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Hello everyone, myself -----today I am here to present the case study of Hayma. One of the culturally unsafe points that I have identified is disregard for religious practices. However, the type of bias demonstrated by the registered nurse is biasness about the patients' cultural background.

Acknowledgment of Country

I acknowledge and pay respects to the First Nation people, the traditional custodians of the land on which we live and work. I recognize the enduring connection that First Nation communities have with their ancestral lands and waters. I honour their unique cultural and spiritual heritage and the vital role they play in our diverse society. It's important to remember that acknowledgment is a meaningful gesture, but it should be followed by actions that support reconciliation, equity, and collaboration with First Nation communities. This may include learning more about their history and culture, advocating for their rights, and actively engaging in partnerships that benefit their communities.

I acknowledge the Noongar Country, the traditional lands of the Noongar people, in the southwestern part of Western Australia. I pay my respect to the Noongar elders, past and present, who have been the custodians of this land for countless generations. I recognize the deep spiritual connection that the Noongar people have to their Country, which encompasses rich cultural traditions, languages, and a profound relationship with the land and waterways. I honour the resilience and enduring heritage of the Noongar Nation and their contributions to the cultural diversity of this region.

Direct Intervention

Two direct Bystander interventions are 1. discuss cultural competence with registered nurses and 2. patient advocacy. Discussing cultural competence with registered nurses will be helpful in emphasizing its importance. Student nurses can recommend registered nurses to promote cultural diversity and inclusivity and encourage a sense of belonging. As discussed in the case study, the RN assumes that Hayma is unable to communicate, so she ignores Hayma and interacts with her uncle. Not having direct interaction with Hayma may lead to false interpretations. The student nurse should advocate for the needs and preferences of Hayma to ensure the delivery of culturally safe care (Priest et al., 2021).

Indirect Intervention

Two indirect Bystander Training interventions are Report to authorities and correct misconceptions.

Student nurses have a responsibility to report incidents of discrimination or cultural insensitivity when they witness such behaviour. Student nurses should make detailed notes about the incidents, including the date, time, location, and a description of what transpired. In the current case study, the student nurse should report how the registered nurse did not involve Hayma in the assessment and was stereotyped towards her religion. Student nurses should maintain a calm and respectful demeanor throughout the conversation and provide additional context to help the RN understand the significance of cultural practices. RNs need to understand and respect Hayma’s cultural background and dietary choices so that her needs can be addressed (Aitken et al., 2023).

Distraction Intervention

Two distraction Bystander Training interventions are Redirect the conversation and involve other healthcare professionals.

One of the distraction interventions is redirecting the conversation. The student nurse should choose the appropriate moment to interject into the conversation without causing disruption or embarrassment. By using neutral language and non-judgmental behaviour, shift the topic of conversation, for instance asking can you provide an update on the treatment plan? (York et al., 2021). The discussion of clinical or patient centered topics can redirect the conversation and can avoid addressing the discriminatory remarks about Hanya’s culture and her faith in Theravada Buddhism. The student nurse can involve any other healthcare professional like other nurses working in the ward by addressing a specific question or comment to a healthcare worker need to be involved (Hennelly et al., 2019).

Protocol Intervention

Two codes of conduct are:

Principle 2: Person-centered practice

Principle 3: Cultural practice and respectful relationships.

The RN assumes that Hayma is unable to communicate for herself solely based on her wheelchair. This assumption disregards Hayma's autonomy and her ability to self-manage her activities of daily living. Nurses should respect and support patient's autonomy, including their right to communicate and make decisions about their care. Nurses should value the attitudes, assumptions, and beliefs of the patients to ensure culturally safe and respectful practice. However, in the current case study, the RN's comment reflects bias and discrimination based on Hayma's religion and dietary choices. RN's comments demonstrate a lack of cultural competence and sensitivity to provide culturally appropriate care

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