People of Haitian Heritage as Patients in the US

Introduction

Haitian patients usually need specific care characterized by cultural or religious competence, education, and social support. On the one hand, Haitians are better prepared for COVID-19 social isolation and other restrictions due to Peyi Lòk, a new form of resistance when the country is in lockdown due to street protesters (Blanc et al., 2020). On the other hand, as a limited-resource country, Haiti has to deal with multiple social and healthcare challenges regularly (Albuja et al., 2017). The current case is complicated by Jehovah’s Witness as the chosen family’s religion, and a 17-year-old daughter, Rhonda, has COVID-19 positive, without knowing about her ectopic pregnancy. A nurse anesthetist should consider Haitian’s views on unplanned pregnancy, viral infections, and blood transfusions to provide the patient with adequate care and use appropriate procedures for the patient emergency surgery.

Haitian’s Views on Unplanned Pregnancy and Viral Infections

Poverty, lack of education, and insufficient care are the major determinants of health in Haiti. The maternal mortality rate has been decreased during the last several decades; still, one of every 80 women could die from childbirth or pregnancy complications in Haiti (“Haiti: A deep dive,” 2018). However, as per Haitian’s views, pregnancy, as well as abortion, is a woman’s issue, which is left to her to decide (Purnell & Fenkl, 2019). Viral infections like Acute Respiratory Infection (ARI), Rhinovirus, and Influenza are common in the country due to the absence of corresponding diagnostic tests (Kim et al., 2019). COVID-19 was a challenge for the nation in the middle of 2020 because of low access to tests and vaccines. Still, Haitians are naturally adopted to cope with pandemics, and viral infections do not frighten the population.

Haitian’s Views on Blood Transfusions

Blood transfusion is a serious topic for discussion among people of Haitian heritage, especially if they are the representatives of Jehovah’s Witnesses. In addition to the fact that Jehovah’s Witnesses reject the idea of receiving any blood products, the Haitians (either Christians or Voodoo people) become emotional about this procedure (Purnell & Fenkl, 2019). They are afraid of associated diseases like HIV and demonstrate apprehension for blood contamination.

Emergency Surgery for Jehovah’s Witnesses

In this case, Rhonda needs emergency surgery due to her ectopic pregnancy. However, blood transfusion is not an option, and the patient needs additional alternatives. A nurse anesthetist is responsible for reducing blood loss in a patient during surgery. Current procedures include treatment with antifibrinolytic agents like tranexamic acid, prothrombin complex concentrates, and hemostatic agents like fibrin glue or argon beam coagulator (Crowe & DeSimone, 2019). Patient blood management cannot be ignored, and religion must be respected at the same time. Therefore, the offered alternative measures should help reduce blood loss complications. A nurse has to cooperate with the patient and her family at the bedside. Clear explanations of the situation, demonstration of cultural competence, and understanding of the family’s religion and culture are necessary to provide Rhonda with high-quality care and support.

Conclusion

In general, Rhonda is a complex patient because her current condition, religious beliefs, and social situation remain contradictory. Regarding the restrictions related to COVID-19 and her pregnancy, she has already neglected healthcare recommendations. Besides, her family’s religion plays an important role in the choice of medications, treatment methods, and routine behaviors. The nurse is obliged to support the patient and her family and strengthen education about life protective means during the pandemic.

References

Albuja, L. D., Cianelli, R., Anglade, D., Owusu, B., Joseph, L., Sailsman, S., & Ferrer, L. (2017). Women’s and healthcare workers’ beliefs and experiences surrounding abortion: The case of Haiti. Journal of Nursing Scholarship, 49(2), 170-176. Web.

Blanc, J., Louis, E. F., Joseph, J., Castor, C., & Jean-Louis, G. (2020). What the world could learn from the Haitian resilience while managing COVID-19. Psychological Trauma: Theory, Research, Practice, and Policy, 12(6), 569-571. Web.

Crowe, E. P., & DeSimone, R. A. (2019). Transfusion support and alternatives for Jehovahʼs Witness patients. Current Opinion in Hematology, 26(6), 473–479. Web.

Haiti: A deep dive: Impacts on maternal health in Haiti. (2018). Every Mother Counts. Web.

Kim, Y. Y., Lew, J. F., Keith, B., Telisma, T., Nelson, E. J., Brantly, A. C., Chavannes, S., Anilis, G., Yang, Y., Liu, M., Alam, M. T., Rashid, M. H., Morris, J. G., & De Rochars, V. E. M. B. (2019). Acute respiratory illness in rural Haiti. International Journal of Infectious Diseases, 81, 176-183. Web.

Purnell, L. D., & Fenkl, E. A. (2019). Handbook for culturally competent care. Springer.