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It is often found that aboriginal and Torres Strait Islander people face various problems since their past such as homelessness, no education, no employment, no health literacy, racism, and discrimination (Stanford, Charlton & McMahon et al., 2019). All these factors resulted in their poor health and health inequities due to reduced access and distribution of the services to the community people due to cultural differences. With time, various policies, standards, and programs that helped in management and working with the individuals of this community (Sivertsen, Harrington & Hamiduzzaman et al., 2019; Stanford et al., 2019). These factors have helped the care or service providers to ensure safe, cultural, and respectful deliverables to the community people. With the use of policies and standards the quality of care, accessibility to resources, strong care providers, and aboriginal patient relationships will develop. In this essay, the following section will discuss the policy and professional standards that need to consider while working with such community people, historical, social and political contexts to the professional standards with reflection and policies, and the changes in practice through this learning and the experiences of the aboriginals on Australia.
The aboriginals have faced various discrimination issues and inequities for resources, therefore, some policies and professionals standards are framed for equal access and culturally safe care or services to them. According to the Australian Commission on Safety and Quality in Health Care (2017), standard 2 of National Safety and Quality Health Service Standards (NSQHS) states that there should be partnering with the consumers. The health care organizations and social workers should ensure that there is effective partnering with the aboriginals and Torres Strait Islander communities so that they get access to the resources and their major needs or concerns are met. Standard 1 for clinical governance states that the governing bodies should ensure that the organization’s or the institute’s priorities are enabling the individuals of the target communities to address the specific needs. The health services should monitor and implement the strategies that make sure that the safety and respect of the communities. The cultural competence and cultural awareness of the workforce of the health care organizations and the associated social workers should be improved so that safe and culturally respectful care is ensured (Australian Commission on Safety and Quality in Health Care, 2020). Such professional standards not only create a safe and welcoming environment for the community patients but also makes them feel safe to express their feelings and have a healthy interaction so that their needs are met. Moreover, it is the duty of the organizational workforce to ensure that standards and policies are maintained because if any discrepancy or unprofessionalism is found then strict actions has to be taken against the violator.
Various policies are also been framed that help in working with the aboriginals and Torres Strait Islander community patients. According to the NSW Government (2013), the policies and various objectives of a government strategy, Closing the Gap, ensures that the issues such as mortality gap, mental health, life expectancy, and various other targets are achieved for the aboriginal individuals. The policy aims at reducing the hospitalizations rates so that medical costs are reduced, reducing the causes of overweight, obesity, building trust among patients, target patient satisfaction, and strengthen the workforce for monitoring and accountability for the community patients (NSW Government, 2013). The NSW Aboriginal health plan policy ensures that the health promotion of the target community helps in meeting the concerns of the aboriginal patients. the aboriginals cultural security policy ensures that the strengthens the access of the services and care to the aboriginals to deliver culturally successful services, to ensure high-quality care, equal and fair care, safe and ethnic care services. This policy ensures that the organization should take action, research, plan, and implement the strategies that address the cultural security of the aboriginals and Torres Strait Islander community patients (Northern Territory Government of Australia, 2020).
According to Goodman, Fleming & Markwick et al. (2017) & Wilson, Kelly & Jones et al. (2020), the aboriginals and Torres Strait islanders faced various issues since their histories such as they never got equal access and distribution of resources, fair services, poisoned flour, high diseased conditions, poor transportation to their regions, no housing services, no employment or health services, no education, and many others. They faced severe racism, discrimination, and oppression problems that badly impacted their development and health. The legislations also never focused on their betterment but instead led to their There was the loss of language, culture, security, cessation of cultural practices, family dispersion, and cultural genocide. However, with time the implementation of various policies and professionals standards ensure the elimination of their problems. With the implementation of the target community, people get various support and advantages such as the health care workforce, the associated social workers and administrative departments get more aware of the community's needs and feelings (Dudgeon, Wright & Paradies et al., 2010). The people get care services in their rural and remote areas as per their economic status, thereby ensuring their socio-economic status while delivering the services. The government has also put various efforts with health care organizations to reduce the disparities faced by the aboriginals by making aboriginal patient-centered policies and professional standards, the health staff is delivering care by encouraging the society and aboriginal patients for their rights.
I felt that it is helpful for a nurse as well to follow the professional standards and work as per the policies so that professionals’ development is ensured and the patient feels safe and secure with the services. The patients should be asked about his/her history so that the plan is economically safe for him/her. They should be involved in the care and educated about their rights so that patient-centered services are delivered. I ensure that communication with aboriginal patients is effective and in an appropriate manner. Their doubts are acknowledged and they are referred to specialists when needed to ensure their health safety. In my practice, I ensure that their feedback is taken so that I can explore more about their needs of care or other concerns to ensure a safe and healthy environment for them. I realized that such individuals should never be judged for their history and fair care should be delivered to them with full respect. I felt that these policies and professional standards ensure access to the services and cost-effective services to the islanders so that they can get easy access without discrimination, racism, and inequities. The effective and frequent monitoring of the patient’s needs and actions to address them ensures that with time the actions have resulted in successful care that respects the ethics and culture of the aboriginal people. In my practice, I also found that the implementation of the policies for the economically poor islanders ensures either free service for the homeless or less costly services for the poor. This resulted in a reduction of the health gaps, disparities, builds trust, and improved health outcomes because the aboriginal people openly express their concerns to get treated fairly and equally.
From this course, a lot about the experiences of the aboriginals in Australia have been learned that helped me to change a few things in my practice. Once, when I was working with the social workers for health promotion of aboriginals in rural and remote regions of Australia, I found that the people were satisfied with the new policies as they were more satisfied with the attitude and high quality continued care services delivered in the hospitals. The people were more aware of the aboriginals services stared by the government and I evaluated that they faced reduced health issues with increased health services in their regions such as health centers or better transport to reach health organizations in the cities. As it was found that these individuals have faced discrimination due to their cultural differences, therefore, I will ensure that in the future that the patient and their family members are actively involved in the services, their views are explored, decisions are respected; so that patient-centered care plan can be delivered that is culturally safe. I will ensure that a strong relationship is developed with my aboriginals and Torres Strait Islander patients so they no more face problems of discrimination. I will encourage my colleges for culturally safe and respectful services for the community people and make sure that the wishes and demands are met for safety concerns. The aboriginals have faced a lot in their history either by the political factors or by the society so now it is the time to deliver them their rights (Zhao, Russell & Guthridge et al., 2017).
I will ensure that I effectively communicate with the community people and make eye-to-eye contacts. I will collaborate more with the social workers for the health promotion of such community people and encourage society to ensure equal and fair treatment with such individuals. If a care provider will act as an educator, trainer, and advocator for the rights of the community people then safe, respectful, and cultural care will be delivered (Durey, McEvoy & Swift-Otero et al., 2016). It should be ensured that if the workplace requires any changes in the policies for the improved care of the aboriginals and Torres Strait Islander community people then the authorities should be immediately informed for the same such as the implementation of e-modes of services so that the rural or remotes aboriginals do not have to spend extra money on traveling and can have access and communicate with respective doctors through online modes. Society is less aware so I will ensure that with the use of simple and language diverse postures or brochures should be used by the service providers to ensure that information transfer is maintained for awareness. It is also found that such community individuals are less educated about health factors so they should be informed about their health disease, signs, symptoms, and self-management approaches so that the chances of occurrences of the disease are reduced to some extent.
It is concluded that while working with aboriginals and Torres Strait islanders few of the policies and professionals standards needs to be ensured such as the NSQHS standard 1 and 2 with policies that ensure that a safe, respectful and culturally safe care is delivered. These efforts ensure that the workforce maintains a safe environment for the target community people and the gap of discrimination and racism is reduced. It is found that these community people have faced restrictions to access to services, poverty, less education due to which they faced various health issues. However, with the implementation of such standards and policies that care providers ask for feedback, needs, and wish if the patients explore their culture and concerns so that a patient-centered plan can be prepared. The practice professionals should ensure effective communication, the involvement of the patient for trust-building, and increased security concerns for equal and fair care. The professionals should work within the standards and policies for safety and culturally respectful care of the aboriginal and Torres Strait islanders. As these communities are poor and faced various oppressions in the past so they should be informed and educated about their rights and the health care professionals with social workers should work collaboratively for cost-effective services.
Australian Commission on Safety and Quality in Health Care. (2017). National safety and quality health service standards user guide for aboriginal and Torres Strait Islander health. Retrieved from: https://www.safetyandquality.gov.au/sites/default/files/migrated/National-Safety-and-Quality-Health-Service-Standards-User-Guide-for-Aboriginal-and-Torres-Strait-Islander-Health.pdf
Australian Commission on Safety and Quality in Health Care. (2020). National safety and quality health service (NSQHS) standards. Retrieved from: https://www.safetyandquality.gov.au/standards/nsqhs-standards
Dudgeon, P., Wright, M., Paradies, Y., Garvey, D., & Walker, I. (2010). The social, cultural and historical context of Aboriginal and Torres Strait Islander Australians. Retrieved from: https://www.researchgate.net/publication/306228426_The_social_cultural_and_historical_context_of_Aboriginal_and_Torres_Strait_Islander_Australians/citation/download
Durey, A., McEvoy, S., Swift-Otero, V., Taylor, K., Katzenellenbogen, J., & Bessarab, D. (2016). Improving healthcare for Aboriginal Australians through effective engagement between community and health services. BMC Health Services Research, 16(1), 224.DOI: 10.1186/s12913-016-1497-0
Goodman, A., Fleming, K., Markwick, N., Morrison, T., Lagimodiere, L., Kerr, T., & Society, W. A. H. R. (2017). “They treated me like crap and I know it was because I was Native”: The healthcare experiences of Aboriginal peoples living in Vancouver's inner city. Social Science & Medicine, 178, 87-94.DOI: 10.1016/j.socscimed.2017.01.053
Northern Territory Government of Australia. (2020). Aboriginal and Torres Strait Islander health. Retrieved from: https://health.nt.gov.au/professionals/aboriginal-and-torres-strait-islander-health/aboriginal-health-policy#:~:text=The%20Aboriginal%20Cultural%20Security%20Policy,in%20delivering%20successful%20health%20outcomes
NSW Government. (2013). NSW aboriginal health plan 2013-2023. Retrieved from: https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2012_066.pdf
Sivertsen, N., Harrington, A., & Hamiduzzaman, M. (2019). Exploring Aboriginal aged care residents’ cultural and spiritual needs in South Australia. BMC Health Services Research, 19(1), 477. DOI: 10.1186/s12913-019-4322-8
Stanford, J., Charlton, K., McMahon, A. T., & Winch, S. (2019). Better cardiac care: Health professional’s perspectives of the barriers and enablers of health communication and education with patients of Aboriginal and Torres Strait Islander descent. BMC Health Services Research, 19(1), 106. DOI: 10.1186/s12913-019-3917-4
Wilson, A. M., Kelly, J., Jones, M., O’Donnell, K., Wilson, S., Tonkin, E., & Magarey, A. (2020). Working together in Aboriginal health: A framework to guide health professional practice. BMC Health Services Research, 20(1), 1-11. DOI: 10.1186/s12913-020-05462-5
Zhao, Y., Russell, D. J., Guthridge, S., Ramjan, M., Jones, M. P., Humphreys, J. S., & Wakerman, J. (2017). Long-term trends in supply and sustainability of the health workforce in remote Aboriginal communities in the Northern Territory of Australia. BMC Health Services Research, 17(1), 1-10. DOI: 10.1186/s12913-017-2803-1
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