• Internal Code :
  • Subject Code : NCS6100
  • University : Edith Cowan University
  • Subject Name : Nursing

Table of Contents

Introduction

Study Rationale

Findings from patient journey

Role of RN

Analysis of social and clinical yarn

Management yarn

Conclusion

References

Introduction

Getting proper health care is one of the basic and primary necessities for every human. However, when it comes for aboriginal patients there are several things to consider. How to supply good health care facilities to indigenous people is in the focus of this report. Primary health care encompasses general physicians, aboriginal and Torres Strait Islander health workers and assistants, nurses, associated health professionals, obstetricians, pharmacologists and dental surgeons. Treating indigenous patients is very much a different issue from treating urban people. The aboriginal people, with the Torres Strait Islander, are culturally and ethnically distinct. As they live in mostly hostile and in terrible condition so they face many challenges to live, both physically and mentally. Therefore, getting the right treatment facility is not always plausible for them. And, giving the health care facility to them can be possible by breaking the barriers which refrain them from these advantages.

Study Rationale

The Australian health system is responsible for providing good healthcare to the citizens and taking care of the necessities and requirements of the Aboriginal people. They are obliged by the law to respond to the needs of indigenous people as stated by the South Australian Health Care Act of 2008. The Aboriginals and Torres Strait Islanders have a specific heritage and cultural distinction which the health care system should recognize and support. For this purpose, the Department of health has established the Cultural Respect Framework for Aboriginal and Torres Strait Islander Health (2004-2009). The fact that quality of health care services for Aboriginals and Torres Strait Islanders are not up to the mark is acknowledged by this framework.

There is a need for improvement of healthcare facilities for these people and the framework focuses on the same. The aim of this study is to discuss the experiences of the Aboriginals and Torres Strait Islander people of Australia with respect to health care services. The study also focuses on exploring the complexities that occur in health care service delivery to indigenous patients. The entire scope of this study is to discover the journey of Aboriginal and Torres Strait Islander people with respect to healthcare in Australia (Chapman et al., 2014).

Findings from Patient Journey

After a detailed study of the complexities faced in health care service delivery with respect to Aboriginal people and Torres Strait Islanders, we can find that:

The protocols and strategies that have been endorsed for dealing with Aboriginal patients are often not implemented systematically (Kelly et al., 2018). The rate of health issues and illnesses among Aboriginals is also high which increases the burden on the healthcare system. Further barriers to access expedites health problems among these people. Also, identification and recording of Aboriginality data is not adequate in clinics and hospitals. Lack of reliable information in health care facilities causes obstacles in monitoring Aboriginal health care. Improvement is required in this regard. Rigidities and gaps in the Australian health care is also likely to affect indigenous patients more (Wylie & McConkey, 2019). Interaction and communication are a major barrier for Aboriginal patients. Past cases of complexities and failure lead to obstacles in rapport building and less trust ability among Aboriginals.

Similar to gaps in healthcare, lack of coordination among healthcare staff and lack of adequate support systems will also affect these patients more. If we sum up all the flaws in the Australian healthcare it seems that the rigidities and complexities for indigenous patients are more. Most Aboriginal patients require tailored responses to complexity. There are several principles and guidelines for treatment of indigenous patients in the Australian healthcare system however when it comes to operation and monitoring support systems are not adequate to deal with complex patient journeys.

Role of RN

Maintaining a balanced health status in aboriginals and Torres Strait Islanders is a global concern. Current mortality and hospitalization data indicates that their health status is falling below that of other ethnic clans within their countries. Nursing and registered nurses have a significant role in improving their access to health services and emergency care. Nurses can use some strategies while communicating and working with aboriginals. Both nurses and midwives have a major part in ameliorating the health status of aboriginal people.

Regular screening for infectious disease, identifying nutritional deficiency, guiding pregnant women- these can be done successfully by RN by following proper guidelines made by general practitioners in these places as aboriginal patients don’t get access to care in city hospitals. As chronic and rare disease sufferers are high in number within their community due to lack of correct diagnosis and treatment so identifying these patients is a problem (Rashidi, Higgs, & Carruthers, 2019). To overcome this clinical data collection is necessary. For this good relation, rapport and respect to aboriginal ritual and cultural beliefs are necessary. In many rural and remote areas of Australia, nurses are providing a large proportion of their primary and regular healthcare i.e. more than 80 percent (Muirhead & Birks, 2020). Infant mortality is another concern among these sects, mainly due to lack of knowledge and skills.

Here, nurses can play a key role to perform in these communities to improve health status by guiding mothers with much sensibility. So nurses have to remember they have to manage both sides- they need to ensure timely treatment as much as possible and the interaction with the patient is mandatory. They don’t have sufficient financial resources to spend on the cost of transport, treatment and admission to the hospital (Muirhead & Birks, 2020). Simultaneously, most of them are living on natural resources only so they don’t want to go to the hospital. Nurses in this case can do immense help as they can provide primary care to them without going to hospital if so trained properly. Diagnostic tests, modern medicine will not be so helpful if the communication cannot be done with these communities (Spurling, Felton-Busch & Larkins, 2018).

Analysis of Social and Clinical Yarn

In case of providing the best possible treatment to the aboriginals, breaking the barriers is a must. Here, making the proper relation between the indigenous people and health care workers is the major issue. Firstly, cultural barriers do not help them, and contribute to inequity in healthcare service provisions for indigenous Australians. Most of them use their aboriginal language so this creates problems for health workers to understand the health complaints of them. Cultural barriers are vital factors here (Smith, Fatima & Knight, 2017). It is important to understand their lifestyle to treat and advise them. Involving indigenous people in their treatment and carefully listening to their needs and problems is required for success.

Secondly, they live in outskirts of the town and mostly in remote places so they cannot reach to the health centre even to the nearest due to huge distance and can’t get very essential medicines too. So it is important for health care workers to reach those remote areas and provide health care facilities. It was found that chronic kidney diseases, certain types of cancers, some infectious diseases, and cardiac problems are common in aboriginal people. Here are some complications, because health care practitioners need to make them understand what to maintain to control their health problem so it must be done in an easy way as much as possible. Dementia in Australia’s aboriginals and Torres Strait Islander older population is a field of significant health and community concern.

In this area, a caregiving system from a family-member should be encouraged. Aboriginal people encounter bad health and below par life expectancy than the urban community (Jennings, Bond & Hill, 2018). Assuring culturally-sensitized care for them is important to upgrade better healthcare provision as aboriginal people are generally very sensitive to their culture, ritual, ethnicity and language. It should be given importance in the urgent section also, which is the pivotal point of access to health care for many native people. Finding accurate information and identification should be done to improve health care services in remote areas. Serving prenatal, post-natal and ensuring regular health check-up- these are basic requirements, not only this, supplying essential food supplements and medicine are paramount (Lin,Green & Bessarab, 2016).

Management Yarn

On the basis of the findings from this study we feel that certain measures should be undertaken in healthcare in order to bring improvements in the health of Aboriginal patients. A process mapping becomes essential for filling the gaps in the healthcare system so that the specific bottlenecks and constraints that cause hindrance in the system can be identified and resolved. Process maps are effective methods of waste and error management in health care. It is a useful diagnostic tool for finding out underlying errors and solving them. This is mostly a statistical tool that takes into account total number of people, total number of steps and the total time taken ("ABSTRACTS FROM THE FORUM ON ADVANCES IN HEALTHCARE MANAGEMENT RESEARCH", 2019). This is much important from the patient perspective. The first stage in the process map involves understanding the patient’s issues and then examining the process map to remove unnecessary in between steps so that the issue can be solved faster.

Problems in Aboriginal Patient Management

There are huge complications and problems in Aboriginal patient management such as: complexities in patient journeys, cultural differences and interaction problems, differential treatment, racism, high rate of vulnerability, absence of adequate information, accessibility and transportation and greater susceptibility to operational and management errors in healthcare (Smith, Fatima & Knight, 2017)

Necessary Measures to Be Undertaken

There is a differential approach keeping in mind the complexity in Aboriginal healthcare. Recruiting staff experienced over a long period of time in Aboriginal healthcare in clinical units. In order to improve accessibility, there needs to be adequate transport facilities and financial help. Also, availability of interpreting services and proper outpatient services is required

Proper roles and protocols for health care staff supported by the local and national authorities could ensure quality and safety in the healthcare of indigenous patients. Well-defined roles for family and community members and their support and cooperation is also important in this regard.

Cultural priorities of indigenous people need to be taken into consideration by healthcare workers (Macniven et al., 2019). Arranging visual cues and community guidelines for the Aboriginal people is also needed. Finally, Non- Aboriginal healthcare staff can also develop required skills for Aboriginal healthcare. Communal integrity and respect towards cultural differences can go a long way in improving the healthcare system of indigenous people.

Conclusion

Aboriginal patient’s healthcare journey is very complex and struggling. A lot of factors are involved here. They have many difficulties in getting the advantages of mainstream health services. Communication with aboriginal patients is difficult because every clan has almost different languages. Distance from city hospitals is another reason for not receiving instant health care service. Providing services to rural and remote people with complex and chronic diseases is very challenging because of cultural differences. Their tendency to avoid screening and giving information about health problems makes their condition worse and damages their health. Registered nurses can play a vital role when it comes to providing the best possible health services to these people. Nurses can maintain regular contact with the patient in order to collect clinical data of patients in Torres Strait Islanders and help them to get in touch with regular treatment for their well-being.

References

ABSTRACTS FROM THE FORUM ON ADVANCES IN HEALTHCARE MANAGEMENT RESEARCH. (2019), 64(6), 447-448. 

Chapman, R., Smith, T., & Martin, C. (2014). Qualitative exploration of the perceived barriers and enablers to Aboriginal and Torres Strait Islander people accessing healthcare through one Victorian Emergency Department. Contemporary Nurse, 4480-4508. 

Jennings, W., Bond, C., & Hill, P. S. (2018). The power of talk and power in talk: a systematic review of Indigenous narratives of culturally safe healthcare communication. Australian Journal of Primary Health, 24(2), 109-115.

Kelly, J., Dwyer, J., Mackean, T., O’Donnell, K., & Willis, E. (2018). Coproducing Aboriginal patient journey mapping tools for improved quality and coordination of care. Australian journal of primary health, 23(6), 536-542.

Lin, I., Green, C., & Bessarab, D. (2016). ‘Yarn with me’: applying clinical yarning to improve clinician–patient communication in Aboriginal health care. Australian Journal of Primary Health, 22(5), 377-382.

Macniven, R., Hunter, K., Lincoln, M., O’Brien, C., Jeffries Jr, T. L., Shein, G., ... & Martin, R. (2019). Accessibility of Primary, Specialist, and Allied Health Services for Aboriginal People Living in Rural and Remote Communities: Protocol for a Mixed-Methods Study. JMIR research protocols, 8(2), e11471.

Muirhead, S., & Birks, M. (2020). Roles of rural and remote registered nurses in Australia: an integrative review. AJAN-The Australian Journal of Advanced Nursing, 37(1).

Rashidi, A., Higgs, P., & Carruthers, S. (2019). Aboriginal people with chronic HCV: The role of community health nurses for improving health-related quality of life. Collegian.

Smith, K., Fatima, Y., & Knight, S. (2017). Are primary healthcare services culturally appropriate for Aboriginal people? Findings from a remote community. Australian journal of primary health, 23(3), 236-242.

Spurling, G., Felton-Busch, C., & Larkins, S. (2018). Aboriginal and Torres Strait Islander health. Australian journal of primary health, 24(5), i-ii.

Wylie, L., & McConkey, S. (2019). Insiders’ insight: discrimination against indigenous peoples through the eyes of health care professionals. Journal of racial and ethnic health disparities, 6(1), 37-45.

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