HLTH90019: Indigenous Health and Nursing - Assessment Answer

Introduction

Health care professionals need to deliver care to a large number of culturally and linguistically diverse patient groups. In such a situation, intercultural awareness and cultural sensitivity are important to provide patient-centred care. A lack of cultural sensitivity may lead to cultural barriers in care and it may threaten the safety of patients (Kaihlanen, Hietapakka & Heponiemi, 2019). This reflective paper aims to conduct a critical evaluation of the key lessons learned in the course concerning cultural identity and health disparity in the context of colonization. In this course, we mainly examined the role of culture in the social and emotional well-being of Aboriginal and Torres Strait Islanders. I will use the Gibb’s reflective cycle to reflect on my world view of health and the impact of knowledge gained in the course in my future nurse practice.

Description

In this subject, I learned about the cultural values and cultural identity of the Indigenous people and the importance of culture for the well-being of the group. They were found to lag behind in health and suffer from health disparity. This was because of the discriminating past health care policies and the impact of colonization. I feel that two aspects that seriously affected the lives of the group were colonization and intergenerational trauma. These events explain the cultural distance between indigenous clients and nurses. The history of colonization was an event that strongly disrupted Aboriginal society and economy as it resulted in the loss of lands and separation from children and culture. It resulted in inequity, racism, massacre and the burden of diseases. The assimilation policy resulted in the separation of Indigenous children from their families and they were subjected to emotional, and physical (Axelsson, Kukutai & Kippen, 2016). Thus, past atrocities results in feelings of distrust and they began practising their own approach to medicine instead of looking at modern medicine and health care. I had my own personal beliefs, values and attitude towards health which has been shaped by my family, ethnicity, religion and schooling. It further made me oppose the Aboriginal people’s dependence on their land and cultural values for well-being. However, knowledge about the history of colonization and other discriminatory policies made me realize why Indigenous Australians do not go to mainstream services and they give immense importance to cultural and social habits

Feelings

The process of completing the course introduced me to many atrocities and harsh realities that the Aboriginal and Torres Strait Islander had faced in the past. By reading about the history of colonization, violence and discriminatory policies for Indigenous people, I am in a state of shock. It evoked different emotions in me. Earlier I had my worldview of health and I could not sense why the Indigenous people did not prefer seeking mainstream health services. In addition, I was unaware about the importance of culture for their well-being. I feel sad to know that the Indigenous people suffered disparities not just in health outcomes, but also in psychosocial outcomes. However, by learning about the attachment to their culture, I have developed more respect for the Indigenous people. For instance, one of the resource revealed that connection with the country, community and culture lies in the heart of Indigenous people’s health and well-being (Readings, 2018). I am still in disbelief that despite facing so many atrocities, they have survived and still fighting to lead a good life. We as health care professionals have the responsibility to be kind and passionate to them. We need to make massive changes in our attitude towards the Indigenous group so that they reinforce their trust in the health care system. We need to use the sociocultural lens to understand their holistic needs and lead them towards a healthy life. The experience of completing the course has resulted in a mindset shift and it will enable me to pay more emphasis to cultural aspects while dealing with Indigenous people in my future nursing practice.

Evaluation

On evaluating my experience of key lessons about the Indigenous people, I have gone through a process of enlightenment and promoting my professional development. The good thing about my experience was that the information on the history of Indigenous people increased my knowledge about the importance of cultural safety and security. According to Curtis et al. (2019), cultural safety is an outcome of nursing education that promotes delivering safe services by the fulfilment of the cultural needs of recipients of care. Most of the health care professionals lack understanding regarding cultural security for Aboriginal people’s health. But I am delighted to express that I have learned this concept by gaining knowledge about the cultural values of the Indigenous group. Their cultural identity involves staying connected to their lands, cultural practices and their concept of spirituality. Due to European settlement, they suffered a devastating loss of sovereignty, experienced dispossession of lands, intergenerational trauma and decreases access to their ancestral lands. All these events contribute to disadvantages for them in the area of education, employment and housing (Fatima et al., 2020). These factors explain the reason behind inequality in health and well-being outcomes of the group. However, the lesson also gives insight into the role of cultural awareness and security in developing connections with the groups. It will support me to react more sensitively to indigenous people and make all efforts to provide care informed by their cultural values and self-identity.

Analysis

By reviewing the role of culture in the social and emotional well-being of Aboriginal people, I have understood why cultural safety is an important parameter in nursing. Cultural safety is linked to shared respect, meaning and shared knowledge. It is about creating a safe environment for Indigenous Australians (Taylor & Guerin, 2019). Earlier, I could not relate their cultural values due to my own worldview of health. But the assimilation policy and the history of colonization helped to establish connected between their health and cultural identity. They sustained great damage when they lost connection to their land, family and their spirituality. The knowledge has eliminated all unconscious biased and stereotypes that I held about Indigenous Australians. My goal is to embed cultural competence in health service by bringing changes in my behaviour, attitude and skills. Now I can keep my own worldview away and incorporate the culture and world view of Indigenous people to improve their health situation. This can be done through compassion, active listening and intervening at points of greatest need to address their health and social problems (Li et al., 2017).

The experience of going through the learning challenged me because of my own worldview and personal biased toward health. As a non-Indigenous group, I never valued cultural and family in the way that the Indigenous. In my education, I learnt about the need to provide culturally appropriate care. But this concept was never embedded in my mind as I did not practice the same. My family relied heavily on health care services and they followed all advice. In such circumstances, seeing the Indigenous family stay away from health services was a strength. But the class resources immensely helped me to understand the cultural values of the group (Coffin, 2007). This knowledge will support me to accept their cultural practices and using gestures that they expect from me. By displaying respect for them, I can contribute to providing equitable health services to Indigenous people (Butler et al., 2019).

Conclusion

Thus, the main conclusion based on my learning is that being culturally aware is important in the nursing profession. It can support nurses like us not only to focus on the physical well-being of patients but also their social and emotional well-being. By learning about the Indigenous people, I have understood what determinants significantly influence their psychosocial well-being. I will be respectful of the differences in culture values and try to address and prevent racism and inequities for the Indigenous group. Hence, I will be able to meet cultural needs of the group when I deal with them in my future practice.

Action plan

To improve my ability to provide culturally competent care to Indigenous people, my action plan is to take part in cultural competence training or workshop. These workshops will support me to gain additional skills such as culturally competent communication methods with the group and ways to deliver intervention aligned to the needs of Indigenous people. It will further support me to be culturally considerate towards Aboriginal people in my future practice and inculcate the same values in my colleagues too (Laverty, McDermott & Calma, 2017).

Conclusion

The report provided a critical reflection on my learning through the subject of cultural safety in nursing practice. Based on the context of colonization and other social policies for Indigenous people, I could identify the extent of trauma faced by the group. It also raised awareness regarding how the loss of land and disconnection with families damaged the community. It gave a clear indication that culture is the heart of their health and well-being. The subject gives lesson to all aspiring nurses to actively promote cultural safety in practice and use appropriate behavior and attitude to provide response and culturally centred care to health consumers.

References

Axelsson, P., Kukutai, T., & Kippen, R. (2016). The field of Indigenous health and the role of colonisation and history.Journal of Population Research,33, 1-7.

Coffin, J. (2007). Rising to the challenge in Aboriginal health by creating cultural security.Aboriginal and Islander Health Worker Journal,31(3), 22-24.

Curtis, E., Jones, R., Tipene-Leach, D., Walker, C., Loring, B., Paine, S. J., & Reid, P. (2019). Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition.International journal for equity in health,18(1), 1-17.

Fatima, Y., Cleary, A., King, S., Solomon, S., McDaid, L., Hasan, M. M., ... & Baxter, J. (2022). Cultural Identity and Social and Emotional Wellbeing in Aboriginal and Torres Strait Islander Children. InFamily Dynamics over the Life Course: Foundations, Turning Points and Outcomes(pp. 57-70). Cham: Springer International Publishing.

Kaihlanen, A. M., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: qualitative study of nurses’ perceptions about cultural competence training.BMC nursing,18(1), 1-9.

Laverty, M., McDermott, D. R., & Calma, T. (2017). Embedding cultural safety in Australia’s main health care standards.The Medical Journal of Australia,207(1), 15-16.

Li, J. L. (2017). Cultural barriers lead to inequitable healthcare access for aboriginal Australians and Torres Strait Islanders.Chinese Nursing Research,4(4), 207-210.

Luijendijk, H. J. (2021). How to create PICO questions about diagnostic tests.BMJ Evidence-Based Medicine,26(4), 155-157.

Reading, C. (2018). Structural determinants of Aboriginal peoples’ health.Determinants of Indigenous Peoples’ health: Beyond the social, 3-17.

Rose, J., & Johnson, C. W. (2020). Contextualizing reliability and validity in qualitative research: Toward more rigorous and trustworthy qualitative social science in leisure research.Journal of leisure research,51(4), 432-451.

Taylor, K., & Guerin, P. T. (2019).Health care and Indigenous Australians: cultural safety in practice. Bloomsbury Publishing.

Zanoni, C. T., Galvão, F., Maria, R. M., Zulli, R., Ricciardi, J. B., Cliquet Junior, A., & Saad, S. T. O. (2021). Effectiveness of a home-based therapeutic exercise program on lower back pain and functionality in Sickle Cell Disease (SCD) patients.Hematology, Transfusion and Cell Therapy,43, 268-279.

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