An Exploration of Specialist Palliative Care Nurses’ Experiences of Providing Care to Hospice Inpatients from Minority Ethnic Groups—Implication for Religious and Spiritual Care
3. The Study
3.1. The Aim
3.3. Ethical Considerations
3.4. Method of Data Analysis
3.5. The Findings
3.5.1. Death and Dying
“When it comes to death...religion plays such a huge part of it.” (Participant no. 1).
“We get so used to how an Irish death works as such...but you have so much more to consider when you have somebody from a different religious background.” (Participant no. 1).
“My experience is mostly with Catholics. I would have some experience with Muslim religion, Hindu religion...but I probably didn’t mind them in the terminal stage of their illness, so...I wouldn’t know exactly what to do when they die.” (Participant no. 5).
“....our Muslim gentleman, he would be having prayer a lot during the day, normally they would pray five times a day. Sometimes you feel...any time before you go in the door might think ‘will he be praying’? Or ...’should I go in’? Or...’will I be disturbing him’?...that’s the difference. So, normally if it’s an Irish patient, say a Catholic patient, even though they are saying prayers they will probably interrupt for the nurse. If you go in and they are saying their rosary, they will probably stop praying, for a minute, but this gentleman, he would probably send you back.” (Participant no. 5).
“...it is going to be very loud when he dies...normally when we hear somebody wailing our instinct would be to help them and to stop it, but we can’t stop this, in this event. I don’t think I’d like to be there.” (Participant no. 2).(, p. 40)
“...they had a six foot tall statue of the Virgin Mary sitting at the bottom of the bed. It’s very difficult for the other patients in the room to deal with things like that. The constant prayers, the rosary beads...and just the volume of people coming in, with the constant prayers, it gets quite loud and it can be intimidating for some of the other patients” (Participant no. 1).
“...we have to think about our other patients, because obviously it’s not the norm for them as well. What actually might be challenging if he did pass away tonight, is three rooms down from him is a gentleman with young children coming in and they are staying overnight. I couldn’t think of anything worse than if it all just happened on the same night.” (Participant no. 2).(, p. 40)
“...when we started a syringe driver for her unfortunately the lines were cut a few times, they just didn’t want it...I suppose it’s your belief...they had it in their head that morphine was going to speed up her death and you can’t do that, you have to let it happen naturally, when God is ready for her to go. I found that hard.” (Participant no. 1).
“They were quite curious about morphine. It’s quite challenging to let them know what the intention of the medication is. It’s so difficult to treat those people...I find that hard to see them, because...we have comfort measures as a priority. And of course, it’s nice to see them controlled, their pain...their symptoms, so they can have a quality-of-life.” (Participant no. 4).
“...they were very anti-opiate. Every time I went in I saw pain etched on her face and yet they’d say ‘no she has no pain’, ‘doesn’t need any opiate, we're not having any morphine’. We did organise meetings with the family to explain the role of opiate and that we wouldn’t be sedating her unnecessarily and we wouldn’t cause all these side effects they were concerned about, but they were very against it. I think she probably could have had a more comfortable death had we been able to get in.” (Participant no. 1).
“That’s their belief. You can only advise them and say that we are here to help...we wouldn’t go against it, it’s entirely up to them…with medication, we just give them the choice.” (Participant no. 3).(, p. 43)
3.5.3. Feeling their Way
“...you always have to think to be more cautious...because you’re not very familiar. You wouldn’t want to offend them or anything. You need to take your time, go slowly.” (Participant no. 5).(, p. 48)
3.5.4. Being Resourceful
“We are coming across more people coming from abroad and different backgrounds, different cultures, religions...it’s time we knew...we need to know.” (Participant no. 2).(, p. 44)
“...you need to know the patient’s beliefs, before you step into their world.” (Participant no. 4).(, p. 44)
“…we are using his Church, so he has his Imam...we are using them and they’re guiding us in their cultural and religious beliefs. We speak to our chaplains here...they have a lot of experience. But they are not going to be the ones actually, on the day, they might not be here...so then what?” (Participant no. 2).
“[the intercultural guide  was good, because we went to it, photocopied it and put it in his chart so that when, in the event of something happening, it can be a guide for whoever is on. But I’d like somebody actually with experience of doing it, rather than just reading it out of a book. Like we look up all the information...for instance, our Muslim patient, in the event that he is dying...what are we going to do? No one actually has experience.” (Participant no. 2).
“I would do a bit of background reading, but I suppose there are many variations of every religion...just because they’re Catholic necessarily mean they want the last rites or candles, or prayers, or a cross at then end of the bed, and just because they are Muslim doesn’t mean female staff can’t go into the room. So I would generally have an idea of what their beliefs would be and then involve both patient and family to find out what they want, what they believe, what they want you to do or don’t want you to do...it’s just about finding out from them all the time.” (Participant no. 1).
“...with Ireland and the economic change we’re seeing more of cultural diversity, there’s definite need for ongoing education.” (Participant no. 3).
“It would be great if there was some kind of study day or something...or if you could bring in different types of maybe, religious or community leaders. It could be so informal as well, couldn’t it...I just sometimes wish we had more hands on [experience], like somebody who actually knows all about it.” (Participant no. 2).
- handling one’s own beliefs;
- addressing spirituality;
- collecting spiritual assessment information;
- discussing and planning spiritual interventions;
- providing and evaluating spiritual care; and
- integrating spirituality into institutional policy.
Conflicts of Interest
Central Statistics Office
Department of Health and Children
Health Service Executive
Republic of Ireland
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Henry, A.; Timmins, F. An Exploration of Specialist Palliative Care Nurses’ Experiences of Providing Care to Hospice Inpatients from Minority Ethnic Groups—Implication for Religious and Spiritual Care. Religions 2016, 7, 18. https://doi.org/10.3390/rel7020018
Henry A, Timmins F. An Exploration of Specialist Palliative Care Nurses’ Experiences of Providing Care to Hospice Inpatients from Minority Ethnic Groups—Implication for Religious and Spiritual Care. Religions. 2016; 7(2):18. https://doi.org/10.3390/rel7020018Chicago/Turabian Style
Henry, Andrea, and Fiona Timmins. 2016. "An Exploration of Specialist Palliative Care Nurses’ Experiences of Providing Care to Hospice Inpatients from Minority Ethnic Groups—Implication for Religious and Spiritual Care" Religions 7, no. 2: 18. https://doi.org/10.3390/rel7020018