Nursing: Josie’s Cultural Case Study

How the nurse can develop a trusting relationship with Josie

In every health care setting, the relationship between the patient, his family, and the nurse is a valuable resource. Trust between the two parties is the most crucial component of their relationship. A firm foundation of trust promotes security, honesty, and confidence (Lippincott, Williams, and Wilkins, 2010). In Josie’s case, the nurse has to cultivate and establish a lasting relationship with the family to win their trust. Being one of the palliative care team, the nurse needs to create an atmosphere, which will enable her to carry on the treatment process (Brunner and Suddarths, 2005). The nurse’s constant visits to Josie and her family through outpatient visits during her child’s hospitalization and frequent visits to her home will enable her to create a trusting relationship with Josie and make her open up. This is because Haitians are considered adamant and reserved when it comes to opening up to health care providers.

Similarly, the nurse’s previous participation in multidisciplinary team gatherings to discuss jack’s care will be an added advantage to establishing a trusting relationship with Josie. Both the nurse and the supporting health care team’s visits to Josie’s family are crucial because they will offer both alternative ways to deal with Jack’s condition and coping skills to both Josie and her family. In addition, the nurse will offer physical care to Josie and Jack, as well as emotional and psychological support. Thus, trusting the nurse with any information concerning the case will be easier for Josie (Snyder and Kozier, 2009).

How the congruent relationship between the nurse and the family influences their relationship

The nurse and the Pierre family share common Haitian culture and religious belief, which holds that health and illness issues are ‘God’s will’. In addition, matters of life, death, illness, and health care God’s decisions. The nurse is from Haiti and well versed with the Haitian culture, especially concerning the definition of illness and the inherent beliefs and attitudes about diseases, she will be able to devise ways of having Josie and her family open up without compromising both the patient and the medical ethics involved. The culturally congruent relationship between the nurse and this family will promote a positive relationship. This is because Marguerite, the nurse, has played a crucial role in bringing support and resources to ensure optimum coping and adaptation of the family to Jack’s health condition, which has caused chronic maternal sorrow and stress. In Josie’s case, the nurse was aware of the impact that maternal adaptation and coping problems in response to chronic stress and sorrow, had on Josie’s family. Therefore, she opted for the best caring model that would restore her family as a functioning unit. The nurse, in this case, offered both emotional and physical support to help put the family back to their feet.

The fact that the nurse and the family in question share similar cultural beliefs and attitudes concerning life in general, will help promote a positive relationship. It also helps create a feeling of cohesion and social closeness, as well as a peaceful environment. This will enable the nurse to offer maximum care and attention to Jack’s illness and support the general family without any feeling of fear.

The positive trust created between the family and the nurse will promote neutral disclosure of different options, the possibilities of their future occurrence, their consequences, and the level of uncertainty concerning the treatment.

Impacts of culture on coping

Ways in which an individual in a society conceptualizes an illness, its cause, treatment, preventive measure, when and where to seek treatment, and the general health-seeking behavior is culturally determined. Culture also determines a person’s coping and adaptation skills. For example, the Haitian culture defines health-related issues as ‘God’s will’ and holds that God determines matters of life, death, illness, and health. In addition, Haitians are believed to be silent and reserved when talking about the illness to health care providers. In other words, Haitians cope with the illness by maintaining silence and avoiding disclosing health issues to the health care providers. Patients in Haitian society solely rely on God’s choice and will, for healing. They only seek nursing intervention to support and strengthen the patient while waiting upon God’s will.

How Josie has been coping

According to Haitians’ cultural beliefs, mothers are the most significant comforters and caregivers. They must also realize and care for the sick members of the family and provide for their needs irrespective of the sorrow and stress resulting from the situation. They must also promote and maintain a functional family throughout the illness period as demanded by the culture.

The devastating and persistent nature of baby jack’s illness caused chronic maternal sorrow and stress, which Josie had to put up with. The fact that his condition progressively deteriorated with age to an extent that he lost the ability to walk and eat, was enough problem for Josie. Despite the case, she had to act as both a mother and a caregiver, as well as promote and maintain the family functioning at all costs. With the support of the nurse and the entire palliative care team, she managed to cope with the son’s condition. The nurse maintained her crucial role in advocating for resources and support to attain maximum adapting and coping mechanisms for both Josie and the family, in response to chronic sorrow and stress caused by Jack’s condition.

Additionally, Josie realized her role as a primary family comforter and caregiver, something that enabled her to cope and provide for the needs of the family. Open communication to the care providers and nurse concerning Jack’s condition reduced the possibility of making decisions without enough notification and involvement. It also helped her share the problem hence, making it lighter.

Josie’s strengths

Josie’s family seems to have progressive health problems starting from her father who had Alzheimer’s disease, to her daughter who had developmental delays, and finally, baby Jack who was unexpectedly born at the age of forty-one weeks. Baby jack had a sudden seizure not related to any other illness or fever. Later, Jack was diagnosed with a degenerative disease, and at the age of 3 years, he lost his ability to walk and eat. Despite the stress, Josie was strong enough to bear the conditions and maintain a functioning family. She was also strong enough to provide care, support, and basic needs to Jack and the entire family.

Conclusion

Adequate communication in life and death conditions, such as Jack’s condition requires particular clarity and honesty. Patients and the people taking care of them should be alerted in cases of uncertainty or even ambiguity, for further clarification regarding the health care objectives (Lippincott, Williams, and Wilkins, 2010). Although Josie began his son’s treatments with the hope of perceived improvement in his degenerative disease, that hope died after some time making the situation seem unattainable. Other options such as tube feeding and wheelchair movement became priorities. It is of essence that patients and the family members taking care of them communicate openly with the care providers attending to the patients. This is because the shared information may be of help to care, providers, when they attend to the patient.

Reference List

Brunner, W., and Suddarths, F. (2005). Textbook of medical surgical nursing. Clifton Park, NY: Thomson/Delmar Learning.

Lippincott, N., Williams, R., and Wilkins, P. (2010). Psychiatric mental health nursing. Philadelphia: University of Pennsylvania Press.

Snyder, K., and Kozier, M. (2009). Fundamentals of nursing: concepts, process and practice. Clifton Park, NY: Thomson/Delmar Learning.