About Cultural Competency in Nevada (342)Page 8 of 18

7. Religion and Spiritualty

A healthcare provider’s religious or spiritual beliefs can have a profound effect on the patient's view of you as a provider. In many cases, overt religious views and iconography can alienate patients. Religious and spiritual beliefs cut both ways. Differing beliefs can cause a patient to wonder if the provider has their best interest in mind.

Religion as an organized system of beliefs, practices, rituals, and symbols designated to facilitate access to the sacred and the transcendent (God, Greater Force, and Supreme Truth). Religiosity corresponds to how much an individual believes, follows, and practices a religion (Borragini-Abuchaim et al., 2021).

Spirituality can be seen as a personal quest to understand issues related to the purpose of life, its meaning, as well as relations with the sacred or transcendent that may or may not lead to the development of religious practices or formation of religious communities (Borragini-Abuchaim et al., 2021).

Religion and spirituality are important to many patients seeking care. However, the diversity of religions around the world can create challenges for healthcare providers and systems related to providing culturally competent medical care. Healthcare providers may not take religious beliefs into account when they are dealing with difficult medical decisions for patients and their families (Swihart, Yarrarapu, Martin, 2023).

Historically—and in many parts of the world today—religious leaders and healthcare providers are one and the same. Only within recent times has medicine relied on a scientific approach to care. This has resulted in a separation between medicine and religion (Swihart, Yarrarapu, Martin, 2023).

The challenge is to understand that patients often turn to their religious and spiritual beliefs when making medical decisions. Religion and spirituality can impact decisions about diet, medicines based on animal products, modesty, and the preferred gender of their healthcare provider. Some religions have strict prayer times that may interfere with medical treatment (Swihart, Yarrarapu, Martin, 2023).

Acknowledging and understanding a patient’s background and beliefs is the first step in providing culturally sensitive healthcare. Providing culturally religious care starts with developing an awareness of the uniqueness of each person's religion and their special needs. It means being respectful, avoiding judgements, and recognizing how values, behaviors, and beliefs may affect others.

Healthcare providers can develop religious competence by avoiding assumptions and asking the patient and family how you can help make their experience more comfortable. Although most healthcare workers are trained to observe body and facial language, it is important to frame these observations in a religious context. If a cultural mistake occurs, apologize, and ask the patient or family member for feedback (Swihart, Yarrarapu, Martin, 2023).

Most healthcare organizations provide interpreters who can help with language and cultural issues. To be effective, interpreters must be medically and culturally competent, and fluent in the patient’s preferred language. Avoid using untrained employees, children, or untrained ancillary staff as interpreters in place of a trained interpreter (Swihart, Yarrarapu, Martin, 2023).

Overt expressions of religious beliefs are less common in hospitals today than in the past. Nevertheless, many healthcare organizations allow the display of religious statuary or other symbols.

Case: Proselytizing

The Situation: David is a social worker in a hospital who specializes in discharge planning and care coordination. In the course of his work, he may meet with patients and families at the bedside but might also bring a patent and/or family member to his office. He has significant social work experience of this type but is relatively new to the hospital where he now works.

David, who is Jewish, is not secretive about his faith with co-workers but does not promote or display this. Recently, leaflets or other postings with Christian scripture have been appearing at the entrance to his office and taped to the wall or door. Some of these are of a clearly proselytizing nature. He removes them, but they reappear quickly. It seems that his co-workers know who is doing this but have the message: “the person (who is doing this) is just like that; shrug it off.”

David has several concerns.

  1. One of the postings could offend or intimidate a patient or advocate; he is concerned that this has already caused some uncomfortable feelings. Someone could report the issue to the administrative head of the hospital.
  2. David is feeling harassed. He thinks that the person leaving the messages may be following him and keeping track of his whereabouts. Why are new messages appearing so quickly?
  3. Furthermore, he feels unsupported by his department head and co-workers and is wondering whether he has a future in his new position.

Next Steps: The employee, Ray, who was posting the messages moved to a different job in another location as the result of a reorganization—this appeared to be coincidental and not the result of a department action. With the tension lifted, David was able to feel more at home and gained some recognition of his good work. But he was still not comfortable with the lack of action he saw earlier, and he was now considering an unexpected job offer. David decided to set up a meeting with the department chair.

Discussion: At the meeting with the department chair, David was able to talk more openly about his background and the effect of the messages on his ability to feel welcomed in the department. He also asked for regular communication in the department collectively or individually to address issues for staff working conditions and to discuss policies and resources proactively.

Outcome: It was fortunate that David's manager was receptive to his ideas and agreed to start regularly scheduled discussions. She had not been fully aware of the effect of the proselytizing. David decided to stay on in the department at least for the time being.

Lessons: (1) David realized he could have taken the step of talking directly to the department chair earlier. (2) Important—to build a culture of inclusiveness, the “small things” count. (3) Any medical facility (or company for that matter) should treat its employees as it purports to treat its patients.