I admitted Hiral Jacobs, a twenty-something college student who’d collapsed in her dorm, directly to the ICU from surgery. The OR report said she’d received two units of blood and was still intubated. Given my forty years of ICU nursing, it sounded routine.
“By the way, the patient is Muslim.”
It was just days after the 2017 inauguration and the backlash from the new administration’s travel ban. I didn’t doubt my ability to manage bleeding, hemodynamics, ventilator weaning or pain. My challenge was to make Hiral and her family feel safe, to show respect for their religion, to earn their trust.
I settled Hiral in, then went to the waiting room and brought her family to her bedside. Hiral’s parents both wore the traditional shalwar kameez, loose trousers and a tunic. Her sister, Neha, wore a niqab, covering her whole face except for her eyes. I recognized their shock at seeing a loved one in the ICU, as I gently explained the equipment and our plan of care.
But I felt inadequate regarding the cultural challenge. Neha seemed to be the spokesperson for the family, so I turned to her and said, “Tell me what I need to do with respect to your sister’s religious beliefs.”
Although I could see only Neha’s eyes, I saw relief in them.
Later, after Hiral was extubated, she said little but always added “please” and “thank you” to whatever she did say. I took extreme care regarding her privacy, and, per her request, asked that no male nurses care for her.
I still wasn’t sure she trusted me–until the removal of a drain caused profuse bleeding. I packed and redressed the wound. The dressing soaked through in minutes. I removed it, found a superficial bleeder and applied pressure with a gloved finger.
“I won’t leave you until this is fixed,” I said. While a colleague paged the intensivist, I held my finger on the bleed. She spoke of her studies, of her plan to go into medicine. She spoke of Neha, who was studying law. She said more in the hour we waited for the intensivist than she had in two days. One stitch stopped the bleeding.
When I found Hiral’s family in the waiting room, they were supping on mats on the floor. “It’s okay for you to come back,” I said.
Hiral’s father reached for me and smiled. “Join us.”
His words embraced me. I understood trust.