The Muslim population is one that varies significantly when compared to other populations. Carrying out highest quality care to the Muslim population entails becoming aware of the practices and beliefs of the Islamic culture. In order to provide care to the Muslim population, it is crucial to first do extensive research on the specific culture to further understand their beliefs and values. Islam is considered to be the second biggest religion in the world, following Christianity (Islam, 2018). “Islam” began in Mecca, Saudi Arabia in the 7th century, until it soon after began to spread across the entire world. The population that practices and follows Islam are called Muslim (Islam, 2018). Muslims follow one God, known as the Allah, who they submit themselves to. They do not do anything without the permission of the Allah (Islam, 2016).
Today, more and more Muslims are immigrating to the United States, creating a more diverse country. Nationwide, Muslims make up roughly two percent of the United States population (Elgamal, 2016). Although this does not seem like a high percentage, the Muslim population has had a significant effect on the United States. This number continues to increase dramatically, with 600 million to be expected in the United States by 2030 (Elgamal, 2016). With this increasing number, it is essential for the United States to be cognoscente and accommodating towards this diverse culture. Although it is important for everyone to be accommodating to the Muslim culture, it is especially important for health care providers who are going to be providing direct contact with them to be accommodating.
As health care providers, it is critical to always provide high quality care to our patients. In order to do this, health care providers must be culturally competent and accommodate to the needs of each patient that we encounter and care for. With the growing population of Muslim’s in the United States, nurses are going to be providing care now, more than ever to this group. This is why nurses have to understand and be aware of their differences in their cultural and spiritual values. Some differences include but are not limited to their diet, their ideas of modesty, their privacy requirements, their touch restriction requirements, etc. (Attum & Shamoon, 2018). Considering their different preferences will allow nurses and other health care providers to deliver suitable care in a non-judgmental, culturally competent way.
One of the first items that should be considered is the patient’s view of health and illness. According to Attum and Shamoon (2018), “For Muslims, health is a state of physical, psychological, spiritual, and social well-being and is considered the greatest bless God has given humankind.” This definition of health is similar to the United States definition of health, which can make it easier to care for them. As nurses, it is crucial to not only address the patient’s physical ailments, but their emotional and spiritual ones as well. If a patient is not healthy emotionally, then they are not going to be healthy physically either. Being “healthy” includes a variety of factors and is not solely based on one thing. It is also important to address their religious beliefs as well in order to provide culturally competent care. Muslim’s believe that illness is no more than a test from God and is considered to be the releasing of one’s sins (Attum & Shamoon, 2018). Having knowledge of their beliefs and values will allow the nurse to provide more efficient care to the patient.
Touch is a huge deal in the Muslim culture and must be addressed during any visit with a health care provider. Oftentimes, Muslims are very hesitant to reveal their bodies to just anyone (Nursing Times, 2015). It is crucial for the nurse to first ask the patient for permission to expose any of their body parts and to always be aware of what they are doing. If a nurse did not know this about the Muslim culture, then the patient could become extremely upset and not want the nurse caring for them. Providing culturally competent care is always the top priority. We always want to build rapport and have trust with our patient’s. Understanding a patient’s culture is the first step in allowing this to happen.
Along with the reluctance of revealing their bodies, they also require a health care provider of the same sex to care for them. It is not permissible for a male nurse to care for a female patient and vice versa. According to the Nursing Times (2015), “Touch – even shaking hands – is prohibited between members of the opposite sex, with the exception of immediate family members.” This can make caring for Muslim patients somewhat difficult if for example, there was a male patient with no male nurses on the floor that day. If it is not possible for this to be accommodated, then it should be expressed to the patient in an appropriate and respectful way. According to Attum & Shamoon, if the patient cannot get a same gender nurse, then the same gender staff member should be in the room, or a patient family member (2018). The nurse must always ask the patient if they have any special requirements so that the nurse can provide care that is respectful and accommodating.
Another important aspect to the Muslim faith is their diet. The Islamic religion prevents Muslim’s from drinking alcohol, eating non-Halal animal fats, pork, and by-products of pork (Attum & Shamoon, 2018). If a Muslim patient is in the hospital and receives hospital food that contains pork for example, this can be extremely offensive to them. In order to be culturally competent, the nurse must customize their diet for their cultural needs and make special arrangements if medically safe and possible. In addition to making accommodations to their diet, it is important to address fasting during Ramadan, Muslim’s fast (Selvam, 2013). Ramadan is considered to be the most sacred month of the Islamic year where the Muslim population fasts from sunrise to sundown for one whole month (Attum & Shamoon, 2018). Ramadan should always be a consideration for the Muslim population because there are special requirements that the nurse should follow in order to provide culturally competent care. For example, there are certain medications and interventions that can and cannot be given during the time of Ramadan.
The medications that can be given are eye drops, ear drops, inhalers, nebulizer treatments, insulin injections and nasal sprays. Dental care and immunizations can also be provided to the Muslim population during Ramadan. Interventions that cannot be performed during Ramadan are IV fluids, donating blood, and oral medications (Attum & Shamoon, 2018). Although it is the duty of the nurse to respect the patient’s wishes, it is important to inform the patient of the possible negative consequences. This is an especially important consideration because not eating or drinking anything can potentially be detrimental to the patient. For example, if the patient is diabetic, this may be harmful to their health and wellbeing. The nurse should educate the patient on the importance of monitoring their blood sugars and keeping them under control in order to prevent complications. The nurse should also provide education on the importance to cease the fasting if the blood sugars get too low. It should be emphasized to the patient that the symptoms of low blood sugar are shakiness, feeling sweaty and disoriented (Nursing Times, 2015). Although this can be a challenging situation, the nurse being knowledgeable about Ramadan and what it entails allows the nurse to be attuned to any potential complications that may occur.
In addressing the Muslim culture regarding privacy, the nurse must be cognoscente of their cultural needs in order to provide respectful and culturally competent care. During a patient’s hospital stay, the nurse should ask the patient for permission prior to entering the room. This is an important question to ask because Muslim patients receive many visitors during their hospital stay. It is an obligation according to the Islamic faith that if a person is sick, close family and friends must go visit them (Attum & Shamoon, 2018). If the patient is receiving multiple visitors, this has the potential to get very overwhelming for them. Asking for permission is a simple, yet effective way in allowing the patient to feel more comfortable as well as at ease. If the nurse gains permission to enter the room, this can show to the nurse that the patient trusts them.
Another way that the nurse can provide care that is respectful is to always ask before doing anything. It is always required that the nurse ask the patient if they can do something before they do it. Although this is important with every individual, it is especially important to the Muslim population because of their religious beliefs. The nurse must adjust their care to the patient’s needs if indicated as well. The nurse should also explain everything that they are doing prior to actually doing it. This will provide a sense of safety to the patient and allow the nurse to have a better relationship with them. Being in the hospital can be a very scary place, if the nurse can allow for the patient to feel more safe and that they are being respected, this will create an all-around better environment for both the patient and the nurse.
In addition to privacy, individuals who practice Islam require health care providers of the same sex to care for them in the hospital setting. According to Padela, Gunter & Killawi (2011), “Our data suggests that this accommodation, above all others, can influence health care seeking patterns.” If the patients are not feeling like they are being respected, then they are going to be less likely to seek medical care. This is why it is extremely important to be culturally competent and accommodating to every patient that we encounter. Although having the same gender nurse might not be a big deal to other cultures, it is a big deal to the Muslim population. This makes it the duty of the health care professionals to address this and to always make our patients feel like they are being listened to and respected. One field where the same gender nurse should be especially accommodated for is in maternity and gynecological care (Nursing Times, 2015). One study was done in 2016 on American Muslim women to figure out whether or not they were apprehensive to receive health care.
Two hundred and fifty-four women of Muslim faith were surveyed asking a series of questions including aspects such as beliefs, discrimination, modesty, and alternative medication (Vu, Azmat, Radejko & Padela, 2016). Studies showed that fifty three percent of women revealed that they postponed seeking medical care due to the fact that there were no female clinicians available to care for them (Vu et al., 2016). It was also shown that individuals who have lived in the United States for greater than twenty years were less likely to postpone getting medical care if there was not a female clinician working (Vu et al., 2016). This study shows that individuals are not going to get medical care solely because there is not a same sex clinician working. This can result in many detrimental effects for the individuals who are very sick but not receiving the care that they need and deserve. It is essential for health care providers to deliver culturally competent care and if that means getting a provider that is of the same gender, then this is what should be done. Doing so has the potential to allow these women to feel more comfortable. If they feel more comfortable then this may change their perspectives on receiving care and they may not be as reluctant to receive the care that they deserve.
When delivering medications to the patients, the nurse must always be conscientious of what exactly is in the medications. Giving a certain medication may have something in it that is against the patient’s religion, having the potential to cause many issues. Any medication that has alcohol, gelatin or pork must be avoided (Attum & Shamoon, 2018). It is important to be aware of the medications that contain those ingredients so that any errors can be prevented. The only time that these medications can be given is in an emergency but even so, alternatives should always be considered. (Attum & Shamoon, 2018). The Muslim population are huge believers of traditional healing methods and remedies. Keeping this in mind will allow for a better relationship between the nurse and the patient. The nurse should ask the patient if there are any alternatives that they would like to use. Together, they can do some research to make sure that any alternative remedies they want to use are compatible with other interventions that are already being utilized. Some alternatives that the Muslim population like to use are olive oil, nigella sativa, honey, cupping, cautery, etc. Olive oil is a fat that can be used as an alternative to help decrease the rate of deaths from cardiovascular disease. Olive oil can also assist in decreasing inflammation, endothelial dysfunction, and thrombosis (Nursing Times, 2015).
Nigella sativa can be given in seed or oil form and is used for treating many respiratory, stomach, and intestinal issues. It can also be used to help with kidney, liver, and circulatory issues, as well as improve the immune system and improve health at large (Nursing Times, 2015). Honey is widely used in Islam as a wound dressing to aid in healing. One study was done that showed how honey was effective in decreasing body weight (Nursing Times, 2015). One very popular remedy that is used around the world is known as cupping. Cupping can be used for a variety of reasons. It can treat headaches, jaundice, stomach aches, nausea, muscular pain and insomnia, amongst other things (Nursing Times, 2015). Cautery is used to break up abnormal tissue by the process of burning, searing, or scarring. This instrument produces electrical currents and is used often in the Muslim population (Farlex, 2018). Cautery is used for issues such as eye problems, headaches, mental illness, jaundice and cancer (Attum & Shamoon, 2018). Cautery is typically used when other remedies do not work. Although these remedies can be very beneficial for these patients, it is always important to first make sure that they are safe to use and should be individualized.
Although verbal language has a huge impact on health care, non-verbal language is just as important. While eye contact in the United States is a sign of respect, eye contact in other countries and cultures mean something different. In the Muslim population, eye contact between individuals of the opposite sex indicate a sexual interest (Attum & Shamoon, 2018). This is one of the reasons that patients should be cared for by health care providers of the same sex, in order to avoid this from happening in the first place. If this is not possible, then the health care providers should be aware that the patient is not giving eye contact for a reason and that the patient is not being rude. If the health care provider is aware of this, then this will avoid any misconceptions and misinterpretations.
Another important consideration is hand shaking. The same thing applies with hand shaking as it does with eye contact. Individuals of opposite genders should not be shaking hands with one another (Hammoud, White, & Fetters, 2005). Knowing this will illustrate a sense of respect toward the Muslim patient and show them that the health care provider is being culturally competent. In addition to hand shaking, the Muslim population believe that the left hand is extremely dirty. In order for the health care provider to be culturally competent, they should be knowledgeable of this and hand anything to them in their right hand (Attum & Shamoon, 2018). Another important consideration is that men who wear beards are not doing it for no specific reason; a beard holds a symbolic meaning (Attum & Shamoon, 2018). If the beard needs to be shaven, the health care provider should ask prior to shaving it so that the patient feels that they are being respected and offense can be avoided. These are just a few of the many considerations that need to be address and followed. If the health care provider is well-informed of these important beliefs and values, then the patient will be more apt to trust the health care provider, which helps to build rapport as well as create a positive environment for all.
The family dynamic in the Muslim population is a unique and powerful part of their culture. The health care providers must be aware of this when delivering their care. As stated above, it is necessary to have a health care provider be of the same gender as the patient. In instances where this is not applicable, the significant other should be in the room with the patient. For example, if there are no female health care providers for a female patient, then the patient’s husband should be in the room with her. Also, in most cases, the husband will answer for the wife (Nursing Times, 2015). The health care provider should be aware of this and always inquire about their needs and wishes. Also, the families make decisions together as a unit, as opposed to the individual making all of their decisions regarding their care. According to Attum & Shamoon (2018), everything the patient does is significantly guided by the spouse, the children, and the relatives. All important decisions made involve the extended family as well. Since the traditional Muslim family is extended, it is important to involve everyone in the patient’s care. Becoming aware of this will allow culturally competent care to be emphasized and delivered.
The Muslim culture is very diverse and although extremely complex, needs to be respected and complied with. More and more health care providers and hospitals have assimilated to environments that are more concentrated on their needs. For example, more hospitals are now serving foods that are specific to the Muslim culture, including Halal (Selvam, 2013). In addition to adding more cultural diversity related to the diet, alternatives to medications have also been offered to the Muslim population. Trainings have also been in place to address the need for the same gender clinician, as well as being aware of female modesty (Selvam, 2013). There still is a lot that needs to be done in order to be culturally competent health care providers regarding the Muslim population, but our society is headed in the right direction.
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