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N.J. Hospitals Strive to Fulfill Patients' Cultural Needs

Oct. 21--Some don't drive on Saturdays. Others don't drink ice water. A number won't accept blood transfusions and some need to stop and pray several times a day.

As North Jersey becomes increasingly more diverse, hospitals here are changing everything from the color of the ink in their pens to the food they provide in an effort to cater to patients from different cultures.

Most hospitals now offer prayer rugs for Muslims, seaweed soup for Koreans and Sabbath elevators that are programmed to stop at every floor. For patients who don't show bare skin in public because of religious or cultural beliefs, some will soon be offering hospital gowns that cover the arms and more of a patient's legs.

"Meeting the different needs of our patients is at the very top of our minds," said Jane Ellis, a vice president at Holy Name Medical Center in Teaneck. "All our employees are trained to things that might be offensive as well as indigenous to our patients."

Holy Name is catering to the region's rapidly growing Korean population with a program geared to screen and treat diseases more prevalent in that population, such as hepatitis B, liver disease and breast cancer.

The hospital has 60 Korean physicians and dozens of Korean-speaking staff and volunteers who are familiar with cultural beliefs and help train non-Korean workers. Among the practices the hospital has implemented for Korean patients: Never address patients by their first name because it is disrespectful. Nurses never write a patient's name in red ink because when done in the Korean registrar office it means the patient has died. The number four is not used if it can be avoided because it means death. And ice water, "which can shock the system," is replaced with lukewarm beverages, said Kyung Hee Choi, administrative director of the program.

Those who question whether such niceties help a hospital's bottom line, need only look at what has happened with Holy Name's efforts. "We are continuing to increase our patient admissions and we're the number one hospital for the Korean population," Choi said.

In the mid-1990s, Englewood Hospital and Medical Center started a bloodless surgery center to help care for patients who are Jehovah's Witnesses, who do not believe in blood transfusions.

Only about 4 percent to 5 percent of the residents in the hospital's area are Jehovah's Witnesses, but the medical center now draws Jehovah's Witnesses from the entire state, New York, and Pennsylvania because "we respect their belief that once blood leaves the body it shouldn't be put back in and they know they won't be transfused against their will," said Sherri Ozawa, clinical director of the Institute for Patient Blood Management and Bloodless Surgery at Englewood.

What started as a decision to help a particular group has now become standard surgical procedure, Ozawa said.

"Blood transfusions are now only used when absolutely necessary," Ozawa said. "There are a lot of complications that can arise from transfusions and we found that we have better outcomes when the focus is on stopping the bleeding rather than just transfusing the patient.

"We do transfusions, but a lot less than at other hospitals," she added. "And the way to reduce the number of transfusions is to prepare patients for surgery, for example, making sure they aren't anemic."

The most difficult change for hospitals has also been the most crucial -- striving to overcome the language barrier between staff and the increasingly diverse patients.

"We have 72 languages spoken among patients so we've made a commitment to language interpretation," said Marybeth Levandoski, chairwoman of the cultural diversity team at St. Joseph's Regional Medical Center in Paterson. "We have 60 staff members who have been trained as medical interpreters."

St. Joseph's and the other local hospitals use a translator service that allows patients to pick up a phone at any time and speak in one of 170 languages to a medically-trained interpreter. The two-headset phones allow physician and patient to be on the same line with an interpreter so the patient can fully understand a diagnosis and treatment plan.

"We had one woman who was from Sarajevo [Bosnia and Herzegovina] who was all by herself, terrified and needed cardiac surgery," Levandoski said. "When she got on the phone, the interpreter was from the exact same village as her and made her feel so comfortable that when the patient got off the phone she showed the nurse the tumors she had all over her body from all the radiation there. That would have never happened if she didn't speak to someone who understood her language."

To serve the religious needs of their Jewish patients, Holy Name, The Valley Hospital in Ridgewood and Hackensack University Medical Center erected temporary sukkahs this year in honor of the Jewish holiday, Sukkot.

The tent-like structures were put up in early October to represent the dwellings Jews lived in as they roamed the desert for 40 years.

"We built a sukkah on a terrace on the fourth floor," said Chaplain Mason Jenkins, supervisor of pastoral care at The Valley Hospital in Ridgewood. "We used bamboo for the roof and our engineers put in three doors."

Meanwhile, hospitals have also discovered that the way to keep patients and families comfortable is through their stomachs.

Among the menu offerings at Hackensack that cater to different cultures: Koreans will find fermented cabbage along with seaweed soup, which they believe aids the healing process.

"We have Kosher refrigerators and pantries in the emergency room and in the women and children's building," Hubbell said. "They are locked and the directions for access are in Hebrew."



Copyright 2012 - The Record (Hackensack, N.J.)

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