Patients religion

[mshow00]

So my question is this: Does your patients religion/spirituality affect/change your treatment/plan of care? As a brand new paramedic living in an area where we have most religions represented, should I take my patients soul into consideration? We have some Muslims (Arab and non Arab heritage), and I know there are very strict rules involving men's interaction with women. We also have Jehovah's witnesses, and they don't give or receive blood, blood products and the such for fear of it tainting their souls (and does synthetic count too?). Any thoughts or words of wisdom...

[spenac]

Your patient has the right to choose the medical care they receive, and that goes for even non religious types. In the field the blood issue will not cause an issue as you probably do not carry any blood products. If a patient informs you of their beliefs and treatment preferences relay that to the hospital.

Try and show respect even if you disagree. If they say a women must take a female patient and no female Paramedics available explain this and if they insist you may have to let them take patient instead or if service allows a person to ride see if they would allow the transport in that case.

[crotchitymedic1986]

A good thing to do is to meet with local church leaders to discuss these issues, many of which are cultural and not religous, but their spiritual leader will know the answers. There are many cultures where touching a body part is taboo, male or female, or is a sign of disrespect. You can then educate your staff.

[HERBIE1]

The cultural component is huge. Obviously in some religions there are very strict taboos about what a person can and cannot do. The muslim head wear is a huge issue in some circles, and unless the person's complaint is related to the head, I see no reason why we need to force them to unveil. I recently had a muslim woman who was in early labor, and we were simply providing routine care. As I went to apply the nasal cannula, I realized her ears were not exposed because of her scarf. I was going to put a mask on her or tape down the cannula, when she saw my issue. Before I could say anything she ripped off her head scarf and allowed me access to her ears. I told her she didn't need to do that but she said- "Do what you need to do- it's OK, I know you are trying to help me." I'm not sure how pleased the husband was after he saw her at the ER, but the patient is the one you are legally bound to listen to and treat.

Another situation I had was also an OB who was actually crowning as we arrived. Delivering a baby with your eyes closed is probably not a good idea, so as I was checking the patient, I realized the family was clearly Muslim, as evidenced by an Arabic TV show in the background, the language the family was speaking and the traditional dress of everyone except our patient, who was in her PJ's. By this time the woman already was in bed with her legs up and I was grabbing the OB kit. I saw the husband and thought that if I involved him in some way, I could avert any potential problems. I had him grab a couple pillows and blankets, and as the baby was born, I asked if he wanted to cut the cord. His eyes got real big, but he agreed. Everything went fine, the baby delivered, and I clamped the cord for him. I handed him the scalpel, and showed him where to cut. He was so happy to have a healthy baby, he never seemed at all upset, and he thanked us profusely. Every situation is different and you need to feel out the attitudes of the patient and the family as soon as you arrive on the scene. Experience will guide you as to how you need to proceed.

If you run into a problem, I would clearly explain why you need to expose something or do what you need to do, have a member of their family present, and if they or the family still refuse, advise your medical control, document this fact and have them sign off on it. The argument or problem is NOT worth the hassle, and in the vast majority of cases, it won't really affect a patient's condition.

Edited September 18, 2009 by HERBIE1

[WolfmanHarris]

I actually think we can make these potential issues worse by getting ahead of ourselves and making judgments based on seeing a crucifix on the wall, a star of david around the neck, certain dress or the like. Within any religious or cultural group is a wide spectrum of observance. My policy is to approach every patient contact with full professionalism and respect and let their actions and attitude dictate our interaction. If you jump the gun and assume certain behaviours out of a group that you're not fully familiar with you may end up offending someone by trying not to offend them.

I work in an incredibly diverse area with one of the largest populations of visual minorities in the country AND one of the largest populations of new Canadians.

You have a job to do that involves assessing and treating your patient. Do that with respect and be responsive to your patient and you should be fine.

[Richard B the EMT]

Ultra-devout Jewish is also not supposed to have a non married man taking care of a woman, or a man be handled by a woman. Also, they are not supposed to ride in a vehicle between sundown on Fridays and sundown on Saturdays.

In my own religious training, attributed to a Rabbi Hillel, a Jewish and non Jewish man are walking on the Sabbath, discussing the affairs of the world, when they heard the voice of a child calling for help from a semi-demolished abandoned house.

The non Jew offers to run and get help, but, instead, the Jewish man joins with the other man, and the 2 of them rescued the child.

A religious council in the town charges the Jewish man with "breaking the Sabbath" to effect the rescue, and threatened to stone him, but the town's Jewish leader, after consideration for a while, told the charged man that no stoning would take place.

He pronounced that "to save a life, one may break the Sabbath.

Like, tolerate, or hate them, that is why you'll still see Hatzoloh Chevra ambulances responding to calls, even on the Sabbath.

Also, I have had calls where I realize I am in either a Moslem or Hindu household. On those times, I apologize for not removing my boots, explaining that I want to take care of the patient that they called me to, not waist the patient's time to remove and then replace the boots. The fact that I am aware of this seems to make a good impression on the people in these households.

However, the woman who wanted my partner and I to take off our boots because she didn't want us tracking in rain water onto her carpet, instead of taking care of her sick 3 year old, was told off, not by my partner or myself, but the NYPD LEOs who responded with us.

[island emt]

I don't let a patients religion interfere with providing care. They called 911 for assistance. If they don't want our help ,don't call.

I do respect that some religions have different beliefs than mine ,but that doesn't stop me from doing my best to give them relief and transport them to an appropriate facility.

A similar thing occurred to us shortly after moving here to a small island community. We responded to a call for a severe stroke and as we walked in the door of the home at 3 am, the family looked at us and said" We don't know you and want to wait for a local to show up"

My wife explained with the patience of a saint that if they wanted to wait for an "islander" to respond they had better call the funeral home and we would wait with them.

There were no native Islanders on the rescue service!

[Mateo_1387]

As far as Muslims are concerned, it is acceptable for a man to take care of a woman when rendering medical care.

[Siffaliss]

So my question is this: Does your patients religion/spirituality affect/change your treatment/plan of care? As a brand new paramedic living in an area where we have most religions represented, should I take my patients soul into consideration? We have some Muslims (Arab and non Arab heritage), and I know there are very strict rules involving men's interaction with women. We also have Jehovah's witnesses, and they don't give or receive blood, blood products and the such for fear of it tainting their souls (and does synthetic count too?). Any thoughts or words of wisdom...

I do my thing as per protocol, unless the patient is of good frame of mind and able to make an intelligent decision and refuses treatment. In such a case if they were refusing something they absolutely needed, I would call in a supe to further my intentions. Who knows, maybe they'd call the medical director (which seriously NEVER happens). If the patient still refuses, well, I've involved more people so I've made a good effort with regard to due diligence.

Now, if I had someone who was unconscious and say needed blood products and we gave those to said patient, and later found out he was Jehovah, would I feel bad? No. It has nothing to do with the fact I don't believe in the same things they do. It has to do with the fact that I had a job to do and I did it. I would rather treat when required or under "implied consent", than do nothing at all and lose my medical license. I do what I need to do for the betterment of my patient regardless of religion, unless there is a legality (patient refusal) that tells me otherwise. I couldn't give a krap about religion. Now I am respectful of others, don't get me wrong ... I really don't care what stuff people observe. Just don't force it on me

When it comes to say a Muslim woman needing us and her husband is on scene, I will ask the hubby to wait outside of the unit while we do our thing. Those women don't really say much around their husbands and I get a more complete and thorough story and history when they're not around. I will always respect if they don't want their skin displayed, and take care to say re-clothe after a 12 lead, and ensure legs are covered etc etc.

Each situation is different, so just react and treat accordingly. Involve more people like supes or docs if possible, that way the heat is taken off you somewhat as you've made an effort to do what you are medically and legally obligated to do.

[Dustdevil]

...a Jewish and non Jewish man are walking on the Sabbath, discussing the affairs of the world, when they heard the voice of a child calling for help from a semi-demolished abandoned house.

The non Jew offers to run and get help, but, instead, the Jewish man joins with the other man, and the 2 of them rescued the child.

A religious council in the town charges the Jewish man with "breaking the Sabbath" to effect the rescue, and threatened to stone him, but the town's Jewish leader, after consideration for a while, told the charged man that no stoning would take place.

He pronounced that "to save a life, one may break the Sabbath.

Interesting story. There is a small town near me that is almost entirely inhabited by Seventh Day Adventists, and is the home of a Seventh Day Adventist University. In the mid 1980s, the mayor happened to see the fire chief at the fire station trying to fix a broke down fire truck on a Saturday. A special meeting was called the next day to fire the fire chief, and they did. Unanimously. Adventists don't play!