Introduction
In the healthcare setting, nurses and care providers often encounter situations that require them to critically consider ethical principles, cultural sensitivity, and patient-centered care in their service delivery. One such scenario caught the attention of Susan, a nurse who was to take charge of Mr. Jackmon, who refused to have a blood transfusion after getting involved in a road accident. The patient is a Jehovah’s Witness, and he asserts that his religion does not allow blood transfusions. After examining Mr. Jackmon, the nurse stated that the patient needed a blood transfusion for his benefit.
On the other hand, Mr. Jackmon remained firm, refusing to compromise his religious beliefs and values. In solving complex cases effectively in healthcare, nurses and care providers can utilize frameworks such as the Staircase Model to enhance self-reflection and guide ethical decision-making while caring for patients. Therefore, exploring the application of the Staircase model in this case is essential to resolving the dilemma by reflecting on a series of questions I would need to consider when caring for Mr. Jackmon.
Self-Reflection and Cultural Competence
Despite the challenges I may experience while on duty, as a nurse, I must always strive to render quality, culturally sensitive, and patient-centered care to patients like Mr. Jackmon. The first step in ensuring that Mr. Jackmon is served with dignity and respect is to take a self-reflection to assess my current position in the Staircase model.
According to Kersey-Matusiak (2018), the Staircase model is a framework that provides valuable insights for nurses and other care providers to engage in self-reflection and ethical decision-making when providing patient care. In the model, I am in stage four, which means that I have strong cultural awareness and can seek cultural information from my network if needed. Therefore, in caring for Mr. Jackmon, I will use the cultural and religious knowledge I have gained to consider his beliefs.
Considering that I am not highly aware and readily apply cultural care knowledge to care planning, I can move on to step five by employing various strategies. According to Kersey-Matusiak (2018), I need to enhance my religious knowledge to incorporate diverse religions and develop empathy, cultural competence, and humility. This implies that understanding the Jehovah’s Witness beliefs and practices that guide their decisions regarding blood transfusions is a crucial first step. I can do this by reading religious texts and seeking help from the hospital’s chaplains (Kersey-Matusiak, 2018).
Moreover, I will also have to develop a high level of empathy. This implies that I must listen to my patients and understand their views (Kersey-Matusiak, 2018). Finally, I will strive to further enhance my cultural competency, as Kersey-Matusiak (2018) noted that it plays a pivotal role in ensuring the quality of care. This can be done by comparing the health beliefs of Jehovah’s Witnesses with those of other religions to challenge any misconceptions Mr. Jackmon may hold.
Understanding Religious Beliefs and Values
Providing quality care to Mr. Jackmon will require that, as a hospital nurse, one possess knowledge of Jehovah’s Witnesses’ religious beliefs, values, and attitudes. Jehovah’s Witnesses are a religious group following a unique Christian interpretation. For example, they have specific beliefs, values, and attitudes based on the interpretation of the Christian Bible (Kersey-Matusiak, 2018).
This group values the sanctity of life and has solid principles concerning war, aggression, and other behaviors such as gambling, stealing, and killing. Moreover, their religion does not allow premarital relationships, incest, or homosexuality. Therefore, I will need to familiarize myself with these beliefs, values, and practices to provide effective care to Mr. Jackmon.
Furthermore, caring for Mr. Jackmon requires me to understand the significant differences between my religion, Catholicism, and the Jehovah’s Witnesses. One of the major distinctions between the two religions is the refusal of blood transfusions. While Jehovah’s Witnesses prohibit this act, Catholicism does not have such prohibitions, thus allowing blood transfusions for medical benefits.
The two also differ in their approaches to medical intervention. For example, Jehovah’s Witnesses prefer alternative medical treatment that does not involve blood use. On the other hand, Catholicism has no specifications and allows Christians to follow doctors’ prescriptions. Regarding religion and traditions, the two also differ significantly. The Jehovah’s Witnesses do not observe traditional Christian holidays, such as Christmas and Easter, which are significant in Catholicism.
Mr. Jackmon’s decision not to receive a blood transfusion, which I considered the best for him, can result in various emotions that can thwart his care. As such, I need to self-reflect and examine my feelings and attitudes toward the patient’s decision, as these are the key determinants of our interaction and the quality of care Mr. Jackmon receives (Kersey-Matusiak, 2018). With the confrontations, I may have developed emotions such as frustration, concern, or, to some extent, disagreement with the patient regarding the only way to save his life. I may not necessarily mean to disagree with him, but my desire to help and promote his well-being may be the reason for my reactions.
My reactions to Mr. Jackmon’s refusal to accept the blood transfusion, citing his religious beliefs and values, may significantly impact the development of a cooperative and supportive relationship between us. Suppose that, as a nurse, I take the situation personally and allow my attitudes and feelings to overshadow my professional abilities; it can lead to broken communication, which affects the quality of services I render (Kersey-Matusiak, 2018).
If he detects disapproval from a nurse, he will be less willing to engage openly, which can have severe consequences for his care. Therefore, I need to reflect on my feelings, attitude, and biases and approach Mr. Jackmon with empathy, demonstrating a genuine desire to help. This could foster a supportive, conducive environment for us to interact and agree on a suitable care plan.
Alternative Treatments and Patient-Centered Care
Serving patients from the Jehovah’s Witness religion, like Mr. Jackmon, who do not accept blood transfusions because of their beliefs and values, nurses should explore other alternatives that respect patients’ needs and meet their medical needs. According to Wu and Chinnadurai (2022), nurses can use non-blood products to treat Mr. Jackmon’s condition, including erythropoietin-stimulating agents and iron supplements to stimulate red blood cell production.
These alternative methods have implications for patients’ religious beliefs and spiritual well-being. As such, the alternative treatments alleviate the conflict between Mr. Jackmon’s medical needs and religious beliefs. However, as a nurse, I should engage the patient before settling on a method, explain the potential risks, and address their concerns.
Although I may decide to explore other alternative methods, as a nurse, I also need to research why Jehovah’s Witness patients do not allow blood transfusions despite their need for them. According to Kersey-Matusiak (2018), this religion prohibits the consumption of blood transfusions based on scriptural interpretations. Thus, Mr. Jackmon held onto this belief spiritually, and nurses needed to respect the decision.
According to Kersey-Matusiak (2018), Acts 15:28-29 and Leviticus 17:10-14 prohibit the consumption of blood transfusions; thus, Mr. Jackmon could not go against his faith, even on his deathbed. As such, Mr. Jackmon’s acceptance of a blood transfusion could violate his commitment to God. Therefore, I need to seek additional knowledge and insight into effective ways to help patients like Mr. Jackmon. I can approach the hospital chaplain, ethical committee consultants, and healthcare professionals with experience in caring for Jehovah’s Witness patients for further advice.
It is also crucial that nurses ensure both physiological and psychological needs are met while the patient receives care that respects his religious beliefs and, at the same time, meets his medical needs. For Mr. Jackmon, I can use non-blood pain management strategies, such as nonsteroidal anti-inflammatories, to reduce his pain (Anderson & Shaheed, 2022). Moreover, I can also opt for emotional support to give them empathetic and compassionate care.
Finally, patient education can also help patients understand the nature of their condition and the care plans available to improve their well-being. As I care for Mr. Jackmon, I can utilize several resources to ensure he receives the standard care he needs. Firstly, I must base my decisions on the hospital’s policies and guidelines about patients with religious beliefs and values. Moreover, seeking advice and guidance from clinical experts and consultants, and utilizing the hospital chaplaincy to provide further direction on what to do.
Conclusion
In conclusion, this paper has dwelled on applying the Staircase model in Mr. Jackmon’s case, a Jehovah’s Witness patient who refuses to accept a blood transfusion care plan as prescribed. The model has highlighted the significance of a nurse’s self-reflection, cultural competence, humility, and seeking advice from hospital resources in providing standard care for patients.
It has also been proven that nurses must evaluate their position in the model and understand the beliefs and values of Jehovah’s Witnesses to provide care that respects their religious practices. Moreover, the importance of an alternative treatment plan is also a factor in caring for a patient like Mr. Jackmon, so they can find a suitable option that does not violate their religious beliefs.
References
Anderson, D. B., & Shaheed, C. A. (2022). Medications for treating low back pain in adults. Evidence for the use of paracetamol, opioids, nonsteroidal anti-inflammatories, muscle relaxants, antibiotics, and antidepressants: An overview for musculoskeletal clinicians. Journal of Orthopedic & Sports Physical Therapy, 52(7), 425–431.
Kersey-Matusiak, G. (2018). Delivering culturally competent nursing care: Working with diverse and vulnerable populations (2nd ed.). Springer Publishing Company.
Wu, H. H. L., & Chinnadurai, R. (2022). Erythropoietin-stimulating agent hyporesponsiveness in patients living with chronic kidney disease. Kidney Diseases, 8(2), 103–114.