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Table of Contents
Personal Interactions with Patients.
Advocacy for Health Service Delivery..
This essay highlights the health inequalities faced by the indigenous community – the Aboriginal community and the Torres Strait Islanders – are a major concern and how through ensuring cultural safety, self-determination and collaboration, their healthcare can be improved upon. The indigenous communities have been facing a health crisis due to various social determinants such as inaccessibility to basic healthcare amenities and infrastructure, lack of awareness, low income and racism. Their idea of healthcare is different from those of non-indigenous backgrounds and there exists a lack of understanding and barrier in communication. There exists a growing need to support and help the indigenous individual’s access traditional healthcare facilities (Auger, Howell and Gomes 2016, p. 393-398). This essay reflects on the reasons behind the poor quality of indigenous healthcare and how can we as healthcare practitioners help bridge this gap and provide them with quality healthcare that aligns with their cultural beliefs.
Cultural safety in healthcare involves the empowerment of both, the patient as well as the healthcare professional (Richardson and Williams 2007, p. 699). The healthcare practitioner must acknowledge the fact that imposition of their own cultural beliefs may harm the patient, placing them at a disadvantage. This understanding is fundamental to the delivery of cultural self-care. Self-determination in healthcare means that it is up to the patient to decide whether or not to accept the treatment or care suggested by the healthcare practitioner (Lindberg, Johansson and Brostrom 2019, p. 161-167). Finally, collaboration implies the working together of the healthcare professionals with the patient in the process of sharing responsibilities, problem-solving and making decisions involving formulating and carrying out plans for patient care. Cultural safety, self-determination and collaboration, to a certain degree, affect the interaction between professionals and patients and their caregivers. To understand how we must first try to understand how they view the concept of health. The Aboriginal community have a different approach to health as compared to the individuals coming from non-indigenous backgrounds. Their concept of health is not just the mere absence of illness, but it involves social, emotional and cultural aspects as well, making it a more holistic approach. Their ideas surrounding wellbeing takes into consideration the feeling of connectedness they experience towards their community and aspects of spirituality. The humanistic elements are given as much weightage as the medical ones, if not more. Thus, the margining of both these aspects would benefit them immensely. Understanding their perspective on health would make them feel safe and validated when they come of medical assistance. Adhering to their socio-cultural norms while working with them is essential (Stoner et al. 2015, p. 68-70).
When I am assigned a patient from the Aboriginal community, I need to educate myself about their culture and belief system surrounding health and medicine. Once I am familiar, I need to ensure that my own beliefs and ideas are not forced upon them because upon doing so, they would feel uncomfortable and be at a disadvantage. I need to ensure that there are no barriers in communication between me and them and they can tell me what is it that they require to feel comfortable as well as safe. Active engagement with the community is a key factor in improving health services, as it fosters a sense of accountability, transparency and trust, resulting in better healthcare (Durey et al. 2016, p. 224). Their demands may be unconventional and deviate from the norms but it is important to understand that they are culturally different and that does not have to be a bad thing or put them at a disadvantage as compared to others. As a healthcare professional, I must step up and do everything in my power to make sure that their cultural beliefs are safeguarded to the best of my abilities and that they do not miss out on quality healthcare just because of their affiliation to a particular community.
As a healthcare professional, I understand the growing concern revolving around disparities in healthcare. The gap in healthcare coupled with discriminatory practices is a tool that oppresses minorities and is contributing to their poor health conditions. If healthcare professionals and other volunteers, from indigenous as well as non-indigenous communities, come together, such disparities will cease to exist. As healthcare professionals, we have a responsibility towards society and the people, irrespective of their background, race, ethnicity, religion or gender. The need to understand how is the system failing those from the Aboriginal community or the Torres Strait Islanders and rectifying these problems is the need of the hour. Improving cultural understanding within the healthcare system is an area which should be focused on. Strategies to ensure that cultural knowledge is integrated into care and support programs for the Aborigines and Torres Strait Islanders with a chronic illness is something which could be successful in bringing about much-needed improvements into the system (Aspin et al. 2012, p. 1-9). The current healthcare services are not designed to address the cultural needs of the Aborigines and other indigenous communities. The services they require need to be family/community-focused and culturally safe. Practitioners also must understand that just like someone from a non-indigenous background, they too have the right to decide which treatment plan and healthcare service they would move ahead with or reject if it does not adhere to their beliefs and standards.
Since I am a part of the healthcare sector, there are some steps that I would like to actively initiate to ensure that adequate healthcare services are being provided to the members of the Aboriginal community and the Torres Strait Islanders. One of the strategies I would like to implement is for all medical professionals to undergo cultural sensitivity training. Training for cultural competence, cultural safety, security and transcultural care will help improve awareness, knowledge, skills and help change negative attitudes and thinking patterns. It will also help rectify one's problematic belief system and assist in shifting to more socially and culturally acceptable forms of thoughts, beliefs and behaviour.
There are various campaigns such as the Indigenous Allied Health Australia and the Australian Indigenous Doctors Association which strive towards creating a safe space for individuals from the indigenous communities by spreading awareness on the importance of bridging the gap and putting an end to discriminatory practices in the healthcare system. I would actively participate in such campaigns not just to educate myself but to use the knowledge and insights I have gathered here to spread awareness among my peers as well as gather support to change healthcare policies, making them safer and more appropriate for the indigenous patients. Healthcare practitioners need to be aware of the differences in culture and adopt more inclusive measures to make culturally appropriate healthcare more accessible to the members of the indigenous communities.
Another measure which I would like to initiate is to conduct workshops and excursions. This will help address issues about ignorance related to these communities. As mentioned above, to change our attitudes, we must first understand how their concept of health is different from the conventional beliefs surrounding health and healthcare.
With the changing times, our policies as well as attitudes must change. A collaborative effort is required to safeguard the cultural beliefs of the indigenous communities in the healthcare sector. Healthcare professions must acknowledge the differences in health concepts and beliefs of the indigenous individuals and must take the necessary steps to not impose their own beliefs on such communities. Just like anyone else, they too have the right to accept and reject medical treatments based on their personal beliefs. To spread awareness regarding the same, I would like to conduct workshops, take part in campaigns to educate myself as well as my peers, gather enough support to bring about changes in policies and implement cultural sensitivity training. To promote a culturally safe environment, integrating their beliefs with contemporary practices is required. Changes in perspectives as well as attitudes should be initiated to improve healthcare services for the indigenous folk.
Aspin, C., Brown, N., Jowsey, T., Yen, L. and Leeder, S., 2012. Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study. BMC Health Services Research, 12(1), pp.1-9.
Auger, M., Howell, T. and Gomes, T., 2016. Moving toward holistic wellness, empowerment and self-determination for Indigenous peoples in Canada: Can traditional Indigenous health care practices increase ownership over health and health care decisions?. Canadian Journal of Public Health, 107(4-5), pp.e393-e398.
Durey, A., McEvoy, S., Swift-Otero, V., Taylor, K., Katzenellenbogen, J. and Bessarab, D., 2016. Improving healthcare for Aboriginal Australians through effective engagement between community and health services. BMC Health Services Research, 16(1), p.224.
Lindberg, J., Johansson, M. and Broström, L., 2018. Temporising and respect for patient self-determination. Journal of Medical Ethics, 45(3), pp.161-167.
Richardson, S. and Williams, T., 2007. Why is cultural safety essential in health care. Med. & L, 26, p.699.
Stoner, L., Page, R., Matheson, A., Tarrant, M., Stoner, K., Rubin, D. and Perry, L., 2015. The indigenous health gap: raising awareness and changing attitudes. Perspectives in Public Health, 135(2), pp.68-70.
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