Nursing Considerations

"In sha Allah- God willing"

Saudi Arabians have a very positive view about illness. For them it is a test of one's endurance, perseverance, or capacity to bear. When someone is sick, he or she responds with humbleness and acceptance. Health and wellness are all from God therefore, every process of life starting from conception/pregnancy is out of their control.

    There is no certain age that a women should start bearing children. It can happen as soon as they get their first menstruation.

Cultural considerations in Saudi Arabian health care approaches

•  Male and female interaction is limited to family units only. It is inappropriate to make a casual greeting with a non-family.
• Separation of male and female is observed among the adolescent and adult wards.
• A handshake is not generally accepted between non-related male and female in the Islamic norms. So do not be offended when a patient refuses.
•  Patient prefer to have physicians of the same sex. Therefore as a nurse you may sometime be required to act as mediator between a patient and an opposite sex doctor.
• Staring or admiring the opposite sex is a equivalent to adultery.

Here are some more things to consider with a Saudi patient...

• Don’t offer alcoholic drinks to an Arab, unless you’re certain that he drinks alcohol. This can cause great offence.
• Don’t walk on a prayer mat or in front of any person at prayer and try not to stare at people who are praying.
• Avoid blasphemy, particularly in the presence of Muslims.
• Avoid putting an Arab in a position where he might suffer a ‘loss of face’ in front of other Arabs. He will appreciate this, if he notices your action.
• Don’t beckon to people with a finger, as this is considered particularly impolite. Arabs might use such a gesture to summon a dog.
• Avoid shouting and displays of aggression or drunkenness at all times, as such behaviour is rarely tolerated.

Ways of life in Saudi Arabia

       Saudis have a very unique and strict culture. There is a vivid line separating the roles of males and females in the home, community, religious functions, and politics. Saudi Arabia has been considered a male dominating country. As evidenced, no females are allowed to go to the mosques, go to school, handle an independent role, to work, to drive and so on. It is always the male who handles major decision-making.

However, recent stories on the media are telling the world that Saudi Arabia supports their women and that women now have freedom and pretty much equal rights with the men.

      In 2002 the Kingdom's powerful "mutaween" police, the Saudi media has accused them of hindering attempts to save 15 girls who died in the fire on Monday.

Saudi Arabia's religious police stopped schoolgirls from leaving a blazing building because they were not wearing correct Islamic dress, according to Saudi newspapers.

      In a rare criticism of the king

About 800 pupils were inside the school in the holy city of Mecca when the tragedy occurred.

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Health/wellness perceptions and practices, including biological variations and processes of grieving, aging, dying.

•       Arabians believe in the evil eye that brings sadness and bad luck to their home. To ward off bad luck, their babies wear blue beads pinned on their clothes.
• Arabians value health and wellness by building hospitals and hiring foreign health professionals to work in their health facilities. While that is straightforward, an interesting finding states that Arabians are not good messengers of bad news such as death to their family or relatives. 
• Biologically, women tend to age faster as they hold the roles of a mother at a very early age.
•     Muslims bury their dead the same day he or she died. Women are not allowed at the burial site, although sometimes this social expectation is lax for the royalty.

Communicating patterns, verbal, and non-verbal practices.



Verbal 
       The love of talk stems from the rich nomadic oral tradition of
greeting travelers and exchanging information.
       Low literacy rates increase the importance of verbal
communication.
      Arabs love poetry and creative speech.  They are fond of
bestowing flowery blessings and colorful swearing.
     When speaking with Arabs keep in mind that they believe that
words have power.  Arabs shun speaking about unpleasantries
out of fear that negative speech compels negative results.
       Also, they will use euphemisms when discussing the plight of
others.  For instance, say a mutual acquaintance is ill and near
death.  Should you inquire about recent news he will likely
respond, “he is well, but a little tired.”  In an operational
situation check the facts after being briefed by an Arab soldier
because he may be sugar coating a bitter pill.

Written 
       Muslims, particularly Arab Muslims, consider the Arabic
Language holy as the Qur’an is written in Arabic.  The written
word has special meaning to them and is respected by the
literate and the illiterate alike.
       Arabs consider advanced education a remarkable achievement
and greatly respect scholars and learned men and women.
       Avoid using newspapers in “unclean” ways as many Arabic
newspapers usually have some reference to Allah and some
Arabs could be insulted in how the printed name of Allah is
treated.

Gestures and what they mean...

Warning!  Gestures indicating obscenities or insults 

should not be used by non-Arabs.  Arab gestures of this 

type have varying degrees of intensity.  Depending upon 

the circumstances and country, incorrect usage could lead 

to serious offenses and cause diplomatic incidents.   

•  Shake Hands with right hand only and at the beginning and end of any visit. Shake hands longer but less firmly than in the West. Left hand grasps elbow.
•  Close friends or colleagues hug and kiss both cheeks upon greeting.  During the Hajj (pilgrimage), people may kiss only on the shoulders as a gesture of friendship and greeting.
• Touching noses together three times when greeting is a Bedouin gesture of friendship and respect.

• Placing a hand on your heart along with a slight bow is a sign of respect.  This is usually done during greeting. US soldiers should limit physical contact to a handshake.
•  “It’s my Obligation” - The gesture of placing the right hand or its forefinger on the tip of the nose, on the right lower eyelid, on top of the head, on the mustache or beard has the meaning of "it’s in front of me, I see it or it’s on my head to accomplish."  
• ”Come Here” -Right hand out, palm down, with fingers brought toward oneself repeatedly in a clawing motion, is the sign for calling someone to come.
• ”I’m thinking” - Grasping the chin with the thumb side of the right fist is a sign of wisdom or maturity.
• “Slow down” - By holding the fingers in a pear shaped configuration with the tips pointing up at about waist level and moving the hand slightly up and down signals "wait a little bit" or "be careful. " This gesture can be observed extensively when driving in the crowded streets of the Arab cities. In such a locale, it may be accompanied by curses from an anxious taxi driver or a pedestrian trying to cross the street. 
• ”Thank You” - Placing the palm of the right hand on the chest, bowing the head a little and closing one’s eyes connotes "Thank
• "You" (in the name of Allah). 
• “No” – A quick snap of the head upwards with an accompanying click of the tongue connotes: "No", "Unlikely", or "What you say is false."
• “I wish evil upon you” - Biting the right forefinger, which has been placed sideways in the mouth, may be a threat or an expression of regret.  In Western culture the "A-OK" sign is a positive gesture. However in the Arab world, if the gesture is shaken at another person it symbolizes the sign of the evil eye.  An Arab may use the sign in conjunction with verbal curses. 
• ”I wish you harm” -Hitting the right fist into the open palm of the left hand indicates obscenity or contempt.  
• ”You’re lying” - Placing a half closed hand in front of the stomach, and then turning it slightly connotes that the person to whom the gesture is made is a liar. 
• ”I insult you” - Placing the tips of the left fingers and thumb together so that the hand faces right, then placing the tip of the right forefinger directly on the left fingertips indicates an obscenity or insult directed at one’s birth or parentage.   
• ”You are unimportant” - Showing soles while sitting is considered rude. and symbolic of  “you being beneath my feet”.  Sit instead with soles toward or on ground to be polite.  Also maintain eye contact; lack of eye contact strongly conveys “you are unimportant” as well.  

Perceptions of time and its influence on day to day living patterns within the community 

• Time is not regarded as much value by young Saudi females who just graduated from a bachelors program, compared to their western counterparts. 
• They are more relaxed and carefree according to a blogger in the article “Saudi Girls and too much time in their hands.” This can be due to a very easy laid back lifestyle in Saudi Arabia. There are maids that serve them.  In addition, their climate changed their perception of time as no one is seen out working or doing anything during the peak of the day. There are two work shifts: nice A.M. to one P.M. then there is a four hour break. Work resumes from five P.M. to eight P.M.

Family as pivotal influence in the life of the individual, community and larger society

• Family is many things to the Saudis. At a larger picture, it is the family, the dynasty of the Sauds that rules the land since its founding. It is like an institution that grants power to the males and sense of servitude to the females.
• When their children are ready, the parents send them out to start their own. This is the expected role of every family in Arabian society. Lastly, a family is an individual’s blessing or curse. Some families have a good reputation, values and standards in life. This could mean a person’s freedom from the bondage of horrible fate.