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Health does not only means being just physically well but, also being socially, emotionally, and culturally well. The Aboriginal and Torres Islander people have been seen to face disparity in every sector be it in terms of health, education, or employment. While focusing on the health sector only it has been reportedly stated that the health sector has now been focusing on enhancing the overall well being of the community (Schultz et al. 2019, p. 488). This reflective essay will be focused on reflecting my understanding regarding the concepts of cultural safety, self-determination, and collaboration as a health care professional as these aspects ensures the overall health of Aboriginal and Torres Islander people. This will entail my interaction with the Aboriginal patients, their family members, and the health workers that belongs to this community. Along with this, the essay will be bifurcated into various sections that will encompass my advocacy for the provision of health care services and advocacy activities that would contribute to ‘closing the gap’.
It was an incidence from my clinical placement where I was working in a multicultural hospital settings where I was allocated with an Aboriginal patient who was 78 years of age. The patient looked very frightened, uncomfortable, and nervous. The patient was not even wanted to get admitted in the hospital but due to a dire emergency, he has to. His son was with him and I asked him first regarding such gestures of the patient as the patient was unresponsive towards me. After having a conversation with the patient’s son I got to know that his behaviour was like this because of his past experience where he faced cultural and linguistic discrimination. I was already working in a multicultural setting since quite a long time so, I knew how to handle the Aboriginal patient in order to ensure that the patient would not face the similar case. I knew that patient’s perspective and cultural values were prejudiced in his past experience. My first approach towards him was to ensure the cultural safety of the patient. While interacting with the patient and his family member I acknowledged the beliefs and values of the patient and his family. In a study presented by Muise (2018, p. 27) it can be understood that to ensure the cultural safety of a patient, cultural awareness is necessary. So, along with cultural awareness; through self-reflection and interprofessional collaboration, I was able to ensure the patient’s cultural safety. Compassionate, empathetic, and acknowledging behaviour towards the patients helped be in calming and ensuring him regarding his health. I also collaborated with Aboriginal health care professionals. Collaborating with them made me self determined regarding my skills towards handling the patient and bought a sense of cultural competency. Cultural competency helped me in effectively understanding and communicating with the patient as it enabled me to build cultural knowledge, cultural awareness, and cultural sensitivity (Hicks, 2018). All these aspects of cultural competency helped me in ensuring the patient’s cultural safety. In this way, my self-determination, collaboration with the Aboriginal health care professionals and patient’s family along with the cultural safety helped me in holistic care and overall wellbeing of the patient.
As a healthcare professional in a multicultural setting, I made myself self-determined regarding ensuring health equity among the Aboriginal people. Aboriginal people face various disparities and find it difficult to access the primary health care services in the say way a non-Aboriginal patient gets without any discrimination. As far as my advocacy regarding the patient to get appropriate un-bias health care services, I took care of the cultural beliefs of the patient. Ensuring cultural safety helped me not only in comforting the patient but also helped me in obtaining the optimal health outcomes of the patient. In order to ensure the overall wellbeing of the other Aboriginal patients that would be admitted to the hospital and would not be allocated to me I further discussed the concern to the higher authorities. By collaborating with the interdisciplinary team that involved both the Aboriginal as well as non- Aboriginal healthcare professionals and social workers we established certain norms in our organization for ensuring the cultural safety of the patients were made. In a study presented by Brooks-Cleator, Phillipps, and Giles (2018, p. 2016) cultural safety in nursing practice is adapted with the goal of making the patients from a different community feel safe. Along with this collaborating with patient irrespective of stigmas regarding his/her community is also an important factor. This means acknowledging the patients’ preferences regarding their care by making them partners in their care process and not just as the recipient of care. In this way, cultural safety, self-determination, and collaboration helped in my advocacy for health service delivery to ensure the holistic care of the Aboriginal patients.
I was able to handle this situation but, it is not necessary that every nurse would be able to do so. My advocacy activity for “closing the gap” included helping and empowering the other staff nurses of our organization to develop knowledge regarding the significance of cultural safety so that they will also be able to ensure the holistic care and overall health of the Aboriginal patients. Organising training sessions regarding cultural safety and how to collaborate with Aboriginal patients will help the staff nurses to develop the understanding regarding the same. This step will contribute to the national action plan by Australian Human Rights Commissions, (2019) i.e., “Closing the gap”. Collaborating with the Aboriginal health care professionals of the hospital organization staff members will be helpful in achieving the goal. The reason behind this is that the Aboriginal health care professionals are proficient in dealing with the Aboriginal patients as they are well aware of the cultural values and beliefs of the Aboriginal people. The cultural barrier has been seen as the most challenging aspect when it comes to communicating with Aboriginal patients. By collaborating with the Aboriginal health care professionals development of cultural understanding will occur and this will help in overcoming the cultural barriers. This will also bring self-reflection among the staff member. Self-reflection will be helpful in bridging the differences that have been faced by Aboriginal patients (Wilson et al. 2016, p. 187).
By reflecting on my own experience while working with the Aboriginal and Torres Islander people in this reflective essay it can be concluded that cultural safety, self-determination, and collaboration with not only the patient but also with the family members and the other Aboriginal health care professionals can result in the provision of holistic care of the Aboriginal patient. This will ensure the overall well-being of Aboriginal patients. It has been seen that the Aboriginal patients have always faced health inequity and by these three concepts i.e, cultural safety, self-determination, and collaboration we would not only ensure the health of the Aboriginal patient but, will also help in contributing in the national health strategy i.e., “closing the gap”.
Australian Human Rights Commission. 2020. Close the gap community guide. Online. Available at https://humanrights.gov.au/our-work/close-gap-community-guide
Brooks-Cleator, L., Phillipps, B., and Giles, A. 2018. Culturally safe health initiatives for indigenous peoples in Canada: A scoping review. Canadian Journal of Nursing Research, vol. 50, no. 4, pp. 202–213. https://doi.org/10.1177/0844562118770334
Hicks, K. A. 2018 ‘Cultural Competence: Facilitating Indigenous Voices Within Health Promotion Competencies’, SAGE Open. doi: 10.1177/2158244018783218.
Muise, G. M. 2019 ‘Enabling cultural safety in Indigenous primary healthcare’, Healthcare Management Forum, vol. 32, no. 1, pp. 25–31. doi: 10.1177/0840470418794204.
Schultz, R., Quinn, S., Wilson, B., Abbott, T., and Cairney, S. 2019. Structural modelling of wellbeing for Indigenous Australians: Importance of mental health. BMC Health Services Research, vol. 19, no. 1, pp. 488. https://doi.org/10.1186/s12913-019-4302-z
Wilson, A. M., Kelly, J., Magarey, A., Jones, M., & Mackean, T. (2016). Working at the interface in Aboriginal and Torres Strait Islander health: focussing on the individual health professional and their organisation as a means to address health equity. International Journal for Equity in Health, vol. 15, no. 1, pp. 187. https://doi.org/10.1186/s12939-016-0476-8
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