Strengths-Based Nursing Care

I learned that Aboriginal seniors in Canada have more health care concerns than non-Aboriginal seniors and their needs are not well understood and were taken for granted by health care providers. I can apply in my nursing practice what I have learned from this topic that I will respect and acknowledge their culture and way of life. In addition to that, I will keep in mind that Aboriginal seniors needs more intensive support than non-aboriginal because of what they experienced at the reserved and residential schools. I want to learn more about their traditional practices

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

Another social determinant of the aboriginal health is the poor compatibility linking the core values of their customary health beliefs and the modern health system. The westernized medical system is mostly interested in the detection and treatment of diseases and illnesses. On the other hand, the traditional aboriginal medication seeks to offer a meaningful justification for illnesses and reacts to the family, personal, and community issues related to the illness (Broome, 2002). This explains why

The Native American culture is the original culture of the United States. Members of Native American tribes live throughout the country. “There are an estimated 4.9 million persons, in 565 federally recognized tribes who are classified as American Indian or Alaska Native (AI/AI), alone or in combination with one or more other designated racial classifications. This demographic group compromises 1.6% of the U.S. population” (Horowitz, 2012). Wisconsin is home to the Ho-Chunk (Winnebago), Ojibwa (Chippewa), and the Potawatomi tribes (“American”, 2014). It is important for nurses within this state, as well as any other state, to understand the Native American belief system in order to provide a quality healthcare experience. Nurses are the primary point of contact in the healthcare setting. Client advocacy is one of the nurse’s major roles. Therefore, the nurse should have the highest level of diversity understanding for the cultures within the local region.

When caring for a Native American patient, it is imperative that the nurse provide culturally competent care. In this scenario, there are two main dimensions along which cultural tensions between the patient and the nurse can arise. The first pertains to the actual practices and values of Native American culture, which may be at odds with the practices and values of dominant healthcare institutions. The second is both broader and more subtle: it pertains to the historical relationship of the Native American people and the

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,

Resilience is defined as a person’s ability to weather adversity and come out of it with a stronger ability to deal with the next challenge (Mosby’s Medical Dictionary, n.d.). Resilience can be noted as a trait within an individual as well as a process through which a person undergoes during adversity (Jacelon, 1997). Measuring resilience can be done by assessing certain qualities within an individual and asking questions to elicit better understanding of their current psychological state (Wagnild & Collins, 2009). Nurses must have a thorough comprehension of resilience and how to measure and promote this among individuals who are met with health challenges. By doing this nurses are better able to provide holistic client centred care and inform the nursing profession.

In order to deliver nursing care to different cultures, nurses are expected to understand and provide culturally competent health care to diverse individuals. Culturally competent care is tailored to the specific needs of each client, while incorporating the individual’s beliefs and values (Stanhope & Lancaster, 2006, p. 90). By being culturally competent, nurses are able to help improve health outcomes by using cultural knowledge and specific skills in selecting interventions that are specific to each client (Stanhope & Lancaster). Therefore, nurses “should perform a cultural assessment on every client with whom they interact with” (Stanhope &

There is a growing number of non-Aboriginals who have begun to blend traditional First Nation healing process and herbal medicines into their understanding of health and healing. Although, other than these few practices, Aboriginals in Canada are often forced to conform and adopt to the Canadian Health system, a system which is causing them harm (Douglas,

To be a successful culturally competent nurse, nurses should assume attitudes to promote transcultural care. Nurses need to be aware of their patient’s cultural differences - taking time to understand and value patient’s cultural needs and perspectives. Nurses should show respect and concern for patients. Nurses should also be empathic with their patients.

Firstly, the nurse should avoid maintaining eye contact with an Aboriginal client to avoid appearing “intrusive, threatening, or harmful” (Potter, 2014, p. 247). Next, the nurse should not assume how the Aboriginal client is feeling based on their calm demeanor. For instance, the nurse should not assume that an Aboriginal client that appears to be calm is not experiencing discomfort. Secondly, if the nurse is faced with a language barrier, the nurse may request a translator for the Aboriginal client. Depending on the available resources, the translator may be sourced from the facility or the community. Thirdly, the nurse should ask Aboriginal tribe members for education regarding traditional Aboriginal practices. For instance, the nurse may learn death rituals that are tribe specific, such as burying personal possessions with the individual (Eliopoulos, 2010, p. 30). Next, the nurse must respect that the Aboriginal client may prefer treatment in the form of “spiritual rituals, medicine men, herbs, home-made drugs, and mechanical interventions such as suction cups” (Eliopoulos, 2010, p. 29). In addition, the nurse should be aware of the emphasis on harmonious family relations and “reverence for the Great Creator” in Aboriginal culture (Eliopoulos, 2010, p. 29). If available, the nurse should direct the Aboriginal client and their family to the nearest

A culturally safe care is defined as “what is felt or experienced by a patient when a healthcare provider communicates with the patient…” (Bickford, 2015). Social justice lists the “rights of all people in our community which are to consider to be fair and equitable” (Social Justice Principles, 2003). These rights are justified through equity, fairness and equality in marginalized groups of society that can be visualized in the healthcare system. The basic principles of social justice, which promotes safe care, are as follows: equity, access, participation and rights (Social Justice Principles, 2003). Social advocacy plays a vital role to help nurses promote safe care by safeguarding patient autonomy, acting on behalf of patient, and championing social justice (Mackey, 2015). The following paper will describe how the principle of social justice and advocacy support culturally safe care regarding the Aboriginal people and women in Canada.

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).

Cultural Competence based on the Purnell Model can provide a comprehensive, systematic, and concise structure for learning and understanding the Palauan culture. Based on the previous paper regarding my Palauan friend, S.S., I will be discussing five areas where I can further improve my transcultural care pertaining to this specific community. These areas are in communications, high-risk health behaviors, nutrition, pregnancy and the childbearing practices, and death rituals (Purnell, 2014). Furthermore, I will present a reassessment of my culture competency to evaluate my learning that can positively affect the nursing care of individuals from diverse cultures represented by the Palauans.

The inequalities and disparities in health status that Māori experience have become one of the most significant ongoing issues in New Zealand. Nursing Council of New Zealand expected that nurses are able to understand and analyse the historical and cultural processes that have impacted on the Māori health inequalities, so that they can best deliver and improve Māori health care (Nursing Council of New Zealand [NCNZ], 2011).