Making Your Cultural Practices Part of Your Baby’s Story
By Lori Ives-Baine, RN, MN, Toronto, Canada
As parents who come from a variety of geographical, cultural and religious communities, you may participate in your baby’s care to different extents based on your beliefs, your previous experience with babies, especially sick or premature babies, and your personal level of comfort. Differing levels of language comfort, distance from home to hospital, family dynamics and work schedules and other children to care for will all impact how you work with the team and are involved in your baby’s care (Board & Ryan-Wenger, 2000).
Some mothers are encouraged to stay home for a period of time after they deliver, even if their baby is in an NICU. While this might seem wrong to the health care team, this may be the way you need to live through the experience (Roberts, 2002). Communicate with your team about your needs, throughout your baby’s stay. This may need to be done with interpreters/translators, so do not be afraid to ask for help if you cannot get your information across to the team or understand their practices (Erlen, 1998).
If you are being told specific information about your cultural, religious or spiritual practices, share this with a trusted health care provider (Erlen, 1998). You may need to accept that some things may not be able to be done, like lighting a candle in an oxygen-filled space like an NICU, but maybe there are symbolic ways to represent these specific requests you have. The only way for the team to help you is to know what you might want to consider (Cheraghi et al., 2005).
Alternative and complementary practices need to be brought to your team before you consider if they are helpful or harmful to your baby. What is possible? In order to answer your question we need to consider how the team can best help in your situation (Redshaw, 2005).
Activities like religious rituals may be very possible, as long as they do not interfere with the safety of your baby’s care, or the other families in the room (. Using certain creams or ointments need to be talked about with the team. There may not be adequate information to help the team to assess the impact, and if this is the case, they may not be comfortable with some options. Keeping religious items in your baby’s incubator or bedspace are possible, but again, make sure that the item is recognized and transferred with your baby when their incubator is replaced. Also, many hospitals will not take responsibility for any valuables that are left with your baby even if they have religious, spiritual or personal significance. We may need to use interpreters to help us understand the specific needs you may have, whether it is a religious symbol kept under the cot mattress (and staff need to remember to safely remove it and place it in a clean incubator when changing them), the saying of prayers at specific times of day, or visiting patterns based on religious or cultural needs and demands (Banks-Wallace, 2002; Erlen, 1998).
Your team’s best way to help you is to ask what works for each individual in the family. This requires time, a therapeutic relationship and gentle education and guidance with each parent or sibling. Whether it is encouraging touch, talking to the baby in your native language or singing to the baby, all will encourage a connection in a positive way. Even when language is a challenge, we can use systems (Language Lines or professional interpreters) to ensure that you really understand what we are asking or sharing with you. We need to use interpreters effectively, planning important discussions and education when this assistance is available. You need to guide us about what is important to you and we need to develop a therapeutic relationship that allows for you to express your needs, as well as to ask difficult questions or provide responses that may be based on religious or cultural perspectives (Hammerman, Kornbluth, et al. , 1997).
The team also needs to know who is in your “family”, whether it is blood or marriage relatives, close friends, or others, as you need to know that we cannot share information with others without your permission. If you are not the primary decision-maker in your community, inform the team so that they might help you to educate others in your family about your baby, so that you can work together to make the best decisions necessary (Woodwell, 2002).
You may have strict rules about decision-making and accessing spiritual advisors- again, share this with the team, so that your support is what you need (Roberts, 2002).
In summary, the team needs to hear about your and your family’s individual and group needs in caring for and making decisions for your tiny baby. They cannot be of help if they do not understand. Help them learn more about you and your baby by communicating this information or having someone else explain those needs.
References:
Banks-Wallace, J. (2002). "Talk that talk: storytelling and analysis rooted in African American oral tradition." Qualitative Health Research 12(3): 410-26.
Banks-Wallace, J. and L. Parks (2004). "It's all sacred: African American women's perspectives on spirituality." Issues in Mental Health Nursing 25(1): 25-45.
Board, R. and N. Ryan-Wenger (2000). "State of the science on parental stress and family functioning in pediatric intensive care units." American Journal of Critical Care 9(2): 106-22; quiz 123-4.
Cheraghi, M. A., S. Payne, et al. (2005). "Spiritual aspects of end-of-life care for Muslim patients: experiences from Iran." International Journal of Palliative Nursing 11(9): 468-74.
Erlen, J. A. (1998). "Culture, ethics, and respect: the bottom line is understanding." Orthopaedic Nursing 17(6): 79-82.
Hammerman, C., E. Kornbluth, et al. (1997). "Decision-making in the critically ill neonate: cultural background v individual life experiences.[see comment]." Journal of Medical Ethics 23(3): 164-9.
Redshaw, M. (2005). "Infants in a neonatal intensive care unit: parental response.[comment]." Archives of Disease in Childhood Fetal & Neonatal Edition 90(2): F96.
Roberts, K. S. (2002). "Providing culturally sensitive care to the childbearing Islamic family." Advances in Neonatal Care 2(4): 222-8.
Woodwell, W. H., Jr. (2002). "Perspectives on parenting in the NICU." Advances in Neonatal Care 2(3): 161-9.
© Draeger Medical Systems, Inc. 2010-2011