As the world’s population grows, so does its cultural diversity. While such diversity clearly
provides for a more interesting world, it can also serve to cause confusion and misunderstandings. In
medical situations, those points of confusion and misunderstanding can actually be life-threatening.
Healthcare providers have a moral and ethical obligation to provide the best possible care for every
individual (Attum & Shamoon, 2018). In this paper, we will explore the case of a post-surgical Muslim
patient in a western hospital and the cultural strategic thinking that must be utilized by hospital staff in
order to provide this patient with the care and respect he needs.
Background
Abdul Hadi, a Muslim recovering after surgery in a hospital in Germany, where he lives. Since
his female nurse, Anna, is not a Muslim and she is basically unfamiliar with the aspects of his religion
that influence their interactions and his care, there is a lot of conflict between them. As presented in the
case study in chapter 7, part 9 of the text Cultural Intelligence for Leaders, 2012, the main conflicts are:
1) Abdul Hadi requires assistance bathing and showering (because of his surgery). His religion
requires ritualistic cleansing before his prayers, 5 times daily, but he refuses Anna’s help
since she is a woman. Male nurses are generally unavailable.
2) Abdul’s medications cannot contain any pork products, alcohol, or gelatin.
3) The food and drink he consumes is also restricted by his dietary laws, and the hospital
cafeteria is not set up to meet his needs.
4) Mr. Hadi is frequently visited by many relatives, and this is disruptive to nearby patients.
5) Abdul Hadi also needs the space and privacy to say his required prayers, and needs a nurse’s
assistance to get out of bed for this; sometimes Anna is attending to other patients when he
needs her for this.
Key Issues and Analysis
From the perspective of cultural intelligence, there are possible underlying issues that manifest
themselves as the conflicts described above.
There are multiple levels of culture that may be involved. While Abdul’s nationality may not
have a direct influence on his cultural practices and beliefs, the fact that he is Muslim most certainly does.
There are Muslims all over the world, so the specific region of the world that he and his family come
from may affect the specific traditions he holds dear. Abdul Hadi’s individual experiences with healthcare
and women may also affect his own perceptions and preconceived notions about the current situation.
Abdul’s cultural background and the services provided by the hospital are clearly unaligned.
In this specific situation his nurse, Anna, although desiring to provide the best care possible,
simply doesn’t have the necessary knowledge (cognition) of what her patient’s needs really are. She is
also not equipped with the metacognitive skills to know how to ask the right questions in order to gain
that missing knowledge.
Recommendations
In a quote attributed to Edward de Bono “Unless you know everything, what you need is
thinking” (Earley & Peterson, 2004, p. 102). Since Anna the nurse cannot be expected to know what
Abdul Hadi’s specific needs are, she must be taught the metacognitive skills to gain that knowledge. With
knowledge comes understanding, and this utilizes developing and practicing cultural strategic thinking.
Anna’s first step, with the help of her supervisor, would be to take inventory of what the
objectives are (providing the best possible care, meeting the needs of her patients), and what she already
knows vs. what she needs to learn. By acknowledging that she has a very firm grasp of what the medical
treatment needs are and in her ability to provide compassionate care, she will boost her own confidence.
By realizing that she needs to be open to learning about what works and what does not work for this
specific patient she will more likely find opportunities to discover these with an open mind.
When Anna intentionally seeks to learn about what she has identified as gaps in her knowledge
and understanding, she can go about gathering this information in many different ways. One fundamental
starting point would be to research the typical needs of Muslims in healthcare settings; much of this is
readily available on the internet. Once she has some basic understandings about how to interact with her
patient, she can ‘restart’ their relationship by apologizing for cultural mistakes she has made and then,
without judgment or assumptions, asking Abdul for specific advice on how to make his experience better
(Attum & Shamoon, 2018). Some of his requests may be able to be accommodated, and for those that are
not, compromises or modifications may be available.
For example, if Abdul Hadi’s dietary restrictions simply cannot be accommodated by the hospital
cafeteria, Anna and her supervisor will need to allow outside food to be brought in by relatives.
According to Hadi’s culture, relatives are obligated to visit their loved ones in the hospital; since Anna’s
obligations extend to all of her patients, every effort should be made to position Abdul Hadi’s room/bed
close to the entrance so that the multiple comings and goings of his relatives disturb other patients less.
By understanding what is important to Abdul Hadi, Anna and the rest of the staff will be better
able to come up with modifications and negotiate compromises. In the Islamic faith, a priority is placed
on taking care of one’s health (Attum & Shamoon, 2018). With this in mind, by framing specific
treatments or medically-necessary restrictions as crucial to his health and recovery, the patient is more
likely to agree to negotiated treatments and restrictions.
Conclusions
According to the Pew Research Center, the global Muslim population is expected to skyrocket by
70% between the years 2015 and 2060 (Lipka & Hackett, 2017). By using cultural strategic thinking, not
only will Anna be better able to serve this patient, but the hospital as a whole can raise its cultural
sensitivity and be more capable of providing superior care to this growing segment of the population.
References
Attum, B., & Shamoon, Z. (2018, May 13). Cultural Competence in the Care of Muslim Patients
and their Families. National Center for Biotechnology Information. Retrieved Sep 18,
2018, from https://www.ncbi.nlm.nih.gov/books/NBK499933/
Cultural Intelligence for Leaders. (2012). Saylor Academy. Creative Commons by-nc-sa 3.0.
Retrieved Sep 6, 2018, from https://saylordotorg.github.io/text_leading-with-culturalintelligence/
index.html
Earley, P., & Peterson, R. (2004). The Elusive Cultural Chameleon: Cultural Intelligence as a
New Approach to Intercultural Training for the Global Manager. Academy of
Management Learning and Education, 3(1), pp. 100–115. Retrieved Sep 13, 2018, from
https://my.uopeople.edu/pluginfile.php/325635/mod_book/chapter/166065/BUS5211Unit
02RA.pdf
Lipka, M., & Hackett, C. (2017, Apr 6). Why Muslims are the world’s fastest-growing religious
group. FacTank - News in the Numbers. Retrieved Sep 19, 2018, from
http://www.pewresearch.org/fact-tank/2017/04/06/why-muslims-are-the-worlds-fastestgrowing-
religious-group/
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