Fostering Religio-Cultural Competence in Nursing

Dear Friends,

On July 19-20, 2018, Tanenbaum convened a number of nursing educators from across the United States, to discuss our new nursing curriculum, Fostering Religio-Cultural Competence in Nursing. This curriculum was created and piloted in partnership with Columbia University School of Nursing’s Masters Direct Entry (MDE) Program to address a gap in nursing education in relation to religious and cultural competence. The event was well attended, with representatives from 16 nursing schools, and 34 attendees overall, including nursing educators, practicing nurses, and people generally involved in health care and health education.

Our speakers at the event, Dr. Vivian Taylor, Associate Dean of Diversity and Cultural Affairs at Columbia University School of Nursing, Dr. Karen Desjardins, Associate Professor and Director of the MDE Program at Columbia University School of Nursing, and our Deputy CEO, Mark Fowler discussed the challenges and opportunities encountered when creating and implementing the curriculum. They further discussed the opportunities for new nurses to have this training in advance of seeing patients. We fulfilled one goal of the Symposium through conversations, garnering feedback on the curriculum content and gaining advice on how to organize the material to attract interest from, and better serve, nursing education programs when the curriculum is made available to the public.

This symposium is the culmination of a 4-year effort spearheaded by Tanenbaum and CUSON staff to create and organize a nursing curriculum on religio-cultural competence that is accessible and easily incorporated into existing nursing programs and class syllabi. The symposium guests responded well to the curriculum, many underlining the necessity of better education and training when it comes to interacting with and treating patients of unfamiliar religious and cultural backgrounds.

Other insights included:

“Great people, awesome organization, and insightful lecturers”

“This conference far exceeded my expectations. I am excited and motivated to begin a new academic year with a new skill set (although I still have much to learn)”

“[The curriculum] seems very thorough”

“It seems very accurate and comprehensive, it’s good to have lots of case studies”

“[I am] really pleased with the material”

We also received some guidance on how to expand the curriculum’s impact by perhaps, making it more concise, breaking up the curriculum thematically rather than by specialty, making the questions more open-ended, both for students and patients, and for certain case studies, including more background information and context.

Overall the Nursing Symposium was a success! The feedback we received was much appreciated and will help guide our next steps as we move this curriculum forward so we can soon make it available to all nursing schools and nursing education programs. We are very excited to continue this project and our effort to ensure that patients of all religious and cultural backgrounds are treated equally and with respect.

Warm regards,

The Tanenbaum Health Care Team

Patient Safety Awareness Week 2018

March 11th marked the beginning of 2018’s Patient Safety Awareness Week, sponsored by the National Patient Safety Foundation (NPSF) in cooperation with the Institute for Healthcare Improvement (IHI). This year, Patient Safety Awareness Week focuses on safety culture and patient engagement, a cause that Tanenbaum wholeheartedly supports. At Tanenbaum, we believe that patients cannot be safe and engaged if they face religious discrimination and bias in health care settings. As our contribution to Patient Safety Awareness Week, we would like to take this opportunity to discuss some small, but meaningful ways that providers can better understand and communicate with patients.

Currently, in health care settings, religion and spirituality are components of patient care that are frequently overlooked or ignored. This is largely because providers don’t think it’s relevant to patient care, except for in end-of-life contexts, or they don’t feel comfortable broaching this topic with patients and their families. Yet, formal religious affiliations and/or spiritual beliefs and practices are often very important to patients and their families. If conversations regarding religion and spirituality don’t take place between patients and providers, providers could miss an integral piece of the puzzle, and miss an opportunity to better connect with and treat patients.

When conducting a spiritual history, we recognize that many health care professionals are pressed for time, so instead of asking a number of detailed questions about a patient’s religious or spiritual beliefs, we suggest that you ask one more comprehensive question, which is “Do you have any religious or spiritual concerns related to your health that you would like me to know about?” This question addresses any immediate concerns a patient or provider might have about religion and spirituality, and makes the patient feel more comfortable discussing these issues with their provider. If the patient doesn’t have any immediate concerns, it is important to revisit the issue as your relationship with that patient progresses.

In order to combat religious discrimination and provide more patient centered care, providers should strive to open pathways of communication with their patients, to build trust and establish stronger relationships between patients and providers. It is important to note that not all religious discrimination is conscious and overt; in fact, it is more likely that the prejudice patients encounter is unconscious, stemming from ingrained attitudes and assumptions that manifest through behaviors. Communication is one of the best tools a provider has to break down barriers and stereotypes that can negatively impact patient care.

For example, when speaking with a patient or co-worker, it is important to listen actively. If you are already constructing what you will say next, that means you’ve stopped listening. In order to be a more effective health care professional and a more respectful co-worker, remember to listen to what the other person is saying, wait until they are done making their point, and take time to construct ta response so you are not responding from a place of anger or defensiveness.

Safety culture and patient engagement are important steps in building a more inclusive and productive health care system. If you are a provider or health care professional and are looking for more communication tips that will allow you to have more effective conversations with your patients, clients, or coworkers we have compiled a list of Tips for Respectful Communication and information on how to conduct Spiritual Histories.

Have a happy and healthy Patient Safety Awareness Week!

Warm regards,

The Tanenbaum Health Care Team

Getting Holy Days & Rituals Right – Health Care Insights

Dear Friends,

This month, Tanenbaum’s Health Care Insights series features the intersection of holy day and ritual observances and patient care. One example involves Ramadan, which ended on the evening of Friday, June 24th. What do we mean? Read on.

The Scenario: A Muslim patient with diabetes is determined to fast for Ramadan.

Click here to learn what a health care provider needs to know to balance the patient’s health with his/her religious observance, and to review more examples of religious observance showing up in health and hospital care.

Explore the many ways religion and health care intersect! For additional case studies from our medical school curriculum, click here. To learn more about the relationship between religion and health care, purchase Tanenbaum’s full Medical Manual here.

In friendship,

Joyce S. Dubensky
CEO

P.S. (Contact us for discounted bulk and institutional purchase rates for the eBook version.)

The Affordable Care Act and Religion: Impact & Support

As Congress debates if and how to repeal and replace the Affordable Care Act, many people have spoken out on how losing health coverage would affect various disenfranchised communities. Often missing from the conversation has been the relationship between the ACA and religion—and yet many religious communities either benefit directly from the ACA, and would be affected by losing health insurance, or have spoken out in support of the ACA based on their religious beliefs.

The ACA has been beneficial to pastors and other church employees who struggled to find health care coverage prior to the ACA. Christianity Today profiled how small churches often function similarly to small businesses, and face similar struggles around providing affordable health care to their employees. Many churches simply do not include health insurance as part of their compensation package, and small church pastors and other employees have therefore come to rely on insurance through the ACA. Many expressed concern over what they would do if the ACA were repealed.

Similarly, Sojourners has collected and published testimonials from Americans around the country about their experiences with the ACA, and many of the people expressing appreciation for the ACA were religious leaders and their families. These testimonials included ones by a Presbyterian minister who could not find insurance when he returned to the U.S. after nine years of overseas missionary work; the wife of a preacher whose church did not provide insurance coverage for their daughter’s pre-existing condition; and a pastor’s wife who no longer has to choose between buying groceries and going to the doctor. All of these individuals were positively impacted by being able to obtain insurance through the ACA.

There are also religious communities who support the ACA not only because it benefits themselves or their congregations, but because of their religious mission to care for people in need. The ACA has helped the poor, racial and ethnic minorities, and legal non-citizens have greater access to health care than ever before. As a result, representatives from a wide array of religious traditions have spoken out in support of the ACA as a means of continuing to provide insurance to the poor.

A surprising source of support for the ACA has come from the U.S. Conference of Catholic Bishops (USCCB), who last month sent a letter to Congress urging them not to repeal the ACA without having a replacement plan. They wrote that “a repeal of key provisions of the Affordable Care Act ought not be undertaken without the concurrent passage of a replacement plan that ensures access to adequate health care for the millions of people who now rely upon it for their wellbeing.” In the past the USCCB has been opposed to the ACA largely because it covers abortion and other reproductive health services and included a mandate requiring insurance to cover contraception. In spite of these earlier objections, the USCCB and other Catholic institutions recognized the importance of continuing to provide health insurance to Americans, particularly those without the resources to get this insurance through other channels.

As the debate over the ACA continues, it is important to remember that repealing the ACA without having a plan to replace it can have serious consequences both for religious communities themselves, and for the values around protecting those in need that are at the foundation of many religions’ missions.

Religion: Acceptance of Drugs & Procedures Health Care Insights

Dear Friends,

Welcome to the 5th installment of Tanenbaum’s Health Care Insights series!

Today, we want to explore how religious beliefs sometimes impact a patient’s decision about whether to use particular drugs or undergo certain treatments.

  • The Scenario: A Buddhist patient refuses to use pain medication. He believes that having an unclouded state of mind at death influences one’s rebirth.
  • Click here to learn about the religious context underlying the patient’s objection, and how the hospital can respectfully manage this objection by working with the patient.

And for additional case studies from our medical school curriculum, click here.

In friendship,

Joyce S. Dubensky
CEO

PS. To learn more about the intersection(s) of religion and health care, Tanenbaum’s full Medical Manual can be purchased here. (Contact us for discounted bulk and institutional purchase rates for the eBook version.)

Religion & End of Life Care – Health Care Insights

Dear Friends,

Welcome to the fourth installment of Tanenbaum’s Health Care Insights series!

This month’s issue features what might be one of the most challenging subjects for health care providers: upholding religious beliefs while delivering end of life care.

  • The Scenario: A Jewish family objects to a DNR order for a patient who is brain stem dead, based on a religious belief that death only occurs when a patient’s heart and breathing have stopped.
  • Click here to learn about the family’s objection and its religious context, and how the hospital can respectfully manage this objection by working with the family and their religious leader.

For additional case studies from our medical school curriculum, click here. To learn more about the intersections of religion and health care, check out Tanenbaum’s full Medical Manual, which can be purchased here. (Contact us for discounted bulk and institutional purchase rates for the eBook version.)

In friendship,

Joyce S. Dubensky
CEO

Conscience in Health Care: Navigating Tricky Terrain

Dear Friends,

Welcome to the third installment of Tanenbaum’s Health Care Insights series.

This month’s issue features a religiously motivated conscientious refusal involving attire in the health care workplace:

  • The Scenario: A Sikh physician wears a full beard due to his religious beliefs regarding uncut hair. This conflicts with the hospital’s policy regarding safety and hygiene.
  • Click here to learn about the religious context underlying the physician’s choice and how the hospital can find an alternative that can accommodate the physician’s requirements, while still ensuring patient safety.

For additional case studies from our medical school curriculum, click here. To learn more about the intersections of religion and health care, Tanenbaum’s full Medical Manual can be purchased here. (Contact us for discounted bulk and institutional purchase rates for the eBook version.)

In friendship,

Joyce S. Dubensky
CEO

Dietary Restrictions & Health Care Resources

Dear Friends,

Welcome to the second installment of Tanenbaum’s new Health Care Insights series!

Each Health Care Insight will present a challenging scenario that sometimes arises in health care, and a download link to information from our Medical School Curriculum, where you will find context about the religious practice involved and better practices for health care providers.

This month’s blog post features religion, dietary restrictions and the impact on health care:

  • The Scenario: The son of an 85-year-old Hindu woman suffering from dementia is extremely upset, when he walks into his mother’s hospital room and finds her eating a meatball.
  • Click here to learn about how the mother’s and son’s religious beliefs influenced this encounter, and some better practices that health care providers can use to avoid or manage this type of situation.

For additional case studies from our medical school curriculum, click here. To learn more about the intersections of religion and health care, Tanenbaum’s full Medical Manual can be purchased here. (Contact us for discounted bulk and institutional purchase rates for the eBook version.)

In friendship,

Joyce S. Dubensky

Conrad Tao Wows – and Connects with Tanenbaum

Last night marked another exceptional performance by Conrad Tao, a dear friend to Tanenbaum and an awe-inspiring artist.  One attendee went so far as to say, “What inner voice; what passion; what power; what joy; what contrasts… what a great concert… and all after a lovely reception with the beauty of songs of peace!”  If you’d like a taste of Conrad’s work, take a look at this video.  

As he did last year, Conrad brought the audience of the 2nd annual A Piece for Peace concert to their feet in a program that included Bach, Chopin, Liszt, and Prokofiev – and a Conrad Tao original! 
 
Almost more impressive, though, was the way Conrad broke the invisible, yet tangible screen between himself and the audience, when he shared his thoughts on Prokofiev’s Sonata Number 7.  Before playing the piece, he explained how Prokofiev wrote the work under extreme duress imposed by Joseph Stalin, and how, in Conrad’s opinion, that the work reflects Prokofiev’s intense desire for peace worldwide, both within us all and between us all.  We couldn’t agree more with Conrad’s statement that, “difference is not something we should fear, but something we should celebrate.”
 
The connection between the piece, the performer, and the audience was remarkable. 
 
If you would like to hear more of Conrad’s work, his Julliard Sessions are now available on itunes.
 
Thank you to all who joined us last night.  And to those who could not come, we look forward to seeing you next year.
 
Mike Ward
Communications Associate