Working With Muslims
Public Sector Series

NHS & Ambulance
Management Guide

Balancing Infection Control (Bare Below Elbows) with Religious Modesty.
Plus: A critical guide to Muslim End-of-Life care.

🩺 Dress Code & BBE ⚰️ End of Life Care 🏥 Patient Interaction 🍽️ Fasting Clinicians

The Care Conundrum

Healthcare is about intimacy and hygiene. Both of these intersect heavily with Islamic rulings on Awrah (nakedness) and Tahara (purity).

1. Clinical Dress: Bare Below Elbows (BBE)

The Conflict

NHS Policy: "Sleeves must be short (BBE) for hand hygiene."
Islamic Modesty: "Women should cover everything except face and hands."

The Solution (Approved by Dept of Health):

  • Disposable Oversleeves: Muslim staff can wear full sleeves, but must pull them up and wear disposable plastic oversleeves (gauntlets) when touching patients. These are changed between patients.
  • Uniforms: NHS trusts provide longer tunic tops to cover the hips/bum. This is vital for modesty during bending/lifting.

2. End of Life & Rapid Release

For Ambulance and A&E staff, a Muslim death is a critical incident.

  • The Rush: Muslims believe the deceased must be buried as soon as possible (ideally same day). Delay is seen as trapping the soul in distress.
  • The Conflict: The Coroner/Police might need an autopsy.
  • Action:
    • Do not leave the body alone (someone will want to sit with it).
    • Facilitate "Non-Invasive Autopsy (MRI)" if your trust offers it.
    • Issue the MCCD (death certificate) speedilly if cause of death is known. Do not say "It can wait till Monday".

3. Patient Interaction (Gender)

Intimate Care

A female Muslim patient may be extremely distressed by a male nurse performing an ECG (requires chest exposure) or catheterisation.

  • Capacity: If they have capacity, they can refuse care.
  • The Fix: Always offer a female chaperone. If none is available, explain clearly: "I need to do this to check your heart. I will keep you covered as much as possible."

Male Staff & Female Patients

Muslim male nurses/doctors should practice "defensive modesty". - Do not be alone in a room with a female patient with the door shut (Khalwah). - Leave the door ajar or take a chaperone. This protects you from allegations and respects her comfort.

4. Fasting Clinicians

Surgeons and Paramedics fasting in summer face unique risks.

  • Surgeons: Standing for 6 hours under hot theatre lights.
    Advice: Schedule complex lists for the morning. If they feel faint, they must break fast (Patient Safety First).
  • Paramedics: Carrying patients down stairs.
    Advice: If it is a "Major Incident", the Fatwa for active duty soldiers applies. They can eat.