LOOKING THROUGH THE EYES OF OUR PATIENTS

LOOKING THROUGH THE EYES OF OUR PATIENTS

JOURNEY South Africa

New Zealand

MAORI INSPIRATION Maori people and their culture. The church near the lake had Maori carvings, and it appeared as if the Lord was emerging from the water

St Faith's Church Ohinemutu ROTOTUA

people from different cultures co- existed in harmony with other cultures

STEPS TAKEN I consulted with the Hospital chaplain, religious leaders and consulting anaesthetist. Books Google Search 52 journal articles

We cannot put religion and ethnic groups into compartments. There is a lot of overlapping and individualism

In this talk it is not possible to discuss every aspect of every religious affiliation or ethnic group.

DEFINITION: According to the Oxford dictionary 2010: Culture has a system of shared beliefs, values, customs, behaviours, and artefacts that the members of society use to cope with their world and with one another, and that are transmitted from generation to generation through learning.

CARE OF PATIENTS In general be polite and considerate respect their cultural norms language barriers

rapport same gender COMMUNICATION:

Communation also involves Body language from both parties Eye contact Tone of voice Speed of talking Small talk Pronunciation Use of medical jargon & complicated words

communities emphasizes loyalty to family and devotion and puts less emphasis on individual feeling

PRIVACY during admission procedures, medical examination, treatment and ward rounds, the patient's privacy must be respected at all times.

DRESS : Dress is something we come across every day and that is what we see when we first approach a patient.

Head Cover:- an alternative covering such as a small cloth or a scarf. A surgical cap is acceptable. The headdress should be respected, and if removed, it should be given to the family or placed with the patient's personal belongings. Do not place the headdress with the shoes.

MODESTY any requests to be treated solely by male or female staff should be respected where possible and appropriate.

Jewellery, Armlets and Tokens none of these items should be removed or cut without the permission of the patient or next of kin. If the Thread has to be cut or removed it should be retained and given to the patient later

Articles of Faith - Sikh 1) Un-cut hair, a gift from God representing spirituality; 2) A wooden comb, symbolizes cleanliness; 3) A steel bracelet, represents self restraint and link to God; 4) A short sword, an emblem of courage and commitment to truth and justice; 5) A type of underwear, represents purity of moral character.

ALL BELONGINGS As far as possible all belongings should be given to the patients next of kin for safe keeping If not sure how to store it, inquire from the patient or Religious and ethnic Affiliations

misunderstood concept. SPIRITUALITY Health staff should be sensitive to the fact that 'Spiritual' needs may be experienced by anyone, not simply those with religious beliefs.

Everyone has spiritual needs these may basically be expressed as: 1. The right to love and be loved 2. The need for meaning and purpose in life 3. The need to feel worthwhile

CRISIS Times of crisis can lead the most unlikely people to consciously or unconsciously experience a spiritual need.

Co-lateral history Reduces anxiety Familiar faces FAMILY SUPPORT: Language barriers between staff and patient Physical contact and comfort {power of touch} Love ones caring for the very last minute before a patient is wheeled into theatre. When family is around it feels like a party.

ALTERNATIVE MEDICINE: guidelines and protocols have been established by the Societies of Anaesthetists either not properly followed or are sometimes difficult to adhere to such as in emergency surgical situations

HERBAL MEDICINE INTERACTIONS combination with conventionally prescribed medicine can prove to be fatal multiple interactions with these herbal and Ayurvedic drugs.

Side Effects increase bleeding tendencies with use of ginkgo and garlic, exaggeration of hypertension with ginseng, excessive sedation with St. John's wart, Garlic increases bleeding tendencies due to inhibition of platelet aggregation,

GINKGO Ginkgo is used for memory-improving qualities. also been reported to possess anti-inflammatory properties as well as it inhibits platelet activity. increases preoperative bleeding.

Guidelines After consultation with the patient by the Anaesthetist, recommendations may be given to discontinue any alternative medication prior to surgical intervention

Birth Marriage Death RITES OF PASSAGE:

Birth: many caesarean sections. culture or traditions of family taken into account. This the mid wife will take care of in most cases.

South Indian Temple

Marriage: Marriage tokens worn by our patients cultures the wedding ring is common. string with charms are knotted around the neck. Hindu culture a dot tokens should not be removed without the patient s permission.

Death: Different religions and ethic groups have different customs dealing with death. If in doubt inquire from the family, religious and ethic leaders.

BIOLOGICAL DERIVED PRODUCTS: informed consent process should include a discussion about animal-derived surgical implants to avoid religious distress and possible litigation

Pigs are considered unclean for Jewish, Muslim and Hindu faiths and some African tribes Cattle for Hindu are considered sacred, auspicious, and important providers.

BLOOD TRANSFUSIONS whole blood or its components, such as packed red cells, plasma, white cells and platelets

Jehovah s Witnesses Jehovah s Witnesses can choose whether to accept products such as albumin, immunoglobins or clotting factors.

Jehovah s Witnesses will accept Blood samples may be taken for pathological testing providing any unused blood is disposed of. Dialysis will usually be accepted. Jehovah s Witnesses will accept medical treatment in all other respects apart from those involving the use of blood or blood components.

Many religions offer a degree of relaxation of their respective laws It is recommended that discussion between staff, patient, family and religious leaders

THE INDIVIDUAL: ask the individual (and/or the family) what is needed and what staff should be aware of

LEARNING FROM COLLEAGUES: minority ethnic groups ensures holistic and culturally competent care

PERSONAL BELIEFS: first duty to make the care of your patient your first concern not allow any personal views prejudice your assessment

BE NEUTRAL your view about a patient s age, color, race, national origin, gender, sexual orientation, lifestyle, marital or parental status, Culture, ethnicity, religion or beliefs social or economic status, disability

DO NOT IMPOSE Not discuss your personal beliefs with patients not impose your beliefs on patients, or not put pressure on patients to discuss or justify their beliefs

BENEFITS OF CULTURAL AWARENESS: comfortable with similar background. relaxed staff is aware about his/her culture. staff has taken the trouble to understand his culture. free to practise his culture

BENEFITS certain cultural groups have certain needs responds physically and emotionally better familiar surroundings. not afraid, suspicious about staff comfort, safety and peace of mind.

NON EXAM SUBJECT: cultural enlightenment NZ is a melting pot many cultures, religions and ethnic groups.

ACKNOWLEDGEMENT Mark Tumai : Charge Anaesthetic Technician Anaesthetic Technicians : Waikato DHB Mark Forster-King :Team Leader Photography and Audiovisual Sagie Govender : Educator Dr Aidan O Donnell : Consultant Anaesthetist Bruce Sligo : Chaplain, Waikato Hospital THANK YOU