Master of Nursing Science
University of Melbourne
Foundation of Nursing NURS90066
Student Id: 970109
Faculty of Medicine, Dentistry and Health Sciences
Subject Coordinator: Mrs Kristen Bakker
Test Teacher: Mr Thomas Mathew, Mrs Bronwyn Tarrant
In today’s era, cultural safety is the principal subject involved in nursing practice. Culture is defined as a group of people of different origins, values, languages they speak, spiritual beliefs and many more. Unsafe cultural practice consists of any action which destroys or deteriorate the overall health and cultural identity of a person or individual. Many factors which influence cultural safety are cultural, socio-economic, political, historical, emotional, which potentially affect the indigenous Australians should be taken into account by service care providers to provide best
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Aboriginal and Torres Strait Islander population across different parts of Australia have lower life expectancy than mainstream Australians (approximately 10 years difference in lifespan between indigenous and non-indigenous people). Late diagnosis of disease is the most prominent, with many indigenous people entering the end or terminal phase of illness before it is diagnosed (Williams, 2016). The colonisation of Australia had a catastrophic effect on Torres islander or Aboriginal people. Behrendt, L, (2012) states that in 1788, Captain Arthur Phillip and other 1500 civilians, marines and crew arrived at Sydney. After 10 years of their arrival, Australia’s indigenous population reduced by 90 percent. Three main reasons for this drastic decline in number were violent conflicts between colonisers, the introduction of new diseases and other civilians or non-native population acquire the large proportion of indigenous lands. Moreover,
Some things that caused the rapid decline in population among Native Americans after the Europeans arrived are disease, warfare, and migration.
Among Aboriginal peoples, there are a number of similar historical and contemporary social determinants that have shaped the health and well-being of individuals, families, communities and nations. Historically, the ancestors of all three Aboriginal groups underwent colonisation and the imposition of colonial institutions, systems, as well as lifestyle disruption. However, distinctions in the origin, form and impact of those social determinants, as well as the distinct peoples involved, must also be considered if health interventions are to be successful. For example, while the mechanisms and impact of colonisation as well as historic and neo-colonialism are similar among all Aboriginal groups. The contemporary outcome of the colonial process
The main ideas that Lisa Bourque Bearskin is stating in this article is that nurses need to be more sensitive to cultural care. They need to be aware of the issues in healthcare and strive to remove any barriers for certain groups, such as the first nations, and they need to disrupt any unequal relations in the social, political and historical aspect of healthcare. The way this can be done is by shifting their thoughts from cultural competence to cultural safety by way of relational ethics. Cultural competence is explained as the knowledge, skills, and attitudes that nurses need to use to care for cultural differences. Another framework described cultural competence as going through the stages of cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire. Cultural competency works very well when making policies in an agency but this view fosters a view of culture that does not encourage nurses to ask questions. (Bearskin, 2011) Cultural Competence causes different cultures to be put in a box, which cannot be done because cultures are constantly changing and every person’s culture is different. Culture is individual. Lisa Bourque Bearskin goes on to say that cultural safety is what nurses should use for ethical practice. In cultural safety, a nurse must strive to improve health care and its access for all people, while recognizing that there are many different cultures that have a right to be recognized. Bourque
Cultural competence in nursing is imperative for effective patient care. A nurse must know his or her own values and beliefs as well as knowing about a patient cultural practices in relation to healthcare. Cultural competence is defined by some as: “the learned, shared and transmitted values, beliefs, norms and lifeways of a particular group that guides their thinking, decisions and actions.” Also it is noted that an important change to this definition is “the recognition of the dynamic,
The outcome of cultural awareness and cultural sensitivity is cultural safety (Berg, 2010). In practicing cultural safety, it is not really expected that health care workers will know all cultures; it is acknowledging and respecting people regardless of their differences and beliefs (Hughes & Farrow, 2006). Moreover, nurses and other health professionals create cultural safe practice when the patients feel safe, respected and understood (Skellet, 2012), as well as if there is a shared understanding and acknowledgement of the unique identity and diversity. Health workers should always consider the cultural and historical background of the Aboriginal and Torres Strait Islander Australians, because practicing cultural safety is significant to
Marmot, M. (2011). Social determinants and the health of Indigenous Australians. Med J Aust, 194(10),
Nursing Council New Zealand (2011) defines cultural safety as the effective nursing of a person from another culture by a nurse who has undertaken a process of reflection and recognizes the impact of the nurses culture on own nursing. Irihapeti Ramsden (1946-2003) introduced the term ‘cultural safety’ into the education requirements of New Zealand nursing during the year 1990 (Wepa, 2012). As a result of this, Ramsden produced a document named Kawa Whakaruruhau. The document outlined concerns surrounding Maori health within New Zealand. In response to the publication of Kawa Whakaruruhau the Nursing Council of New Zealand amended, in 1990, the standards of nursing and curriculum assessment processes to include cultural safety (Wepa, 2012). Ramsden and Spoonley (1994) discuss that during the
The racism that goes on around Australia has a very serious impact on Indigenous Australians; this impact is the gap in the life expectancy between Indigenous and Non-Indigenous Australians. Life expectancy for native Australians is in comparison with third world countries with the probability of death being around 20 years lower than other Australians, which has increased since 1997 (Kim 2007). The life of Indigenous Australian 's is short-lived compared to other Australians as 66% of the deaths of native Australians were before the age of 65 (Australian Institute of Health and Welfare 2011). The life expectancy for non-indigenous Australian 's is 75 for males and 81 for females. The life expectancy for Indigenous Australian 's has been the same since the 1900’s with the life expectancy of males being 56 and females 61 (Human Rights and Equal Opportunity Commission 2001). The gap in life probability between
“The status of Indigenous health in contemporary Australia is a result of historic factors as well as contemporary socio-economic issues” (Hampton & Toombs, 2013, p. 1).
The Assimilation policy (1961) has impacted on Indigenous Australians within their physical and mental state and identity present in today’s society. Australia is commonly considered to be free and fair in their culturally diverse societies, but when the Indigenous population is closer looked into, it is clear that from a social and economical view their health needs are disadvantaged compared to non-Indigenous equals. In relation to this, the present Indigenous health is being impacted by disadvantages of education, employment, income and health status. Even urban Indigenous residents are being affected just as much as those residing in remote and rural areas of Australia.
The Aboriginals also known as the Indigenous people are the first people’s inhabitants of mainland Australia (WIKIPEDIA). Historically, Aboriginals enjoyed better health before any invasions from non-Indigenous peoples. They didn’t suffer from any major illnesses though they did have other type of health issues, but their life was happier and content. Everything started to change after 1788 when non-Indigenous people introduced illnesses where the mortality rate of Aboriginals population started to increase, and this affected their life and the community (http://www.healthinfonet.ecu.edu.au/health-facts/overviews/the-context-of-indigenous-health). There are various factors that contribute to the poor health status of Indigenous people, and this is part of the social determinants of health which should been seen in a broader context (1)(2). Factors such as employment, income, stress, gender, education, behavioral aspects, working and living conditions, social networks and support, are interrelated and complex, and are part of the social
Cultural safety is a concept that is integral to providing best care to patients in nursing practice. The CRNBC defines cultural safety as a process requiring RNs to reflect on their cultural identity, and develop their practice in a way that allows them to affirm the culture of their patients; cultural unsafety can be defined as any actions which demean, diminish, or disempower the cultural identity and well-being of people; this also addresses the dynamics of the power relationship between the Health Care Provider and the patient (p17). Although an environment of cultural safety is a standard that we are held to as nurses, this ideal is not always reached. In this paper I will discuss one such incidence, as well as some of the changes that will assist myself as a nurse, as well as others members of the healthcare team to create an environment of cultural safety.
Aboriginal health standards are so low today that all most half aboriginal men and a third of the women die before they are 45. Aboriginal people can expect to live 20 years less than non-indigenous Australians. Aboriginals generally suffer from more health problem and are more likely to suffer from diabetes, liver disease and glaucoma. The causes of their poor health and low life expectancy are poverty, poor nutrition, poor housing, dispossession of their traditional land, low education level, high unemployment, drug and substance use, unsafe sex, limited health care and diseases.
Practicing cultural safety requires nurses to have undertaken personal reflection of their own cultural identity. This enables them to recognise the impact that their personal culture has on their professional practice (Cox & Taua, 2013). This personal reflection should allow the nurse to provide effective care to an individual or family from a different culture (Cox & Taua, 2013). In this essay I will reflect upon two of my own cultural groupings, discuss the concept of “other”, the relevance of cultural safety to nursing practice and how I might care for someone who is culturally different from myself.
This encounter referred to as biculturalism, is an important aspect of cultural safety. This means that the interaction between a nurse and a patient is always considered bicultural as this involves the nurse’s culture and that of the patient’s. In this contact there is hidden power structure and a dominant culture (Henderson, 2003; Jarvis, 2012; Papps & Ramsden, 1996). As stated earlier, in New Zealand the colonisation British enabled them to dominate over all aspects of New Zealand’s way of life and culture, hence in the health care setting, the non-Maori culture prevails. As a culturally safe practice, nurses should learn to respect and acknowledge the culture of the care recipient whether it similar or different from them. Recipients of cares should be encouraged to participate and utilize their culture in managing their health and treatment (Papps & Ramsden, 1996). The nurse’s self awareness of one’s culture while acknowledging and respecting another’s is a fundamental requirement in order to practice cultural safety in nursing (Papps & Ramsden, 1996; Polaschek, 1998; Robinson et al., 1996).