Amish Culture history final PDF

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Amish Culture history final...

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The Amish culture was created when a group of people fled Germany to escape religious persecution and (mostly) settled in Pennsylvania in the 1700’s, creating their own community. They are a protestant group currently comprised of roughly 200,000 members and are descendents of European Anabaptists that are known for their nineteenth-century style life. The community is the heart of life in this culture and the uniformity of the community is important. For example, a dress serves as a symbol of membership to the culture and community, as it is modest and orderly throughout the community. The Amish speak three languages typically. They use a German dialect of Pennsylvania Dutch to communicate in daily life and it is considered very disrespectful to speak with an Amish person in this language if you are not Amish yourself. At service, High German and English is used to communicate with people outside the Amish culture, as well as in daily life in some communities. The Amish are an isolated community and devote their lives to the service of God. In order to maintain their strict culture they have their own private education system with over 1,200 schools. Reading, writing, arithmetic, and religion are all heavily emphasized subjects in Amish schools that educate students until the age of fourteen. At age fourteen, children are considered fully educated and are expected to begin work in the fields and to be a functioning member in the community. Traditional gender roles are a pertinent part of the culture. The Amish encourage their children and future generations to continue the structure of their patriarchal society. Women are expected to stay home and run the household and raise the children while the men earn the money ("Religions: The Amish", 2009). It is due to these many attributes that Amish culture differs from general “American” culture, and it it is necessary for healthcare professionals to be aware of their patients cultures in order to provide culturally competent care.

Before providing care for patients, it is expected that nurses are able to perform a culture self-assessment. A culture is defined as a series of beliefs, common experiences and ways of being in the world that are shared by groups of people that share a commonality (Andrulis, "Conducting A Culture Competence Self-Assessment"). It is essential to be able to recognize one’s own patterns and biases in order to provide culturally competent health care to others. Making such a reflection involves examining the schedule of day to day life and the views that affect the decisions that are made within daily life. As explained in class, nurses are capable of providing better and more competent care if they understand the aspects of their own culture. One of the first aspects of the Purnell Model of providing culturally competent care is acknowledging assumptions. People’s cultures vary based on nationality, race, color, gender, age, religious affiliation, educational status, marital status, socioeconomic status, occupation, military experience, political beliefs, and residence amongst many other variables. Making a selfassessment of your own culture involves analyzing your own beliefs, ideas, and ways of life and how they are altered by the aspects that your culture. There are many tools available to assist health care professionals in making a cultural self-assessment. Many of the tools available consist of surveys that ask questions about personal values and beliefs. For example, in the Journal of Critical Care Nursing, there is a survey in which you rate how frequently each statement is true, such as, “I feel comfortable when discussing alternative lifestyles with clients.” At the end of the survey, the points are added up based on your response and an, “always” response to the statements results in more points which is correlated with a higher degree of cultural awareness (Flowers, "Culturally Competent Nursing Care", 2004). While the survey is not unbiased because it is filled out by oneself, the statements

are meant to help consider aspects of the way that you think and behave that you may be able to improve cultural competence in and assists in doing so. As a health care provider, there are many aspects of my own culture and typical behaviors that I should be aware of before providing care for patients. For example, I am from an uppermiddle class family in which I have always been able to afford any medical treatment necessary. However, for Amish people, it is prohibited to have any form of insurance such as health insurance that may help with costs of medical treatments. Additionally, cost has been proven to be a major factor in the decision to receive treatment or not in the Amish culture, yet this has never been a question for me. In the home that I was raised in, if I was in any discomfort I was brought straight to the doctors. In the culture that I was raised in, healthcare professionals are seen as people that are trusted who can help with any discomfort or health-related problems. While some people may see this as being overly dependent on doctors, this is the social norm in my society. However, the Amish culture differs in that the doctors are a last resort. For the Amish, the order in which they seek help is first to self-medicate. If this does not work they will seek out the treatment of a chiropractor. However, if this does not work and massage therapy does not work, only then will they seek treatment from a physician upon approval from the church. Additionally, I was raised speaking English and have never been able to master another language. This is in complete contrast to the fact the Amish culture uses several languages to communicate. While it is not the norm in my culture, it is important for providers to be comfortable with patients communicating with families in the language they feel most comfortable with. Additionally, it is important that professionals do not offend them by speaking in their Pennsylvania dutch dialect of German if they are not Amish. There are many aspects of

my culture that differ from the way that the Amish culture operates, and if I am able to acknowledge these differences, I will be able to provide more competent care. Upon assessing one’s own culture, a nurse must evaluate the knowledge that they have about their patient’s culture. It is useful to utilize the self-evaluation questions found in the Purnell Model for this assessment, professionals must analyze which 12 domains of the Purnell model define the knowledge that they already have about their patient’s culture and which they need to obtain more information about. Additionally, they need to consider how they will acquire unbiased and accurate information about their patient’s culture. Finally, they should consider where they feel they lie on the spectrum of conscious and unconscious competent care based on the information they have on their patient’s culture("2016 Diversity Toolkit - Cleveland Clinic). Another great tool to assess and gain knowledge about a patient’s culture is to ask Rankin and Stallings questions during a health assessment. One question that it is recommended to ask is what they believe is the cause of their problem and why they believe it started when it did. In asking a more broad question surrounding their concerns, they may provide answers to the question that the practitioner could not have anticipated. Additionally, asking what the most important results the patient hopes to gain from treatment is important. For example, patients diagnosed with a serious and chronic disease may not desire to be cured if it involves certain treatments and goes against their religion and may simply seek to reduce side effects. The goal of treatment must be clear to both the patient and the professionals, as that determines the choices that are made surrounding treatment. Consulting the patient on what kind of treatment they believe they should receive may be helpful in the cultural assessment as well. This question opens up the conversation about what kinds of treatments that their culture may use that professionals may not be typically accustomed to. For example, Amish people utilize faith

healing frequently and this may be one option of treatment that they would like to pursue that professionals may not have considered had they not asked. Other questions that it is recommended that professionals inquire about are “what are the chief problems your illness has caused for you?” and “what do you fear most about your illness?” ("Doing a Cultural Assessment"). In the Amish culture there are many specific beliefs about healthcare that are important to be aware of as a provider. In Amish communities, the health care practices are passed down by the women of the household. Typical health trends passed down by women involve selfmedications and many herbal treatments. It is important to find out what types of self-medicating and herbal treatments that they may have utilized before seeking medical attention. Healthcare practitioners are only used when absolutely necessary such as in emergency circumstances. Reflexology and massage are also frequent forms of treatment used in Amish communities. If either of these are good forms of treatments for a certain issue, it should definitely be recommended to the family, as this is how they prefer to treat things. Faith healing is a large aspect of their health care practice. Brauche, otherwise known as sympathy curing, laying on of warm hands, and powwowing are common forms of faith healing treatments utilized. Powwowing or Brauche are spiritual rituals that call upon god to help treat ailments. In the perspective of the Amish culture, good health is seen as a gift from God and medicine helps, but god heals. This is why higher medical treatment is not seen as necessary. While this does not change the treatment that Amish people receive, it is important to understand what they believe to be a determining factor in their health. Additionally, understanding their religious beliefs and how they affect their healthcare decisions is helpful because nurses are able to offer support through religious services in many hospitals. It is important to know that preventative care is not

utilized in their culture because they only utilize medical professionals in emergency situations. They do not use prophylaxis treatment such as immunizations or prenatal care typically. They may use herbs like blue cohosh pills to enhance labor, but that is the only intervention they prefer to utilize(Rearick, "Amish Culture and Healthcare")....