Above Us Only Skies...

There is nothing more precarious than having to deal with good old religion when caring for a terminally ill patient. Not only you have to make sure that you are adept with whatever quirks and oddities these religious nuts have, but as a Nurse you have to ensure that you remain sensitive to their cultural needs as well. It is very, very frustrating, but it’s part of the job. Since I have worked in a few other countries prior to coming over here in England, I know what some of them are like. Although most are quite sensible, they have needs that often breach “unit policies”. Some cultures are very, very closely knit as families which I guess is a good thing, but they will overcrowd the bedspace no matter how you tell them that you can only have two relatives at a time. Okay, sometimes you can understand the grief that these families are bearing and you can be a bit flexible, but oftentimes you just find their behaviour quite challenging:

“Hey! Did you buzz before before you bust your ass in here..?”

There is actually a doorbell outside that has a huge sign in English that says: Ring the bell and wait for the Nurse to take you inside.” It is quite understandable if you are dealing with older people who perhaps couldn’t see properly or may have language issues, but not with obstreperous girls and boys who just don’t care about anything whether they know how to read or write.

“And hey! No flowers, please. They got little bugs in them that we don’t need more than what we already have in here.”

Moslems may request a special food that may have been ritualistically slaughtered in whatever manner their religion called for, and may ask for it to be placed in a location that does not necessarily conform to unit policy on infection control, but cultural sensibility is tops- so you can perhaps, let them get away with it. Make sure there is no newspaper lying round the bed with cartoons of Mohammed in it. They also get ‘arsey’ when they find little specks of blood on the bed, but this time they can keep their anal behaviour with them and shut it because you can’t be bothered to change the bed sheet every time you take blood gases. You stick to your priority: Save the patient by keeping him breathing and the planet by conserving energy and reducing laundry detergent use.

The Jehovah’s Witnesses will get barmy if you give them blood even if they will die bleeding. Imagine this: A man is dying of bleeding from a perforated duodenal ulcer, but the family is refusing a much needed blood transfusion. Jehovah's Witnesses believe blood is sacred, representing life, and the Bible tells them to abstain from blood. Some artificial blood products may be permissible but never natural human blood or its byproducts. I know this is quite painful to watch, but to be a culturally competent care provider means recognizing that patients have a right to make this choice. So you’re faced with the dilemma whether to save their life or their soul. Okay then, save their soul.

It’s the added pressure of having to deal with self-righteous, over zealous and raving evangelists that makes saving lives much, much more difficult that it is quite a refreshing break to find a simple good natured atheist on a deathbed. He was admitted following a bowel operation and was extubated the next day. Because of his cancer that has already spread to his lungs and kidneys, the Doctors decided not to re-intubate him in case he deteriorates. He was told of the poor prognosis and he was pretty much happy with the plan for his care and even refused to be resuscitated. “I’m not scared to die”, he said. I noticed that he had loads of books with Jedi Knights on them and a copy of HG Wells: War of the Worlds, so I asked him:

“Do you believe in aliens?”

He said, “Not really”, then added, “Same as I don’t believe in an all powerful being who demands to be loved and adored by his people unconditionally, then punishes them according to his whims and fancy.” He asked me if I go to church, and I told him sometimes, because I’m Roman Catholic.

Then he said: “Pardon my irreverence, but do you believe in God?”

I told him, “If you mean God that punishes according to his whims and fancy, then maybe I’m an atheist, but non-belief doesn’t stop me from being a good Catholic.” So he laughed hysterically, and told me it’s the funniest thing he ever heard.

The patient died the next day and I was told his family was very angry that a Nurse asked for a Catholic priest to do last rites for him. I learnt that this Nurse thought he was doing good service by providing spiritual care even if he didn’t know what the patient’s religion is, which I thought is very insensitive. There should be a commandment that says:

Thou shalt keep thy religion to thyself!