Wasilowsky, Bonnie, RN, BSPA-HCA, CNRN

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Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksPatient Care Services / NursingOpen to the Public: Meeting the NursingChallenge of a Diverse AmericaBonnie Wasilowsky RN, BSPA-HCA, CNRNLehigh Valley Health Network, Bonnie.Wasilowsky@lvhn.orgFollow this and additional works at: http://scholarlyworks.lvhn.org/patient-care-services-nursingPart of the Medical Sciences Commons, Medicine and Health Commons, Neuroscience andNeurobiology Commons, Nursing Commons, Race and Ethnicity Commons, and the Sociology ofCulture CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtWasilowsky, B. (2011, MArch). Open to the public - meeting the nursing challenge of a diverse america. Poster presented at: The AmericanAssociation of Neuroscience Nurses, Kansas City, MO.Hispanic1.8%African American4.6%Caucasian50%American Indian/Alaskan Native0.4%Asian or Pacific Islander3.3%Unspecified7.5%Two or MoreRacial Backgrounds1.5%Hispanic14%African American13%Asian5%Caucasian67%American Indian/Alaskan Native1.5%Native Hawaiian/OtherPacific Islander1.5%Lehigh Valley Health Network, Allentown, PennsylvaniaCultural belief systems affect how patients and families respond to stress, genders, authority, and end of life decisions. The Unites States is home to an increasing diverse population who bring their belief systems, cultural rituals, and languages into the Neuroscience ICU. Nurses may struggle to assist patients and families understand the treatment plan and recommendations in the face of cultural and language barriers. One Magnet hospital has developed a cultural awareness program that optimizes the resources available to aid patients, families, and caregivers to communicate clearly, understand cultural beliefs, and respect end of life decisions. A handbook was developed addressing cultural and spiritual beliefs for over 30 religious or cultural communities. In-house interpreters are available, fluent in over 50 languages and books of faith are available on the nursing units.  Case studies will be presented illustrating cultural issues that left unresolved would have impacted patient and families emotional health.     Open to the Public: Meeting the Nursing Challenge of a Diverse AmericaAbstract:Objectives:Bonnie Wasilowsky, RN, BSPA-HCA, CNRN2004 National Ethnic Breakdown•  Discuss the impact of trans-cultural patient expectations on  nursing care.•  Describe the resources available to meet diverse patient populations’ spiritual and cultural needs•  Review 2 case studies that demonstrate trans-cultural beliefs that impacted nursing care and family response to the medical environment. •  70 year old male admitted with large ICH•  Bosnian Muslim•  Requested spiritual support from Imam and Koran•  Islamic Center utilized to determine appropriate Imam•  Organ donation refused so body could be buried “whole”•  Face the patient toward Mecca at time of death•  Designation of approved funeral home prior to withdrawal of care to assure proper care of body•  Fulfill patient wish to return to BosniaCase Study #1Language Paradigm Shift•  52 million U.S. residents do not speak English at home•  21 million U.S. residents have limited English proficiency•  54 year old Chinese male admitted with large basil ganglion bleed•  Majority of family in China/Niece in US•  Females may not have authority to make a value decision•  Male hierarchy prevails regardless of geogrpahic disparity•  Brain death is not death in presence of beating heart•  Belief in prolonging life toward attaining “Enlightenment” by any means•  Contacted male relatives in China for end of life decisionCase Study #2African Americans•  29% higher rate of heart disease•  50% more likely to suffer a stroke•  30% higher rate for cancer•  64% of new HIV/AIDS infections are African American womanHispanics•  Higher rates of cervical and stomach cancer•  Twice as likely to have diabetes•  Account for 20% of new cases of TB•  50% higher rate of low birth weight babiesAmerican Indian/Alaskan Native•  Highest rate of depression and suicide of all ethnic groups•  Higher rates for colon and rectal cancer•  Higher rates of infant deathsHealth Care Disparity in United States•  U.s. Department of Health and Human Services web site: http://www.hrsa.gov•  The Office of Minority Health web site:    http://www/omhrc.gov•  State/City Resources Available  •  Department of Health  •  Community centers  •  Churches  •  Social groups•  Institutional resource available  •  Cultural Diversity Liaison  •  Interpreter Phone covering 150 languages  •  Interpreter Services  •  “GEORGE” - video remote interpretation for hearing impaired  • Patient education provided in 10 languages  • Cultural Diversity HandbookResources Available to Meet Cultural and Spiritual Needs2004 Nursing Force Ethnic BreakdownUnited States Culture Paradigm Shift2050 Projected Ethnic BreakdownHispanic23%African American14%Asian8%All Other Races5%Caucasian50%

Open to the Public: Meeting the Nursing Challenge of a Diverse America

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1053&context=patient-care-services-nursing

Open to the Public: Meeting the Nursing Challenge of a Diverse America

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Lehigh Valley Health Network: LVHN Scholarly Works