When someone's religious perspective is different than my own I try to focus on the positive aspects of the care. It is important for patients to have those things with them that are comfortable and supportive when they are ill or struggling. As long as the care does not harm myself or others I try to be respectful and non judgmental.

I have Native American patients that refuse care until their shaman comes and blesses the treatment. This is difficult when you can see a diabetic struggling with DKA or a child with severe dehydration. I have gotten all the supplies ready and started lines making sure everything was ready.

Then as soon as the shaman entered the room I would ask them to pray over the fluids or medications before they started their medicine dance, that way the medication could be going in while the patient was receiving their prayer/dance. We have had the shaman come in and bless the department so that the Native Americans know that the treatment rooms are sacred and can be used to give care.

I think a weakness I have is when it comes to children as they cannot make their own decisions. Sometimes parents think they are making really good decisions regarding care and in reality it is really poor.

I try and give good patient education making the information more scientific than religion based. I feel that after I have given them all the scientific evidence that I have about the decision they are left with the decision to make but it is hard when you feel like it is the wrong choice. I also have said, "If this was my child I would to do this, but you need to make the decision for what is right for you and your child."

If I was the patient my husband would have the final ethical decision making and interventions for me. We have had extensive conversations about different situations. I feel like him and my father understands my perspective on issues. My children are too young to understand the concepts but as they grow older I feel it is important to have these conversations with them as well.