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Post by kbright on Apr 28, 2009 21:45:30 GMT -5
Hello!
My name is Kerri, and I am a first semester nursing student at the California State University of Sacramento in the BSN program.
I am trying to do some research for a class on Nursing Professionalism. A group of students and I are doing a cultural presentation on Jewish patients, and special considerations that should be taken to provide optimal, and culturally sensitive care.
Im afraid Im not terribly aware of jewish practices, and I was wondering if anyone here might be willing to answer a few questions that our group came up with. I saw this group, and just thought who BETTER to answer them then Nurses!
Please, feel free to either post here, if you have the time, and we can discuss them, or email me.
Thanks in advance for any help you can offer.
1. How long have you been a practicing member?
2. What group do you identify with (Orthodox, Conservative, Reform)?
3. What do you feel are the top 3 health care beliefs nurses should be most familiar with for Jewish patients?
4. What if any are common home remedies used in your community?
5. Do you know anyone that has one of the diseases that is associated with the Jewish community?
6. What are the dietary limitations?
7. How strictly do you follow the dietary limitations (in daily life, in the hospital,)
8. If you are hospitalized who is it important that we contact (Rabbi, parents, etc)
9. In an emergency situation, if you are unable to make your own decisions, who makes them on your behalf?
10. What spiritual practices must be taken with a deceased Jewish member?
11. What characteristics do you look for/avoid in a health care provider?
12. Is there anything else you would like to make us aware of particularly associated with the care of a jewish person?
Kerri Bright
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Post by kbright on May 2, 2009 21:49:45 GMT -5
Please, if you read this, could anyone respond? Short answers are fine! Im running out of time.
Thank you in advance,
Nursing student,
Kerri
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Post by Rivka P on May 2, 2009 22:33:28 GMT -5
I think the reason some people may be hesitant to respond is because there are diverse views out there. The members of this forum, I think I can safely say, are all orthodox. Even within orthodoxy, there are differences in observance.
The laws are complex. For example, you ask what are the dietary restrictions. Simply put, all packaged food needs a kosher symbol, that tells us that all the kosher laws were observed in the production of the product. A list of all the kosher laws can't really be explained on one foot.
There are different issues also, that affect different areas of care. Labor and Delivery is one area where the husband's role can vary between families, in accordance to what their Rabbi allows. My husband was in the room the entire time when I had my baby, as per my request, but after a certain point in the labor, we did not touch and he moved to the front of the bed and was careful not to see me uncovered. Again, this is very simplistic, but it might help your project.
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Post by Rivka P on May 2, 2009 22:37:32 GMT -5
I urge you to read through the halacha and minhag section of the forum, for more information, as well.
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Post by achot on May 3, 2009 6:33:03 GMT -5
Hello! My name is Kerri, and I am a first semester nursing student at the California State University of Sacramento in the BSN program. I am trying to do some research for a class on Nursing Professionalism. A group of students and I are doing a cultural presentation on Jewish patients, and special considerations that should be taken to provide optimal, and culturally sensitive care. Im afraid Im not terribly aware of jewish practices, and I was wondering if anyone here might be willing to answer a few questions that our group came up with. I saw this group, and just thought who BETTER to answer them then Nurses! Please, feel free to either post here, if you have the time, and we can discuss them, or email me. Thanks in advance for any help you can offer. your questions are flawed and dont lend themselves to be easily answered...for example 1. How long have you been a practicing member? practicing member of what- nursing, judaism etc. I am a nurse for 20+years and was born jewish- In our religion, you are jewish even if you dont consider yourself to be one or even if you "arent a practicing member"
2. What group do you identify with (Orthodox, Conservative, Reform)? a jew is a jew is a jew see above, those things matter not.
3. What do you feel are the top 3 health care beliefs nurses should be most familiar with for Jewish patients? s ame as for any patient- regardless of race, color or gender- provide respect, confidentiality and of course, do no harm!!!!!
4. What if any are common home remedies used in your community? It would take a book as big as the encyclopedia- no different than any other group- and mostly influenced by the country of origin, availability of resources, socioeconomic and educational status and so many other things5. Do you know anyone that has one of the diseases that is associated with the Jewish community? What diseases are you talking about? 6. What are the dietary limitations? for whom? a jewish diabetic? a jewish pt with Crohn's etc. Are you referring to Kashrut? That would take a long time to explain7. How strictly do you follow the dietary limitations (in daily life, in the hospital,) another extremely personal question!!!Depends on so many different things8. If you are hospitalized who is it important that we contact (Rabbi, parents, etc) ditto9. In an emergency situation, if you are unable to make your own decisions, who makes them on your behalf? ditto10. What spiritual practices must be taken with a deceased Jewish member? There are laws and there are custom, a topic that could take hours to explain- when in doubt call the hospital chaplain or family Rabbi11. What characteristics do you look for/avoid in a health care provider? Honesty, coverage, availability, affordability, quality of care- I imagine like everyone else!!!12. Is there anything else you would like to make us aware of particularly associated with the care of a jewish person? A wise man was asked to explain the jewish religion while the student stood on one foot, the wise Rabbi said: "Do unto others as you would have others do to you"
That is the jewish religion in a nutshell
Good Luck!!Kerri Bright |
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lazer
New Member
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Post by lazer on May 3, 2009 6:56:55 GMT -5
Dear Kerri,
Wish you luck with your project! I'll try keep this short and sweet.
1) If 'practicing member' means member of the Jewish faith then I have been a member my entire life. Being Jewish is not the same as Catholicism in which one ceases to be a Catholic when one no longer adheres to its tenets. That person becomes a Jew who we might call "non-observant" of its laws, but he remains Jewish. Judaism is not determined by membership in a synagogue and there is no central body among whose membership we belong in order to be considered Jewish.
2) orthodox
3) a) The exclusive consumption of kosher food products. This is not as difficult as it sounds as many regular store-bought products are supervised by kosher supervision agencies which place a distinctive registered mark on the product. (Search 'kosher supervision' or 'orthodox union'.) Prepared food needs to be cooked in utensils which have been used only for kosher food. In addition, utensils used for milk products cannot be used for meat products and vice versa.
b) Sabbath and holiday observance - The period starting eighteen minutes before sunset on Friday aft. till 45 minutes after sunset Sat. aft. is 'Shabbos' during which time we refrain from creative activities. Some common issues a Shabbos observer might have in a hospital include the non-manipulation of electricity. Notice we may use electricity by reading from an electric light, but we cannot turn that light off or on. Other things which may be an issue include use of an electric call bell, changing the position of an electric bed, sensor-activated doors, lights, towel dispensers, and faucets.
To clarify the above, it is the Jewish Sabbath and a Jew may not ask a Jew, even a non-observant one to do something for him which would violate the Sabbath. In fact, even though non-Jews are not at all bound by Shabbos restrictions, a Jew may not routinely ask a non-Jew to do something which he may not do himself. One who is in the hospital would be permitted to ask a non-Jew due to their status of being 'sick' which allows leniencies in this area. However, many people are not used to using these leniencies so they might tell the nurse, "It sure is dark in here!" as a method of hinting they would like the light to be turned on. If they say, "The head of my bed is too high." on Shabbos, take it to mean "please lower it".
3) End of life issues: In Jewish law a person is considered alive until he's dead. One who hastens a person's death is considered as if he killed him While not every patient needs to be a 'full code' in every circumstance, we don't do things which will actively cause the death of a pt. We would not withhold oxygen, food or fluids (as tolerated). We are not necessarilly obligated to perform extraordinary measures such as hemodialysis. Each situation is different and is treated as a matter of life and death. The exact level of intervention should be evaluated by a multidisciplinary team including doctors, pt., family and rabbi.
A common situation which arises is one who might not be required to be a 'full code' in the eyes of Jewish law who deteriorates and is intubated. Once he is intubated and fully dependent on ventilator support, that is, he would die shortly after withdrawing support... he may not be removed from the ventilator! The role of the nurse might be to get the appropriate people to discuss code status sometime before the pt. goes downhill. Note: There are many orthodox people who mistakenly believe that all rescusitative efforts should be done under any circumstances. It is not up to you to disabuse them of this notion, but a rabbi with experience in end-of-life issues should be brought on board.
There...I wasn't short with my answers. Hope I helped!
Lazer
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lazer
New Member
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Post by lazer on May 3, 2009 9:13:57 GMT -5
4) The Jewish community is culturally extremely diverse. There have been native Jewish communities in virtually every country in every continent. Each community certainly had its folk remedies in the old days, but I haven't myself seen or heard of any. By the way, the Talmud (the main book of Jewish law and lore committed to writing over 15 centuries ago; it's over 7,000 pages long!) is replete with remedies for various maladies, but the use of those remedies fell into disuse due to changes in people's conditions and difficulty in identifying the exact herbs and methods used.
5) For a list of and info about genetic diseases with a higher incidence in the Ashkenazic (descendants of those who lived in Europe about 1,000 years ago) Jewish community, check out the Dor Yeshorim (Association for Prevention of Jewish Genetic Diseases) website. Crohn's disease is a well known one, and I know people who have it. I don't know that there is any disease which is exclusive to Jewish people.
6) Kosher rules in a thumbnail:
Fruits and veggies are OK (as long as they are bug-free...even little buggies like the thrips found in broccoli 'trees' are a no-no).
Fish need to have fins and scales to be Kosher. Tuna, whitefish are pike are OK. Crustaceans are not...never had a lobster, shrimp or catfish. So too, ixnay the squid, eel and octopus.
Fowl - Chicken, turkey, pheasant, dove are Kosher birds.
Beasts - need to ruminants (animals which chew their cud) and have hooves which are entirely split in two. Kosher animals include cows, sheep, goats, deer, and...bison (yes, I've seen it marketed).
Fowl and beasts must be slaughtered by a shochet (a ritual slaughterer), a type of specialized rabbi who is trained in it. The knife has to inspected to ensure it doesn't have the slightest nick, the cut must be a slicing not a chopping motion. The animal is inspected internally after the slaughter to ensure it is free from certain organic diseases. If it considered that the animal has a disease that would take its life within one year, that animal is not considered to be Kosher. The meat then goes through a process of soaking and salting to remove the blood.
Food preparation must be done in special Kosher utensils; using seperate ones for meat and milk.
The above is to give you a general idea of the Kosher laws. As far as in the hospital, you would be able to provide milk and juices to a Kosher-law observing pt. Saltines and honey-graham crackers that I see around have Kosher certification (look for the capital 'U' inside of a circle, that is mark of one of most common certifications). Kosher meals are generally airline-type presealed meals. Do not open them except in front of the pt! If they are eating chicken or beef, don't bring them milk to drink or half-and-half for their coffee. After eating meat, Jews wait for six hours before consuming milk products.
NOTE: There are some people for whom any prepared hospital food, or even milk, will not be Kosher enough for them due to various strict practices. Please do your best to understand and try to work with them.
During the holiday of Passover, there are many additional restrictions. When I was a kid, I had surgery during the Passover holiday and the nurse brought me a prepackaged Kosher meal which was not Kosher for Passover!
7) I follow them strictly. I bring my food from home, but I could also purchase many of the vending machine snacks and drinks, they're Kosher certified.
8) Contact my family. The family will contact the rabbi if needed.
9) Again, my family would contact the rabbi. However, it may be appropriate to get the conversation started in certain cases of terminal illness and the pt. is a full code. As noted above, there are circumstances in which a rabbi might determine that heroic measures are inappropriate, but once that pt is coded and on the ventilator, it's may be forbidden to withdraw support.
10) When a pt dies, it is considered an indignity for his body to be uncovered. We even cover his face (no, he won't suffocate). A person's soul remains in proximity to the body and is able to see and hear what is happening to its former residence, so we don't talk of things unrelated to the departed in the presence of the body. (Btw, nurses tend to want to talk and joke when they have the somewhat depressing task of preparing the body for the morgue. This might be something to think about.) Blood which comes out at the and after the time of death is buried with the body. Therefore, do not remove saline locks or central lines. The burial society will take care of it. In my facility, the nurses are instructed not to remove anything, even urinary catheters of endotracheal tubes. In my hospital, the orthodox burial society usually arrives within an hour of being called, so they pick up the body from the room.
If a person is actively dying, there may be a minyan, ten adult men in the room. It is not considered proper to leave a person while they are dying. We also do not even move a limb of a dying person in order not to hasten his death.
11) An orthodox Jewish female may not be comfortable with a male caregiver, at least with anything that's very 'hands-on'. If a woman has a male visitor, besides her immediate family, check with her before you allow his entry to see if she is decent. In Jewish terms that means that she is covered appropriately including covering her hair married women. Another nurse once asked my to help her clean her pt. who had diarrhea in the bed. The lady was alert and oriented and I found out later was an orthodox Jewish lady who felt very uncomfortable with my (a male) assistance. That taught me that I shoulda asked.
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lazer
New Member
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Post by lazer on May 3, 2009 9:37:15 GMT -5
12) It is not considered decent to see one's parent unclothed. You might encounter a situation where the pt. has a roomful of family and they call you to assist them to the bathroom! Now you know why!
Orthodox Jewish men do not generally shake hands with a women due to keeping a strict seperation between the sexes. (I know I'm a nurse and am hands-on, but it's OK when done as a professional...but was it weird for a while!) If a women extends her hand many will shake it in order not to offend her. Some will not shake. Give them a break, just be friendly, don't touch them casually (pat on the shoulder, etc.)
Also, you'll find things which don't jive with what I wrote here. There are different traditions and some people follow more or less strict rabbinic scholars.
Kerri, I want to personally thank you for taking upon yourself to educate yourself about Jewish practices in order to better service the Jewish community. I appreciate and respect that desire and took the time to do my best to help you with your project. I hope you knock 'em dead! (...just an expression! Hope you get a 'A'!)
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Post by Rivka P on May 3, 2009 12:12:05 GMT -5
Re: #5
I have a number of friends with crohns disease, one being my best friend from elementary school, another is her brother in law. Then there's a boy from my class, a girl I went to college with and I think the list goes on. My best friend was recently hospitalized after the MD punctured her bowel during a routine colonoscopy. Not fun to say the least.
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Post by achot on May 4, 2009 4:25:45 GMT -5
I would just like to add to Lazers response of question 10 - (spritual practices of a deceased..)
NEVER cross their arms the way you do with a Christian.
Again, you would need better questions and a lot more time, to really get proper answers.
As a nurse you will encounter many individuals of many various religions, Just because one person requests something doesn't mean another patient of the same religion will.
Nurses must learn to be non-judgmental, flexible, respectful and open-minded- Just because one Jew will refuse non-kosher food, doesn;t mean that if another Jew requests a ham sandwich that they are doing the wrong thing- there are so many issues and situations involved. You really have to ask and treat each situation uniquely.
For that there are Chaplains, Social Workers and family.
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Post by kbright on May 5, 2009 16:37:31 GMT -5
Thank you all so very much.
Im processing all the information I have recieved, and I may have a few follow up questions.
I cant tell you though how nice the insight has been. I feel like I've learned more from your answers than I did in the last book I read looking for information.
Kerri
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