Palliative And End Of Life Care: A Case Study

“Health is influenced by culture and beliefs” (NRS-429V, 2011, p. 1). In order for the nurse to properly care for the patient, she must know and understand the patient’s culture. “Cultural care is a comprehensive model that includes the assessment of a client’s cultural needs, beliefs, and health care practices” (NRS-429V, 2011, p. 1). It is not enough to just know where the patient lives or where he came from. The nurse must embrace the concept of cultural competence and cultural awareness. This requires not only the awareness of the cultural beliefs and values of their patients, but also

64). Reflecting one owns practice is the first principle, and it is a critical part for nurses because it is a vital characteristic for achieving professional competence (Mann, Gordon & MacLeod, 2009). While minimising the power gaps between the nurses and the Indigenous patients is the next principle (Atkins, De Lacey & Britton, 2014). An Indigenous client view nurses to have more power more than them, thus acknowledging the Indigenous practices lessen the power imbalance (Durey & Thompson, 2012). Thirdly, in implementing cultural safety it is actually engaging sensitively with the patient to gain understanding of their viewpoint (Atkins, De Lacey & Britton, 2014). Some health care providers lack true engagement to the Indigenous clients in the health care settings (Ware, 2013). For an instance, the use of medical jargons and abbreviations while talking, a culturally safe nurse includes simple language or explanation that the patient can understand easily (Skellet, 2012). Additionally, having an Aboriginal and Torres Strait Islander health workers in health care facility can excellently build trust and can promote better engagement among Indigenous client (Hepworth et al,

In relation to Aboriginal health, this will require nurses to develop greater awareness of culture and the influences that affect it including racism, colonialism, historical circumstances, and the current political climate in which we live. Nurses working with aboriginal communities need to understand the history, socio-political climate and culture within the specific community (Foster, 2012). Nurses must emphasize the need for solutions that will strengthen cultural identity, identify and promote both existing and traditional sources of strength within First Nations communities, incorporate traditional healing methods, and rely on local control and self-direction by First Nations communities (Mareno & Hart, 2014). In addition to placing a high priority on cultural awareness, nurses should also understand the concept of respect in aboriginal terms and apply respect in all their encounters. Self-awareness of their own beliefs and assumptions are important in order for nurses to have an effective relationship with the community (Foster, 2012). It is important for nurses to reflect on their own cultural knowledge, awareness, skills, and comfort in encounters with a diverse population of

In nursing school, we are normally taught that we should respect the dignity and rights of all clients. As the "world becomes reduced" and societies and individuals become more mobile, we are progressively able to network with people that are from other cultures. Cultural respect and competence for others becomes particularly significant for us as nurses and patient supporters. Applying the principles and theories of communication is important for sufficient patient care. A lot of various communication methods are executed and have diverse focuses. Small groups use mechanisms such as objectives, standards, cohesiveness, behaviors, and therapeutic issues. Duty, process and midrange groups are separate categories. Orientation, tension, cohesion, working and dissolution are stages groups go through. Successful personal and professional communication profits the patients and other health professionals; however, the lack of applicable communication can lead to poor patient results and a hostile and fruitless work setting (Doane, 2004). However, the cultural group targeted in this paper is the Native Americans because this group has become a challenge for public health nurses.

Remote communities such as those in northern Canada consistently experience a shortage of healthcare providers (HCP) including nurses (Place, Macleod, Moffitt & Pitblado, 2014). Due to the cultural and geographical uniqueness of these areas, challenges are inevitable, however, it can be undoubtedly rewarding. Nurses can particularly gain valuable experience regarding the importance of cultural competence and its implementation.Therefore, this paper will discuss the context of northern Canadian communities as well as three challenges and three benefits faced by nurses working there. Considering the populations in these communities are culturally diverse, it is especially essential for the nurses to have the appropriate cultural knowledge and skills in working with these populations. Consequently, we will also explore the definition of cultural competence, other terms used to describe this concept and how nurses can ensure they have the necessary cultural competence to work with these communities.

After finished the module of “Aboriginal and Torres Strait Islander Cultural Awareness,” I feel that cultural awareness may be a solution to many Australian aboriginal health care problems. In this reflection, I am going to explain how cultural awareness help to overcome communication difficulties between Australian indigenous people and health care workers, as an

While working with a client from an Indigenous background, it imperative that a practitioner be culturally competent in order to ensure that the client’s culture is acknowledged and incorporated into the system of care provided (Cross, Bazron, Dennis, & Isaacs, 1989, p.1, in Herring et al., 2013). It also ensures that the practitioner is able to adapt his service to meet culturally specific needs of the client as culture plays a key role in the lives of Indigenous people.

Nurses’ attitude and behavior toward Indigenous consumers is thought to be improved based on the knowledge they gained from cultural awareness training (Downing & Kowal, 2011). Although this framework does not require mastering the culture of the Indigenous community, it does involve a thorough understanding of their history and background. Westwood and Westwood (2010) indicated the importance of CAT as a key strategy in achieving positive health outcomes for Aboriginal

Australia is one of the healthiest countries in the world, with one of the most dramatic rates of social inequalities in the health between Indigenous and non-Indigenous populations (AIHW, 2014). This paper will examine why culturally safe nursing practice, through cultural competence, is a key strategy for reducing inequalities in access to healthcare. This paper will additionally define what is meant by cultural competency, and how culturally competent nursing practice is significant and beneficial to the health of Aboriginal and Torres Strait Islander (ATSI) populations.

Indigenous peoples experience racism and discrimination commonly in healthcare (Denison, Varcoe, & Browne, 2014). Nurses may be unaware of the discrimination that occurs around them and the oppressive behaviors they themselves project. Nurses must give indigenous patients extra time and make a concerted effort to build a trusting relationship and provide culturally competent care. Ultimately, colonialism is still affecting the health of the Aboriginal population. In this paper I will discuss an incident of discrimination I witnessed that many of the staff were probably unaware was actually discriminating to the patients. Nurses compose the majority of health care providers and therefore we have the responsibility and power to make a change (Canadian Institute for Health Information, 2013). Nurses must gain cultural competence and gain awareness about the power they carry as both health professionals and Caucasian nurses in order to help decrease discrimination and increase healthcare outcomes of indigenous peoples.

Hence, this will provide the foundation for accurate diagnosis and treatment and an establishment of a caring and therapeutic relationship with the patient.4 This should consist of shared perceptions and feelings regarding the nature of the problem and the outcome. Therefore, appropriate communication should integrate both patient and doctor centred approaches.4,9 However, this is especially hard to achieve within remote areas where a vast percentage of the population are elderly Aboriginal and Torres Strait Islander people. Furthermore, the indigenous culture’s focus on interpersonal communication and protocols differs significantly from the Western medical model on systematic consultations.5 Henceforth, this barrier is cited to be prevalent and has resulted in poor communication as an ongoing health crisis limiting delivery of effective healthcare services to Indigenous Australians.3,6 Therefore, effective cross-cultural communication skills are crucial to providing culturally-sensitive healthcare to elderly Aboriginal and Torres Strait

According to Newbold (1998), the determinants of health framework states that health status is dependent not only upon access to health care services, but encompasses a much broader range of determinants, including those of culture and language (p.68). The theme addressed within this paper focuses on how language and culture of Indigenous or Aboriginal peoples, impact their access to healthcare, and overall quality of that care. Aboriginal peoples face many more challenges in maintaining their health in comparison to the general population (Cameron, Camargo Plazas, Santos Salas, Bourque-Bearskin, & Hungler, 2014). To understand why this may be, we will be discussing exactly how their culture and language may impact their access to quality healthcare, and how nurses can venture a response to these issues.

So, what are ways to provide cultural appropriate care? To begin with, Nurse Practitioners must understand what it means to be present with someone. When we focusing on Western principles of autonomy this could lead to isolating and disempowering the patient (Hiruy, Mwanri, 2014). Thus, learning to be present with another human being, especially one who is in the dying process, is a skill we acquire.

To highlight the importance of Indigenous cultural awareness within the healthcare system, in order to enable effective support for Aboriginal and Torres Strait Islander service users.

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).