Maintaining a culturally diverse staff and working with a culturally d

QUESTION

Maintaining a culturally diverse staff and working with a culturally diverse patient population is an important function of a nurse manager who works in the hospital of a large medical center.

On your palliative care unit, you have recently received complaints from families about ineffective pain management for their family members and you determine this occurs primarily when certain nurses are working. What approach might you take to resolve the concerns of the families, patients, and potentially, the staff?

a. Reinforce to staff that practice guidelines support as-needed analgesia for the terminally ill.
b. Ask staff input on the development of stricter guidelines to ensure that all terminally patients are given sufficient analgesia.
c. Encourage conversation with patients and among staff that facilitates learning about cultural beliefs and priorities in dying.
d. Advise families that the administration of analgesia is based on the expert clinical judgment of nurses who are familiar with care of patients in palliative care.

ANSWER:

ANS: C
The cultural and religious backgrounds of nurses influence their perceptions of dignity-conserving care. For example, foreign-born Catholic nurses stated the dying experience should not be altered by analgesics to relieve suffering or by attempts to hasten death by forgoing curative therapy or by other means. Approaches to working with differences in the diverse cultural and religious backgrounds of patients, families, and nurses alike include taking time to have conversational chats with patients in end-of-life and with colleagues that will facilitate learning about each other and provide care that fits with the patient’s cultural beliefs about dying.