Central Skill for a Nursing Practitioner

Discuss about the Central Skill for a Nursing Practitioner.

Introduction

Reflection assessment or reflective practice is a central skill for a nursing practitioner. Engaging in systematic reflection assessment qualifies a nurse to cope with personal and professional effects of addressing vital wellbeing and health requirements on a quotidian basis. The reflective cycle by Gibbs (1988) provides the effective steps of reflective practice. As a nurse, I believe that Aboriginal and Torres Strait Islander communities are much neglected population. Torres Strait Islanders are distinct from Aboriginal people but both are Indigenous populations of Australia. This reflective study will help me to know their situation better and I will be able to provide culturally safe care. I personally consider that a nurse should be reflective practitioner and reflective assessment plays key part in this.

Barrier to health care and good care experience

Aboriginal and Torres Strait Islanders face health care barriers due to various social, cultural and environmental limitations (McBain?Rigg and Veitch 2011). Around 12.7 percent Aboriginal and Torres Strait Islander children had eye sight difficulties (14.4 percent in non-remote zones compared with 6.3 percent in isolated regions) and 10.4 percent children had hearing problems. Around 45.1 percent people aged 15 years and over suffered disabilities, including 7.7 percent who required help with basic activities (Abs.gov.au, 2016). I think that for these Indigenous people, the focus on interpersonal relationships between health care staffs and themselves is paramount.

One positive information is that the majority (93.4 percent) of Aboriginal and Torres Strait Islander children aged 0–3 years had a birth-mother who went to clinics during pregnancy among these women who took folate during pregnancy was 58.0 percent in 2014–15, up from 48.8 percent in 2008 (Abs.gov.au, 2016). Four sexually transmissible infection curriculums provided by primary health care facilities in distant Indigenous communities demonstrated that clinical best practices and well-coordinated sexual healthcare programs can effectively decrease STI prevalence in remote Aboriginal population.  In the Anangu Pitjantjatjara Yankunytjatjara (APY) of northern South Australia, there was a decrease in the prevalence of gonorrhoea and chlamydia by 67 percent and 58 percent, respectively (1996 to 2003). In the Ngaanyatjarra of Western Australia, occurrence of gonorrhoea and chlamydia reduced by 48 percent and 36 percent, respectively from 2001 to 2005. In the Tiwi Islands of NT, gonorrhoea and chlamydia lessened by 34 percent and 94 percent, respectively from 2002 to 2005 (Guy et al. 2012).

Reflection of attitudes, values and beliefs and assessment of the impact

From my perspectives, limited health literacy is a foremost difficulty among these people and is associated with miserable health outcomes. Inferior learning level among ATSI people is liable for their reduced health knowledge and capability to attain their basic health requirements (Markwick et al. 2014). After involving in nursing career my attitudes towards the Indigenous Australians changed a lot. I certainly started to become more deliberate and connected with their problems.

In year 2012 to 2013, Indigenous Australians suffered 3 times more from diabetes mellitus in comparison to the non-Indigenous residents. The death occurrence from diabetes in ATSI inhabitants was 7 times higher than the other Australian residents. According to the statistics of AHS (2011–2012), physical inactivity is allied with high body fat build-up which accounts for 11 percent of the totalled illness in the ATSI community. These data made me think about them and influenced me to do something which will positively change these statistics.

I value their cultural ethnicity, their respect for human dignity and their spirit and integrity. I believe in equal value of people but it doesn’t mean sameness, it means commitment to distributive justice and fairness. I know that my attitudes, values and beliefs will positively impact on Indigenous patients when I will deliver health care practices. But one negative impact may be my too much concern for them and can affect my responsibilities towards other communities.

Culturally safe health care practices

Cultural safety is the effective nursing practice of an individual from another cultural background that is determined by that person. Cultural safe amenity is important in enhancing individual authorisation and hence promotes more meaningful and effective trails to independence among Indigenous people. Imposition of personal cultural views by any healthcare practitioner can be disadvantageous for the recipient of healthcare (Purnell 2014). My cultural awareness and sensitivity helps me to deliver culturally appropriate healthcare in Australia. According to Hunt et al. (2015), culturally safe health care practice should include strategic planning and service delivery activities, documented procedures to ensure cultural safety across all service and activities at all levels, processes to monitor, identify and understand existing and emerging social and legal requirements of Indigenous communities. I quite support the recommendations made by Hunt et al. (2015). A health care program named the Stanford Chronic Disease Self-Management Program (CDSM), in 3 Queensland Aboriginal community included local culture and traditions, used conventional methods of cultural communication, facilitated participation and leadership of the Indigenous community in their program. These steps determined the success of this program within each community, eventually influenced its effectiveness, satisfactoriness and sustainability (Barnett and Kendall 2011).

Liaw et al. (2011), examined 173 papers related to chronic disease care courses piloted in rural and distant Aboriginal communities. Among these programs only 17 were found to adopt cultural competence, cultural security and cultural respect models. I totally agree with the authors that effective chronic disease care and nursing interventions require sufficient engagement of Aboriginal communities, utilisation of local information, united responsibilities, strong leadership, sustainable resources and integrated systems.

Advocating and contributing towards improved health outcomes

I think that advocating for Indigenous patients demands:

• Working on behalf of patients to defend their values, privileges, welfares and benefits if patients are unwilling or unable to defend or represent themselves
• Safeguarding autonomy of patients and encouraging self-determination if patients are willing and competent to make choices allied to their medical care
• Supporting social fairness to confirm widespread access to sufficient health and nursing care in organizations, society and community
• Performing as an intermediate between patients, other healthcare staffs and patient’s family.

By analyzing some journals, I recognized some vital areas where patient advocacy for the ATSI is required the most. These areas are cultural and ethnic sensitivity, respect for patient’s dignity, complex social problems, grievance and appeal process of patients, healthcare reimbursement, medical errors, inadequate consent and provider-patient conflicts in regard to expectations and desired outcomes (Choi 2015).

For contributing towards improved health care outcomes for Indigenous Australians ensured culturally safe services must be done. Cultural safety policy and cultural environment policy must be incorporated in healthcare institution guidelines (Britt et al. 2013). I want to raise awareness among my fellow practitioners by organizing annual cultural awareness and cultural competency programs.  These programs should involve management committee members, all staff members and volunteers. I want to do client satisfactory surveys and document the feedbacks from patients. Connecting local ATSI communities, people and families with institutional discussion process working to notify strategic development and service delivery accomplishments is needed.

Conclusion

In this reflective essay I talked about the barriers of health care for the Aboriginal and Torres Strait Islander communities. Racial discrimination is a big problem for Australian health industry to deliver effective care to the Indigenous people. But there are also some examples of how culturally safe practice can decrease the prevalence of disorders among ATSI people. Thus, promoting consciousness about culturally safe health care practice can work as wonders in enhancing ATSI health care services.

References

Abs.gov.au. (2016). 4714.0 - National Aboriginal and Torres Strait Islander Social Survey, 2014-15.

Barnett, L. and Kendall, E., 2011. Culturally appropriate methods for enhancing the participation of Aboriginal Australians in health-promoting programs. Health Promotion Journal of Australia, 22(1), pp.27-32.

Britt, H., Miller, G.C., Henderson, J., Bayram, C., Valenti, L., Harrison, C., Charles, J., Pan, Y., Zhang, C., Pollack, A.J. and O'Halloran, J., 2013.General Practice Activity in Australia 2012-13: BEACH: Bettering the Evaluation and Care of Health (No. 33). Sydney University Press.

Choi, P.P., 2015. Patient advocacy: the role of the nurse. Nursing Standard,29(41), pp.52-58.

Guy, R., Ward, J.S., Smith, K.S., Su, J.Y., Huang, R.L., Tangey, A., Skov, S., Rumbold, A., Silver, B., Donovan, B. and Kaldor, J.M., 2012. The impact of sexually transmissible infection programs in remote Aboriginal communities in Australia: a systematic review. Sexual health, 9(3), pp.205-212.

Hunt, L., Ramjan, L., McDonald, G., Koch, J., Baird, D. and Salamonson, Y., 2015. Nursing students' perspectives of the health and healthcare issues of Australian Indigenous people. Nurse education today, 35(3), pp.461-467.

Liaw, S.T., Lau, P., Pyett, P., Furler, J., Burchill, M., Rowley, K. and Kelaher, M., 2011. Successful chronic disease care for Aboriginal Australians requires cultural competence. Australian and New Zealand journal of public health, 35(3), pp.238-248.

Markwick, A., Ansari, Z., Sullivan, M., Parsons, L. and McNeil, J., 2014. Inequalities in the social determinants of health of Aboriginal and Torres Strait Islander People: a cross-sectional population-based study in the Australian state of Victoria. International journal for equity in health, 13(1), p.1.

McBain-Rigg, K.E. and Veitch, C., 2011. Cultural barriers to health care for Aboriginal and Torres Strait Islanders in Mount Isa. Australian Journal of Rural Health, 19(2), pp.70-74.

Purnell, L.D., 2014. Guide to culturally competent health care. FA Davis.

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