Amish Cultural Project-Group 1

1. Amish Culture Project
Created by: Ellen Moore, Terry Bozman & Joan Fultz
for Wilmington University

2. SCENARIO:
John, 25 years old, and Rebecca, 23 years old are married and live on the family
farm in Dover, Delaware. They are members of the Old Order Amish Faith. They
have three children: five year old Jacob, three year old Anna, and one year old
Thomas.
Rebecca has given birth at home to a 36 week gestation baby girl which is anoxic
after delivery.
They do not have a vehicle, therefore a neighbor has brought them to the
hospital with the baby.
The baby has been admitted to the NICU and has been placed on a ventilator for
respiratory support.
The baby weighs 7 lbs. 8 oz.
There is no health insurance

3. Nursing Diagnosis
 1) Ineffective health maintenance related to
cultural and religious beliefs as evidenced by lack
of prenatal care, lack of transportation, lack of
health insurance, limited knowledge about
available health care and limited resources.

4. Interventions for culturally competent
care
 Assess social economic status: Financial stressors related to a baby in the
NICU, transportation cost and the expense of medical treatment. (The family
does not have health insurance).
 Assess coping mechanisms. Identify family’s support group. (The family has
three young children that will require supervision and care).
 Assess family’s knowledge deficit. Assess the family’s understanding of the
baby’s disease process. (The baby is in NICU on a ventilator.)
 Assess cultural practices that may be different when caring for the family and
infant.

5. Specific Interventions by the nurse that
could be implemented to provide
culturally competent care
-Discuss resources available to help with the medical expenses and other
expenses accrued while the infant is hospitalized.
-Provide resources for transportation to and from the hospital.
-Initiate a plan of communication between the family and the medical team.
The Amish community does not have modern technology. They do not have
cell phones, email, texting capabilities or land lines.
-Identify possible special needs for the infant once it is discharged from the
hospital. The Old Order Amish Faith group is a known carrier of genetic
defects and disorders. (Sieren, Grow, GoodSmith, Spicer, Deline & Zaho,
2016). Therefore, it is imperative to do as many newborn screenings as
possible because this infant may not receive further modern health care
upon discharge from the hospital.

6. Specific Family/Community Members
included in the plan of care
 Family members that are included in
the plan of care are the Bishops or
leaders (elder men) in the family’s
community.
 Families and neighbors are involved in
caring for the family and property of
the sick patient/family.

7. Evaluation of the plan of care
 Have open lines of communication that are culturally diverse with the Amish
culture; consistently reassessing the family’s knowledge and understanding of
the baby’s disease process and outcomes.
 As the baby progresses, involve the parents and support system in the infant’s
care to assess for accuracy.
 Visit the home to assess for readiness to care for the infant.
 Ask open ended questions while evaluating their understanding. Allow the
community support to elaborate.

8. CONCLUSION:
In Conclusion, I believe the RN should develop a trusting relationship with
the family by understanding Amish norms regarding technology, social
structure, and socioeconomic barriers. As the nurse you must reflect and
acknowledge the difference between your own beliefs and the culture of the
Amish population. In this case the patient is in the NICU so the nurse will
provide updates and education to the family in a respectful way. The nurse
has to understand that technology and medical equipment may not be
familiar to the family. I have taken care of Amish families in the NICU and
they are respectful of nurses and their cultural differences have never stood
in the way of getting the best treatment for their babies. Ellen Moore

9. CONCLUSION:
In order to acknowledge and incorporate this family’s religious beliefs and
cultural differences, it is imperative to request information from the
family. How do they communicate out side of their normal routine? I
would explain to them why it is important for me to seek information
about their culture and explain that I will do everything possible to
respect their beliefs. I would ask open ended questions and give them the
time to elaborate as well as attempt to identify any barriers of
communication. I would invite the family to help take care of the infant
and observe their interactions. Mostly, I would show kindness, compassion
and caring for the complete family and community.
Terry Bozman

10. CONCLUSION:
 In conclusion, I would provide culturally safe care by first identifying the
needs of the Amish family and organizing the appropriate resources such as
translation, social work, and case management. My interactions would help
the family to develop a comfort level and a level of trust. In my role, I will
advocate for the family communicating their needs to support staff. Although
my beliefs and practices may be different, it is my job to respect their
differences. My focus is the patient and family and their beliefs and
practices. I would ensure that I was communicating with the family, in a
respectful manner during this very difficult time. Joan Fultz

11. References
Adams, C.E. & Leverland, M.B. (1986). The effects of religious beliefs on the healthcare practices
of the amish [Abstract]. Nurse Practice, 11(3), 58, 63, 67. abstract retrieved from http:
//www.ncbi.nlm.nib.gov/pubmed/3446212
Ineffective Health Maintenance: Nanda Nursing Diagnosis and Nursing Diagnosis and
Nursing Care Plan. http//dailyrn.com/ineffective-health-maintenance-nursing-diagnosis-care-
plan
Jalil (2017). 5 unconventional amish practices, amish facts, amish America. Daily RN, http://
amishamerica.com/5-unconventional-amish-health-practices/
Sieren, S., Grow, M., GoodSmith, M., Spicer, G., Deline, J., Zhao, Q., … Seroogy, C. (2016).
Cross-sectional survey on newborn screening in Wisconsin Amish and Mennonite
communities. Journal of Community Health, 41, 283-288. doi: http://dx.doi.org.mylibrary.
wilmu.edu/10.1007/s10900-015-0094-1