1. Unit 7

2.  Upon completion of this unit you should be able to: ◦ Explain the importance of religion in America ◦ Describe the role of religion within various cultures ◦ Give examples of specific religious health beliefs and practices ◦ Explain the purpose and functions of nurses working within faith-based organizations

3.  To provide holistic care to patient’s and families nurses must support not only the physical concerns, but also the mental/emotional and spiritual needs.  Nurses sometimes neglect to address spiritual needs of their patients due to several factors ◦ Religion and spirituality is viewed as a private matter ◦ Nurses are uncomfortable with their own beliefs or deny having any religious/spiritual beliefs ◦ Lack of knowledge regarding different religions and beliefs ◦ Psychosocial needs are mistaken for spiritual needs ◦ Meeting the religious or spiritual needs are not seen as a nursing responsibility

4.  America has a diverse religious population. As a nurse you will encounter many different religions and in order to provide holistic care it is important to have a knowledge base about the central beliefs and health practices of different religions.  The population that has been identified as being responsible for the recent changes in the nation’s patterns of religiosity and religious identification are Young Adult Americans.  During 2013, the American Religious Identification Survey (ARIS) conducted a National College Student Survey. Answers from 1710 students from 38 four-year colleges and universities were recorded. This survey gives some insight into the religious affiliation trends in America. http://commons.trincoll.edu/aris/files/2013/07/ARIS-Sudent-survey-for-Website.pdfhttp://commons.trincoll.edu/aris/files/2013/07/ARIS-Sudent-survey-for-Website.pdf; http://www.secularhumanism.org/index.php/articles/5283 http://www.secularhumanism.org/index.php/articles/5283 http://www.trincoll.edu/Academics/centers/isssc/Documents/ARIS_2013_College%20Students_Sept_25_final_draft.pdf

5.  College-age Americans identify with three distinct worldviews: Religious, Secular, and Spiritual.  Gender differences were noted: more males identify with the Secular group, more females identify with Spiritual groups, and males and females identify with the Religious group.

6. Religious group:  70% firm believers - similar to the general American adult population  Most attended religious services on a regular basis in childhood (>91% monthly) Secular group:  70% Nones (profess no religion, agnostic or atheist)  49% were raised in actively religious homes and 51% attended rarely early in their life Spiritual group:  1/3 are Nones  2/3 were raised in religious homes

7.  The following slides outline the basic beliefs and health practices of Buddhism, Christianity, Islam, Judaism and Hinduism.

8.  General Beliefs ◦ Foundation is based on four noble truths: 1) truth of suffering, 2) truth of the origin of suffering, 3) suffering can be destroyed, 4) the way that leads to the cessation of pain ◦ Eightfold path leads to Nirvana and includes  Understand suffering  Renounce all attachments  Express oneself lovingly  Behave correctly  Avoid hurting others  Work towards spiritual growth  Develop the ability to reflect on personal experience  Establish perfect intellectual concentration

9.  Birth ◦ Reincarnation allows for the opportunity to reach Nirvana  Death ◦ Euthanasia is allowed if life cannot be prolonged. This allows the person to be reincarnated and continue their path to enlightenment ◦ Peace and quiet should be provided at time of death ◦ The more composed and calm the mind is at death, the greater opportunity for a better rebirth ◦ After death the body is kept in peaceful state for 3 days- the body is taken home and is untouched ◦ Following death, the spirit enters a “Bardo” or intermediary spirit for up to 49 days before the new life begins ◦ Mourning periods are not usual as reincarnation allows the person to be “reborn”  Dietary practices ◦ Some are vegetarians some are not ◦ Moderation is encouraged

10.  Health Care Practices ◦ Believe in Karma and that for every action there is a consequence in this life or a future life. Illness may be attributed to poor choices in this or a previous life ◦ Spiritual peace and liberation from anxiety promote healing and recovery ◦ No restrictions on medications, vaccines or other medical interventions. As long as the therapy aids in the person’s path to enlightenment it is allowed. ◦ Birth control is accepted  Holidays ◦ Saga Dawa is the observation of Buddha’s birth ◦ Fasting may be observed

11.  General Beliefs ◦ Began as a sect of Judaism. Followers believed Jesus was the promised messiah ◦ Many denominations exist within Christianity ◦ Belief in one God and most believe in the three dimensions of God (trinity) known as Father, Son and Holy Spirit. ◦ The death and resurrection of Jesus provides an opportunity for salvation ◦ The sacrament of baptism signifies the passage into Christianity ◦ The sacrament of communion (practiced by some branches) is a symbol of the body and blood of Jesus Christ

12.  Birth ◦ Considered a time of celebration ◦ Many denominations prohibit the use of birth control  Death ◦ Believe in an afterlife ◦ Prayers, rituals or sacraments may be offered for the dying ◦ For most Christians, euthanasia is not permitted ◦ Autopsy and organ donation are permitted.

13.  Dietary ◦ Vary among the different denominations ◦ Some believe in fasting of some form such as no meat during some religious observances  Holidays ◦ Major holidays include Advent, Christmas, Epiphany, Ash Wednesday, Lent and Easter ◦ Not all holidays are recognized by all denominations ◦ Most recognize Christmas and Easter

14.  Health Care Practices ◦ Some denominations practice sacraments for the sick and blessings by a minister or priest ◦ Most do not have restrictions on medications or therapies ◦ Organ transplantation and donation is permitted by most denominations

15.  General Beliefs ◦ Thought to be the oldest religion in the world ◦ Many variations found around the world ◦ Some worship one God, while others worship more than one God ◦ Founded on the sacred written scripture called the Vedas ◦ Brahman is the principle and the center from which all things proceed and return ◦ Believe in karma  Birth ◦ Reincarnation ◦ Noting the exact time of birth is important to determine the baby’s horoscope ◦ The infant is not traditionally named until the 10 th day of life although in American hospitals the baby is often named at birth

16.  Death ◦ Death is considered one more step towards Nirvana ◦ Euthanasia is not practiced ◦ Autopsy and organ donation is acceptable ◦ Prefer to die at home with a priest present to give last rites ◦ Believe in reincarnation with the soul reborn over and over until its karma is used up ◦ Excessive mourning is discouraged  Dietary practices ◦ Eating of meat is forbidden so most are vegetarian. Some do eat meat but avoid beef and pork  Holidays ◦ Recognize the different deities. Recognition of the holiday depends on the deity that is worshipped

17.  Health Care Practices ◦ Birth control acceptable practice ◦ Males are not circumcised ◦ Breastfeeding is expected ◦ No restrictions on blood, medicines and therapies ◦ No specific beliefs regarding abortion ◦ Some believe that illness is God’s way of punishing people for their sins

18.  General Beliefs ◦ Founded in the seventh century by the prophet Muhammad who is the messenger of God or Allah ◦ Translated literally as “submission to the will of God” ◦ Recognizes one God ◦ A follower of Islam is referred to as a Muslim ◦ Essential practices are the “Five Pillars of Faith”  Profession of faith  Ritual prayer fives daily at dawn, noon, afternoon, sunset and night facing Mecca (Saudi Arabia)  Almsgiving to the needy  Fasting from dawn until sunset throughout Ramadan  Making a pilgrimage to Mecca at least once in one’s lifetime

19.  Birth ◦ Babies are washed before being handed to the mother ◦ The father, mother or Imam whispers the call to prayer in the baby’s ear so that the first sounds it hears are about the Muslim faith ◦ Ten days after giving birth and 5-6 days after menstruation is considered a cleansing period for women and they are exempt from daily prayers  Death ◦ May wish to sit facing Mecca when dying ◦ Muslim scripture, the Koran, may be recited over the dying person ◦ Immediately after death, the body is covered and placed with the feet facing towards Mecca ◦ Only another Muslim can prepare the body for burial ◦ Burial is performed as soon as possible- no cremation

20.  Diet ◦ Pork and pork products are not allowed ◦ Alcohol is not allowed ◦ Only fish with scales may be eaten  Health Care Practices ◦ Females prefer female practitioners, and males prefer male practitioners ◦ No restrictions on medications, blood products or therapies ◦ Euthanasia is prohibited ◦ Organ donation and transplants are allowed

21.  General Beliefs ◦ Is an ancient religion ◦ Recognizes one God as the creator and sustainer of the universe ◦ Basic belief is that God created people, provided them with guidance and free will to choose between good and evil, gives redemption, salvation, and ultimate justice after life ◦ Three main divisions are Orthodox, Conservative and Reform ◦ A fundamentalist sect called Hasidism exists. Hasidic Jews usually live and work only within their Jewish communities.

22.  Birth ◦ Brit Milah, the covenant of circumcision is performed on all males on the 8 th day after birth and is performed by a Mohel  Death ◦ Euthanasia is prohibited ◦ A person near death is encouraged to unburden themselves of worries, fears, guilt ◦ The dying person may be surrounded by family, friends and their rabbi ◦ After death the body is ritually washed and clothed in simple white shrouds ◦ Embalming is prohibited ◦ Public viewing of the body is not performed ◦ Shiva is the mourning period ◦ Cremation is not allowed

23.  Dietary Practices ◦ Dietary laws are strict, but the degree to which they are followed varies according to the individual ◦ Strictly observant Jews do not eat pork or predatory fowl. Milk dishes are not mixed with meat dishes. Only fish with fins and scales are eaten and shellfish are prohibited ◦ Kosher practices include proper slaughter of animals, and proper preparation of foods ◦ Dishes and utensils for different types of foods may be kept separate

24.  Holidays ◦ Rosh Hashanah, the Jewish New Year and Yom Kippur are the “high holidays” ◦ The Sabbath is the holiest of all holy days  Health Care Practices ◦ If the condition is not life threatening medical procedure should not be performed on the Sabbath or on holy days ◦ Prayer is an important aspect to healing ◦ No restriction with medications and therapies