pain

• eye contact

• family dynamics

• religions

What is a stereotype?

• A generalized belief about a group that creates expectations about individuals in that group

• Leads to an expectation that people might have about every person of a particular group

What can stereotypes contribute to?

Prejudice, oppression, and discrimination

Examples of stereotypes

• a certain religion not accepting blood products

• not making eye contact with certain cultures

• a religion not believing in certain care

Give an example of a harmful cultural assumption in care.

Assuming someone refuses blood products or avoids eye contact solely because of their religious or cultural identity.

What is bias?

An unfair preference or prejudice for or against a person, group, or thing

Usually in a way that is considered to be unfair

Can derail attempts to improve the culture of diversity, equity and inclusion

What is conscious or explicit bias?

A bias that a person knows they have.

What is unconscious or implicit bias?

An attitude or stereotype that influences understanding, decisions, or actions without conscious awareness

A bias we don’t know we have, everyone has them

Why is recognizing implicit bias important?

Self-awareness is an important step toward reducing biased behavior.

Examples of implicit bias

• non-white pts receive fewer cardiovascular interventions, fewer renal transplants

• black women are more likely to die after being diagnosed with breast cancer

• non-white patients are less likely to be prescribed pain meds

• patients with obesity receive fewer preventative health services

What are health disparities?

Differences in health opportunities or outcomes associated with factors such as race, ethnicity, sex, age, disability, socioeconomic status, sexual identity, or geography

All contribute to an individuals ability to achieve good health

What broad concept contributes to health disparities?

Social determinants of health.

Why are diversity and inclusion important in healthcare?

They support improved health outcomes and benefit patients, communities, and the workforce.

What is mattering?

• the general sense of being significant, valued, important

• idea that each person wants to feel as if they make a difference, are appreciated

What is diversity?

The presence of different people and perspectives.

What is equity?

Fairness in policy and practice, with attention to what people need.

What is inclusion?

Ensuring different voices and perspectives are welcomed and involved.

What are three personal strategies to reduce bias?

Acknowledge your biases; build empathy; treat each patient as an individual rather than a stereotype.

Slow down, be mindful, listen

Who developed Culture Care: Diversity and Universality Theory?

Madeleine Leininger.

Transcultural Nursing

Her theoretical framework is shown in the Sunrise Model

Culturally congruent care

What is transcultural nursing?

Comparative study of similarities and differences in care across human cultural groups.

What are culture-universal characteristics?

Similarities found across cultural groups.

What are culture-specific characteristics?

Differences associated with particular cultural groups.

What model represents Leininger’s theory?

The Sunrise Model.

What is culturally congruent care?

Care that fits the patient’s cultural values, beliefs, and practices.

What do primary colors represent in the mandala?

• Cohesive cultures with strong identities.

Who developed the Theory of Cultural Humility presented in the slides?

Cynthia Foronda.

What is the goal of Foronda’s Theory of Cultural Humility?

To foster appreciation of diversity and the application of cultural humility in a complex world.

What are the five assumptions of Foronda’s Theory of Cultural Humility?

• Humans are diverse yet part of a global community

• Inherently altruistic

• Equally valuable

• Cultural conflict is expected

• We are all lifelong learners

What model illustrates Foronda’s theory?

The Rainbow Model of Cultural Humility.

Why use Arthur Kleinman’s questions?

To understand the patient’s own explanation and experience of illness.

What are the 8 Kleinman questions?

• what do you call your problem? what name does it have?

• what do you think caused your problem?

• why do you think it started when it did?

• what does your sickness do to you?

• how severe is it? short or long-term course?

• what do you fear most with this disorder?

• what are the chief problems that your sickness has caused for you?

• what kind of treatment do you think you should receive?

What practices support culturally competent care?

Assess cultural needs

Respect differences

Avoid judgment

Maintain a learning mindset

Accommodate practices

Include patients in decisions

How should nurses address language barriers?

Use appropriate translators or interpreters and attend to nonverbal cues.

What does ESFT stand for in cultural assessment?

E - Explanatory model

S - Social and environmental factors

F - Fears and concerns

T - Therapeutic contracting

What are key elements of respectful care?

Awareness, mutual respect, shared decision-making and informed consent, autonomy, dignity, and accountability.

What is spirituality in holistic nursing care?

A source of hope, meaning, strength, trust, values, forgiveness, relationships, and sometimes religious faith

Is spirituality limited to organized religion?

No. It can include purpose, personal beliefs, relationships, creativity, and self-expression.

What is spiritual care NOT?

Imposing beliefs, trying to convert a patient, or assuming spiritual support belongs only to a religious leader.

What is the HOPE Assessment?

What does H stand for in the HOPE assessment?

Sources of Hope, meaning, comfort, strength, peace, love, and connection.

What does O stand for in the HOPE assessment?

Organized religion.

What does P stand for in the HOPE assessment?

Personal spirituality and practices.

What does E stand for in the HOPE assessment?

Effects on medical care and end-of-life issues.

What is the Open Invite approach/mnemonic?

Open the door to discussing spirituality, then invite the patient to share spiritual needs and preferences.

What nursing interventions support spiritual care?

Show empathy, assess spiritual needs, listen and be present, understand beliefs, and refer to appropriate support.

What clues may suggest spiritual needs?

A patient’s expressed concerns, disposition, or meaningful personal artifacts.

Spiritual support referrals…

Interfaith chaplains or chapel, bereavement support, social work, and counselors

What is holistic care?

Care that considers physical, psychological, social, and spiritual needs

What are physical needs in holistic care?

• management of pain

• control of symptoms

• nutrition

What are spiritual needs in holistic care?

• opportunity to give and forgive

• encouragement to end quarrels and reconcile

• calm and peaceful frame of mind

What are psychological needs in holistic care?

• professional counseling to provide safety and security

• helping to rediscover a sense of worth and self-esteem

What are social needs in holistic care?

• acceptance as part of a group

• encouraging sense of belonging

• treated with dignity as a fellow human

How can nurses preserve dignity in holistic care?

Learn and use the patient’s name, listen sincerely, respect preferences, and reinforce their worth."

What approaches can help with anxiety or pain in holistic care?

Ask what helps, use appropriate nonpharmacological pain methods, and offer support based on patient preferences."

What should nurses remember about eye contact and touch?

Connection and therapeutic touch, but nurses should assess each patient’s cultural preferences and consent.

How can a nurse provide holistic care after a stillbirth?

Offer compassionate presence, assess emotional and spiritual needs, respect individual religious preferences, support family involvement as desired, and offer bereavement resources