How to write a nursing PMHNP Reflective Journal
- Respecting patients’ cultural and religious beliefs that conflict with treatment plans.
The diversity of cultures and religions around the world creates a challenge for healthcare providers to provide culturally competent care. Healthcare providers are supposed to deliver services that meet the cultural, social, and religious needs of patients. Without cultural competence, patients may have untoward health consequences, receive poor quality care, and be dissatisfied with the care provided (Ayvaci, 2017). Cultural competence is seen as a necessary skill for mental health nurses to provide effective patient-centered care, yet some of the actions conflict with patient treatment plans.
Religion plays an important role in American society and people with psychiatric illnesses can rely on religious beliefs to cope with their condition. A recent encounter I had involved a 13-year-old African American female patient with depression. This was the second time the patient was brought to the facility following two suicidal attempts. During care delivery, the parents were very reluctant about the patient’s admission stating that she was possessed with evil spirits. They opted for less medical intervention and requested her to be taken to their local pastor for prayers. I also noticed that she has not been on antidepressants prescribed two months ago when she experienced the same because the parents relied on religious beliefs to cope with their condition.
While addressing this challenge, I realized that it is important to involve the family pastor to promote acceptance while explaining to the family the consequences of not taking medications. Despite this approach, I observed that the family was reluctant to discuss their religious concerns because of their perception that healthcare providers are not sensitive and knowledgeable about their religion. Additionally, I observed that the patient was not interested in group therapy sessions for fear that it could challenge her religious beliefs. This experience made me realize that understanding the patient’s cultural perspective of life can affect treatment and recovery. Initially, I found it difficult to separate normal and pathological expressions of religiosity. Studies have demonstrated that psychiatrists only discuss cultural and religious aspects in about 36% of the cases and there is a general difficulty in discussing the subjective experience of the patient’s religiosity (Ayvaci, 2017). Cultural competence can aid in planning for patient care and can promote quick recovery if well utilized.
- From where does this originate?
Cultural competent care is a practice recognized by national and international health organizations to improve quality care. For instance, the Joint Commission (TJC) requires hospitals to be accountable for maintaining the patient’s rights which include the accommodation of their religious, spiritual, and cultural values (Swihart et al., 2021). To address the issue of diversity in healthcare, it is crucial to provide care that abides by the beliefs of different cultures. Apart from this origin, culturally competent care is an aspect that can aid in achieving the healthy people 2020 goal of eliminating ethnic and racial disparities (Swihart et al., 2021). Healthcare systems should develop strategies and techniques to respond to the religious and cultural needs that will always impact care delivery.
- Discuss one of the nursing theorists behind this.
Madeleine Leininger’s culture care theory emphasizes the importance of providing culturally consistent care to patients. The theory postulates that the importance of nursing is curing and healing (McFarland & Wehbe-Alamah, 2019). Patients are observed to comply with treatment when nursing care is congruent with their beliefs and ways of life. Additionally, the theory suggests that nurses must modify the environment to meet the patient’s needs (McFarland & Wehbe-Alamah, 2019). Important aspects to note when providing care should include communication and language, gender, sexual orientation, age, diet, socioeconomic status, and appearance among many others. Leininger’s theory proposes three models of providing meaningful care and they include maintenance/preservation, accommodation/negotiation, and re-pattering/restructuring.
References
Ayvaci, E. R. (2017). Religious barriers to mental healthcare. American Journal of Psychiatry Residents’ Journal, 11(07), 11-13. https://doi.org/10.1176/appi.ajp-rj.2016.110706
McFarland, M. R., & Wehbe-Alamah, H. B. (2019). Leininger’s theory of culture care diversity and universality: An overview with a historical retrospective and a view toward the future. Journal of Transcultural Nursing, 30(6), 540-557. https://doi.org/10.1177%2F1043659619867134
Swihart, D. L., Yarrarapu, S. N. S., & Martin, R. L. (2018). Cultural religious competence in clinical practice. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493216/
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