Jane is a primary school teacher. She has a daughter, who is 4 years old. Her daughter needs immunization. Therefore, Jane has to visit a healthcare unit which is nearby. It is not that easy if a person is belonging to an aboriginal race. The historical background of the aboriginals reveals the dominance of outsiders in their culture. The heredity of these people is enriched with their traditional concepts. Beyond this discrimination, the present-day non-aboriginal dominant governments and culture are trying their best to bridge the gap between these two population (Mackean et al. 2020). The nursing unit, however, is failing to provide a safe culture environment. The researcher will be analyzing the reason that provokes jane to consider Aboriginal Controlled Community Health Services (ACCHS) over Public Health Care (PHC) due to the gene inherited from her grandmother. The researcher, thus, will provide a framework to solve these issues with a sociotechnical model. Besides, the community-based control program such as ACCHS is dedicated to serving the Aboriginal and Torres Strait Islander population.
The data of 2008 and remeasured data of 2014 reassured the hindrance of Aboriginal and Torres Strait Islanders to visit the PHC in Australia. Apart from this, Tremblay et al. (2019), however, mentioned that both these organizations are targeting to improve the health of human therefore, the service offered by them are similar. In contrast to this, Doran, Wrigley and Lewis (2019) further mentioned that the cultural and social behaviour of Aboriginals is different than non-Aboriginal people in Australia. The similarities and dissimilarities are mentioned below.
The primary health care units in Australia are recognized as the best health care units as per the records of WHO. It provides health care education, social education, technology-based treatment, counselling and chronic services to the people. The same services are also available in the aboriginal based care units. As the Aboriginals are always preferring the place, where the service providers are only belonging to their community only. Thus, a special unit has been implemented. The Aboriginal health care units have pharmaceutical that provides preventive medicines and supports rehabilitation. The same can be found in the PHC of Australia. Both these health care units provide postnatal, antenatal, child and maternal care service to provide support at most remote places (Fleming, Creedy & West, 2020). Another similarity can be found in both these organizations, that is, the organization of the seminar and cultural program to point out the environmental health issues. They provide the knowledge-based program to educate people about social and emotional importance in life.
The PHC is open to all service system in Australia. It was predated before the Aboriginals' service care units. As mentioned earlier, the Aboriginals somehow kept themselves aside from the non-Aboriginal people. This psychology prevented them to attend a PHC. Thus, the Aboriginal health care system was developed. The major difference between these two sectors is one target a community and the other (PHC) targets the general people. The treatment process is also different in the Aboriginal care system. For example, ACCH provides cultural safety to the aboriginal. It further diminishes the language barrier (McKenna, 2020). The doctors and nurses belong to their community. Thus, a perfect cultural safe environment helps them to share more information with the medical practitioner. However, the holistic approach is very orthodox in PHC in Australia.
As per the given case study, very little information has been provided. We do not know the cultural prejudices of Jane and so her family. Only the race of her grandmother has been given in this case study. This research, thus, presumes several facts to prove the possibility of Jane's choice.
Ryder et al. (2019) opined that the violent history of racial combat between the aboriginals and Europeans in the nation has created an enormous barrier between these two races. After so many years, even in the 21st century, the aboriginal refuses the language and culture of non-aboriginals. Their education standard is poor for the protection of their prejudices.
Equity to Health Services
People like Jane, who successfully overcame the barrier and became a primary school teacher, are also subjected to discrimination by non-aboriginals. The highly educated and proficient English-speaking people in Australia are accused on many occasions for neglecting an aboriginal. PHC is no longer different than others. As per the report of Sydney Herald, one aboriginal complained about being misbehaved and neglected at a PHC. Even the Public Health Act 2016 bounds the PHC to provide equal service to every individual in Australia regarding their race and language (Taylor & Guerin, 2019). Many nurses, however, complained that serving people beyond the linguistic barrier is always a headache for them. Nowadays, many aboriginal people have trust issues over PHC in Australia.
Cultural safety The researcher has no clue regarding the cultural prejudices of Jane. It is possible that Jane has been brought up by her Grandmother and the idealism followed by her are transferred to Jane and that later is inherited to her 4 years old daughter. If it is, then Jane probably seeking for cultural safety in the PHC. A cultural safe environment is established when the patient will feel safe to share personal beliefs and not getting spoofed.
As per Schill and Caxaj (2019), one of the key challenges for aboriginals is fake blaming. According to the annual crime report, the exaggeration to victimize an aboriginal is very prone in Australia. The officer often presumes an aboriginal involvement in the crime. The situation is similar in the nursing industry. For example, a nurse complained that an aboriginal lady continuously called for help but without a valid reason. The tone of the old lady was rude in fact. The violent historical background of the aboriginals permits others to take advantages. They make fake blame against these people. Therefore, the aboriginals are losing trust in the PHC and opting the services of ACCH.
The racial discrimination, social determinants and code of conducts in health premises are other facts that drive a person to visit a health centre. If Jane has ever been a victim of racial discrimination, then she shall never allow her daughter to feel the same. The social determinants provided in the ACCH are concerned with the aboriginal origin. That is, Jane will always be prone toward the ACCH. Apart from this, it is not that ACCH has a lower medical standard (Lock, 2019). They have technology-based services as in PHC. The doctors are trained and not liable to the government. Therefore, the treatment process is faster in these organizations.
As per the above discussion, it is clear that Jane can consider both ACCH and PHC as her choice. However, if Jane as an educated person successfully overcomes her prejudices and opt for the best health care system (Dudley, 2019). The analysis revealed that the success rate higher in PHC than ACCH. As an educated person Jane is quite aware of her daughter's choice and opt for the PHC. However, the equal possibility is there to choose aboriginal care services as per the recent trend in Australia.
There are several ways and framework to manage the issues associated with cultural safety. The sociotechnical framework, however, is the most essential tool as it perfectly matches the requirements of the Australian healthcare system. This framework has seven different keys. Schill & Caxaj (2019) mentioned that the Australian health system already considered this framework since 2014. The result has been very fruitful until then. Thus, the researcher is focusing on the goal of these organizations based on this framework.
Quantitative and Qualitative Analysis
At first, the health system should identify their present status. For example, the ACCH surveys on an annual basis since 2014. The response of the patient after treatment is recorded. The similar system is also available at the PHC. This feedback system helps one analyzer to identify the present scenario. For a patient with the aboriginal origin, if any issue is recorded as vulnerable to racial discrimination then the patient is provided with the opportunity to represent the event in descriptive format (Dudley, 2019). Every individual associated with the event is then interviewed to justify the blame.
Based on the responses of the HIMSS stage of the organization is identified. This process is mainly performed by an electronic simulator. According to Ryder et al. (2019), it is not always perusable to completely rely on the HIMSS stage identified by an electronic simulator. In many occasions, the government has identified a flaw in data due to this simulator. Therefore, Ryder et al. (2019) recommend the government to rely more on qualitative data rather on this electronic stage analyzer. Petric (2019), however, reclaimed that it should be mandatory to identify the present stage using this simulator then challenge the result with qualitative analysis.
Assuring the Clinics to Voice on Decision Making
The reason that aboriginals are finding ACCH as a better cultural safe place than PHC is the ability of those organization to take decision instantly. If any nurse is creating racial discrimination then the clinics should have rights on voice to make a decision. The traditional legal system, however, is prolonged and claims an unsafe culture for the aboriginals.
The government of Australia suggests every clinic consider IT support especially on attributes, such as patient safety and risk management. Every room is installed with CCTV. The behaviour of every staff is monitored. The aboriginal patient has the right to react to any event that challenges one's culture (Fraser, 2019). However, the control of immediate action is still a big question and requires to be solved.
Report by The Frontline Clinics
The management or governing body of the PHC should encourage the frontline clinicians to promote multi-cultural practice in their working area. 3.4% of the total patients in Australia are aboriginals. Around 4% of the population is aboriginal (McKenna, 2020). These frontline clinicians should promote harmony to encourage aboriginal people to join the PHC as their workplace. Therefore, multi-cultural practice would be claimed.
Enhanced Safety Using a Better Interpreter
PHC provides an interpreter to every non-English speaking patient. The nurses, however, are mostly English speaker. The safety can be enhanced by an intermediate as an interpreter. However, the interpreter should be a person belonging to the aboriginal race. Other than the gap, that is required to be bridged, will last forever.
Diligence in safety with IT tools
The entire program should be managed by IT tools. The clinics must track the risk and safety of aboriginals in the healthcare system. Besides, webinar programs should be arranged the clinics to spread the culture of aboriginals (Fraser, 2019). The program focuses on the requirement of these people in the nation. The doctors and nurses should be diligent to the safety of these people. The motto should be supporting as a human rather supporting as a superior.
In this assignment, the researcher found that Jane, whose grandmother was an aboriginal of Torres Strait Islander race, was finding the best choice for daughter's vaccination. Jane, who is a primary school teacher, is very certain of the discrimination facts associated with PHC. Jane, however, has another option. The researcher never identified the prejudices of Jane over her education. However, the record at present steers Jane toward the aboriginal healthcare systems. It is not that the PHC has low medical support rather than ACCH. Besides, the cultural safety of the aboriginals in PHC is still a long route to go. The researcher, thus, is claiming the implementation of a socio-technical framework to implement a culturally safe environment in the PHC. Here, the social gap will be recovered by technical assistance. Healthcare systems in Melbourne and South Australia is considering AI units to serve an impartial culture. Places like Victoria, where the number of aboriginal populations is high, are not considering such things. The future research should focus to implement a safe culture environment in Victorian states.
Doran, F., Wrigley, B., & Lewis, S. (2019). Exploring cultural safety with Nurse Academics. Research findings suggest time to “step up”. Contemporary nurse, 55(2-3), 156-170.
Dudley, M. (2019). Multidimensional Cultural Safety in Information Literacy. Representatives and finding research. Women and Care, 56(1-2), 5-21.
Fleming, T., Creedy, D. K., & West, R. (2020). The influence of yarning circles: A cultural safety professional development program for midwives. Women and Birth, 33(2), 175-185.
Fraser, S. (2019). A Disjuncture of World Views: Manifestation in Burns Care for Aboriginal and Torres Strait Islander Children in Australia (Doctoral dissertation, Flinders University, College of Nursing and Health Sciences.). Health safety for the Aboriginals. 12(5), 67-78.
Lock, M. J. (2019). Australian Open Disclosure Governance-Closed to Cultural Voice. Critique of Australian Open Disclosure Governance and the Cultural Voice of Australia's First Peoples. Newcastle: Committix Pty Ltd. New South Wales.
Mackean, T., Fisher, M., Friel, S., & Baum, F. (2020). A framework to assess cultural safety in Australian public policy. Health Promotion International, 35(2), 340-351.
McKenna, B. (2020). Cultural safety: There is no turning back!. Journal of Psychiatric and Mental Health Nursing.
Petric, S. (2019). " Bridging two worlds?”: Towards cultural safety within schools of nursing in Australian universities. Health and Care, 28(2), 215-241.
Ryder, C., Mackean, T., Ullah, S., Burton, H., Halls, H., McDermott, D., & Edmondson, W. (2019). Development and validation of a questionnaire to measure attitude change in health professionals after completion of an aboriginal health and cultural safety training programme. The Australian Journal of Indigenous Education, 48(1), 24-38.
Schill, K., & Caxaj, S. (2019). Cultural safety strategies for rural Indigenous palliative care: a scoping review. BMC palliative care, 18(1), 21.
Taylor, K., & Guerin, P. (2019). Health care and Indigenous Australians: cultural safety in practice. Macmillan International Higher Education. London
Tremblay, M. C., Graham, J., Porgo, T. V., Dogba, M. J., Paquette, J. S., Careau, E., & Witteman, H. O. (2019). Improving Cultural Safety of Diabetes Care in Indigenous Populations of Canada, Australia, New Zealand and the USA: A Systematic Rapid Review. Canadian Journal of Diabetes, 18(1), 291.
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