Consider the following scenario of a male-identifying

Consider the following scenario of a male-identifying patient with strong cultural and religious preferences, who just received a total hip replacement. He is recovering from his operation in a hospital near his home. The nursing staff are increasingly frustrated; feeling like they are having to make many accommodations for his needs. This patient is devout with his prayers but because of the nature of his surgery, it is difficult for him to take a shower or bathe himself. When preparing for prayer, he needs to cleanse himself and he declines the help of female nurses. Finding a male nurse or healthcare aids to assist him to bathe has been a staffing challenge. His prayer times are at specific times of the day, and he needs to have a nurse help him get out of bed, but he has complained that his nurses cannot always make it there in time to assist. Because of religious requirements, he does not eat pork. The cafeteria food often contains pork products or by-products, it is hard to find food that fits his needs to ensure he eats well balanced meals. Medication provided to him must not have any pork products or alcoholic substances-this limits some of his treatment. He has many relatives that visit him every day; as a result, the patients that share his room complain about the noise, level of activity, and lack of privacy. The solutions to solve the problem are Concerns: Finding male nurses to assist with activities of daily living such as bathing, cleansing, leaving the bed and overall assistance. Look into staffing schedules for the week and make amendments to schedule male healthcare personnel during the patient’s praying hours. Praying hours are specific within the day making it easier to predict what time the patient needs assistance. If male nurses are not available on during the praying hours, look into schedules of other members of the healthcare teams such as male orderlies and nursing assistants who may be available during the required time. Laying out the shift schedules of male nurses and members of the healthcare team and planning their shifts ahead of time would allow proper staffing during the time the patient needs assistance. Once shifts of male healthcare personnel have been planned out and communicated, look into gaps in schedules that may require more male individuals to assist. For these gaps, consider asking male family members to visit on those hours so they can help out. Communicate the plan with the patient to gain his cooperation. Provide him options if despite efforts of amending staff schedules is still not enough. Communicate what are his options and ask him who among his family can provide help. Diet restrictions- pork products not allowed Refer patient to a nutritionist who can provide food options that can make up with diet restrictions. Communicate diet restrictions with attending physician as well so they can provide alternative medication or treatment approach that respect’s the patient’s religious belief. Communicate recommendations from nutritionist to the cafeteria so they can provide options as well. Include the family members in planning meals to also explore what other options can be provided for the patient. Room noise due to relatives visiting Communicate feedback of other patients to the family. Schedule visits during wake hours so as not to disturb other patients. Since patient would need help on other activities to prepare for prayer, ask family members if they can visit by batches. Proper and respectful communication is the key to resolve complaints. Compromise is always a key. What super positive and innovative ideas can you look outside the box? Have a multidisciplinary type of care for the patient. Involve and collaborate with other members of the healthcare team to address patient concerns. Involve orderlies and nursing assistants if lack male nurses to provide care. Involve family members as well if still lacking in manpower. For diet issues, collaborate with nutritionists and dieticians including suggestions from family members as they know the patient well and what food he is most comfortable to eat. Schedule family visits accordingly. Check for hospital policy for visits and allow families to abide on these rules. Being objective and having proper communication that is respectful to all parties involved is important. What solutions can be presented based on the problem/scenario? Provide all options that allows compromise and communicate them with the patients. Showing that you explored all options and tried your best to find a middle ground can help gain patient’s and family’s cooperation. Stick with hospital policies on approaching these scenarios as they can help you decide and let the patient know that there are rules in place that is followed by everyone. This can help in their understanding and gaining their cooperation. What are your next steps? After exploring all options, present it to the patient and the family and ask if they agree or if they have other suggestions that might work for them. Document what was agreed upon. Carryout what was decided on. Questions: Identify if anything that you think would not work and help the group eliminate or change aspects of the plan based on negative consequences Are there ways to mitigate the things that could go wrong? Is there any evidence to say that something will go wrong? Is the reason I have for not liking this idea a valid one? Will this go wrong in practice?

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