Providing Holistic Care to the Family Members

During palliative care, the nurse ought to establish trust to enhance a successful therapeutic relationship with the patient (Kozier & Erb, 2012). The nurse could establish trust in the therapeutic relationship with Josie through four ways. At the outset, the nurse ought to comprehend the current patients needs. In this case, Josie carries the responsibility of caring for the extended familys health needs. As such, Marguerite ought to understand the various challenges that Josie is currently experiencing and the role conflict that is apparent in her career. The nurse should be approachable and able to guide Josie on ways that she can provide care for the outpatients. Second, the nurse should be able to exhibit both attitudes and actions that imply that she cares about the tribulations and challenges that Josie is experiencing. It is imperative to understand that Josie will welcome a palliative care nurse into her household with the belief that they care about the patients (Leininger & McFarland, 2002).

Further, the nurse should be able to provide holistic care to the family members of Josie. In so doing, the nurse will have addressed the cultural and ethnic backgrounds of the patients and achieve cultural congruency (Kozier & Erb, 2012). It will therefore be easy for Marguerite to build trust with Josie when she adopts an approach that considers all aspects of the patients as well as those of their immediate family members. Finally, the nurse should be able to act as an advocate for both the patients and Josie. Trust is built overtime and the continued connected relationship with the patients is a way to win trust with Josie.

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Culturally Congruent Care
Culturally congruent care is important in palliative care as it provides the nurse with a multidimensional perspective through which they can establish a relationship with the patients. For this case study, the nurse is Haitian and so are the elderly Josies parents. Besides, working in an American context could as well be an important factor in provision of care to Marie and Jack. As such, the knowledge of cultural diversity will provide a positive effect and enhance holistic well being of the patients. In addition, it will provide important insights for establishing a client centered relationship.

Knowledge of all the cultural dimensions of her patients assists the nurse to design a particular lifestyle that will result to successful therapy and for a specific patient (Kozier & Erb, 2012). This is critical in enhancing the nurses ability to incorporate her diverse knowledge with actions that aim at meeting the objectives of palliative care. In this type of care, all the actions that Marguerite will undertake are centered on the best interests of the patients. Besides, culturally congruent care dictates that both the patient and the nurse should participate proactively in designing, planning, implementing and evaluating the specific mode of providing care to the patients (Leininger & McFarland, 2002). Additionally, working closely with the patients enhances the nurses knowledge on the pertinent issues that relate to cultural diversity of the patients. Finally, a culturally congruent approach incorporates various traditions, values and beliefs of the patients (Leininger & McFarland, 2002). This makes trust to develop throughout the entire therapeutic period, which boosts the chances of a successful therapy.

Impacts of culture on coping
Culture shapes the manner in which people perceive the world and . In fact, it dictates the way of life of different social groups since it is responsible for the development of values, beliefs, taboos, and norms amongst many cultural other dimensions (Kozier & Erb, 2012). Therefore, coping is a human aspect that is heavily reliant on culture. While some cultures reinforce ways that people cope with different situations and occurrences, others impede the development of coping mechanisms. In a fatalistic culture where all things are attributable to fate, people are able to reduce their stressors by assuming that the causative factors are related to fate (Kozier & Erb, 2012).

On the contrary, societies whose culture regards misfortunes, diseases and natural calamities as punishment from the gods, the patients may be unable to develop successful coping mechanisms. It is agreeable that cultural background plays an important role in the general health of a patient. Kozier & Erb (2012) say that establishing a relationship with the patient to enable them to cope with lifes stressors is dependent on comprehension of cultural affiliation of the patient. Leininger, the founder of the concept of transcultural nursing explained that the apparent gap in the profession of nursing is in the failure to appreciate that the patients are products of their respective cultures (Leininger & McFarland, 2002). In context where culture may present a challenge to the coping mechanism of the patients, the nurses are able to intervene by addressing the cultural aspects borne by the patients (Leininger & McFarland, 2002).

How is Josie Coping?
Apparently, Josie faces various sources of stressors. From the onset, she contends with numerous roles that create a conflicting career life. She plays the role of caring for her children, Marie and Jack who and chronic degenerative disease respectively. She also takes care of her aged parents. Besides, she has to meet the needs of the family by teaching an elementary school. Other members of her family like her husband and the second daughter provide little or no emotional support for her since they are on fulltime job and college respectively.

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