Cultural Safety National Indigenous Point Essay

Question:

Discuss About The Cultural Safety National Indigenous Point.

Answer:

Introduction

Aboriginals and the Torres Islanders follow cultural factors that are quite different from that of the cultural traditions followed by the non-natives of the nation of Australia. One of the most important cultural issues is the concept of time. Often it is seen that the Aboriginal’s observance of time as well as measurement sometimes become a source of conflict when the healthcare professionals try to provide care to the people (Shepherd et al. 2016). Time is rigid for the non-natives and they are very particular about the time of appointments with patients. On the other hand, native people provide more importance to kin and relationships and often may turn up late, as they do not follow structured time and schedules. They call this koori time and hence it may become a source of conflict. Another important issue is their concept of maintaining silence. Often their culture supports them to maintain silence in the midst of the interactions or discussions. They consider this as a norm to provide respect and values. However, non-natives may misinterpret it with lack of understanding of the natives and many try to fill up the gaps. This may result in conflict and disappointment among the natives and non-native people.


One of the biggest issues that may influence relationships development and communication among the natives and non-natives is the language barriers. The English language that is used by the Aboriginal and Torres Strait Islander people is quite different from the Standard Australian English. Therefore, even if they speak in English, there might raise many issues where if the healthcare professionals follow their real meaning of the words, then they may misunderstand what the native people really wanted to mean and express. This can be explained with the help of examples. When the Aboriginal and Torres Strait Islander people say, “your treatment was deadly”, they actually mean that the treatment was fantastic as according to them, deadly means great, awesome or fantastic (Couzos et al. 2016). If they state, “my dubbay is goomi”, what they actually mean is “my girlfriend is alcoholic. Therefore, professionals need to be knowledgeable about their language to avoid any issues and misunderstanding. Another issue is that the Aboriginal and Torres Strait Islander people has a very different concept of shame in comparison to that of the non-native people. Often, during primary healthcare treatment, it is seen that healthcare professionals need to be well aware of different personal information and habits in order to provide proper recommendations. While the non-native patients are quite outspoken about such facts, the Aboriginal and Torres Strait Islander people suffer from the feeling of shame while sharing private and personal information, cultural beliefs and others. This may also create issues as the healthcare professionals may fail to provide a comprehensive care plan to help them overcome their disorders.

Cultural safety can be defined as the aspect of being acceptable to various differences along with possessing the ability for analyzing the power imbalances, colonization, institutional discriminations and different relationships with settlers. Researchers are of the opinion that cultural safety is mainly about providing of quality healthcare that aligns successfully with the familiar cultural values as well as norms of the persons who are accessing the service that differ from the dominant culture or the culture of the providers (Raman et al. 2017). Cultural safety in the workplace can be developed by planning for cultural safety training which would mainly aim at the enhancement of the capacity of the health sector for improvement of program policy designs. Moreover, it would be also aimed at the making the employees culturally competent by helping them to develop knowledge abut cultural traditions, inhibitions and preferences of the Aboriginal and Torres Strait Islander people and thereby developing skills and cultural sensitivity and cultural respect to ensure satisfaction for the native people. This will help in development of strong relationships among the native patients and healthcare professionals that would ensure better health of the Aboriginal and Torres Strait Islander people.

The healthcare professionals of the present organizations follow a number of interventions to ensure cultural safety in the workplace. The first important aspect is maintaining of the protocols. Professionals show respect to the native people, ask for informed consent, ask questions to seek for cultural knowledge, demonstrate reciprocity and engages in community accompaniment. However, the organizational culture still needs to provide more effort to make the healthcare professionals to develop cultural awareness and cultural knowledge on their own terms by going through evidence based articles, internet websites and many others (Brown et al. 2017). The organization should try to encourage employees to develop the skills and personal knowledge and such encouragement will help individuals to be more efficient. The third important aspect that is well followed in the organization is the culture of effective partnership. The employees ensure to promote the collaborative practice where Aboriginal and Torres Strait Islander people seeking for help are welcomed to a joint problem solving approach and treat them as carriers if important information and are respected entirely making them the centre of the decision making procedures. The fourth aspect is following of the proper process that engage in mutual learning, frequent evaluation to check that proposed programs are working well and aligning with the recipient’s values, preferences, and lifestyles. The last aspect is positive purpose that are built on achieving the service recipient’s goals by building on strength, ensuring confidentiality and causing no harm to patients culturally, mentally and physically.


Cultural biasness can be defined as the phenomenon for interpreting as well as judging different phenomena by the standards that are inherent to one’s own culture. It is mainly the interpretation of another phenomenon that remains based on own cultural standards. I am from a non-native background and I never got the cope to mingle and be friends with any Aboriginal and Torres Strait Islander people. Therefore, I was not aware whether I had any cultural biasness towards them. After going through the courses to be culturally competent, I thought that I have developed the ability to overcome such biasness and provide culturally safe practices to them. It was only after several interactions with such patients, several complaints were lodged against me (Cox 2016). I realized that I had a feeling that they were illiterate and had not health literacy and therefore my interaction made them feel humiliated making them feel inferior. I realized that in order to be extra careful, I have behaved and communicated accordingly with their preferred cultural norms but somehow my inner thoughts about the, being illiterate was reflected in my communication with the patient. This is an example of cultural biasness where I thought that since they are Aboriginal and Torres Strait Islander people, they have no health literacy. I need to change such aspect of my communication procedure to make them feel respected.

Intercultural communication and being culturally aware of the people coming from different backgrounds are extremely important to maintain effective teamwork. Collaboration can only be ensured only when all the people working together are aware of each other’s cultural norms. Preferences and inhibitions and thereby respect the aspects to ensure effective bonding. When the employees feel that their organization as well as their colleagues is respectful to each other’s, they will be able to develop better bonds and this will help them to be emotionally dependent on each other (Mercer et al. 2014). Deep bonds help in development of trust among the people coming from different cultures and therefore, productivity of the team would be higher. Better the cultural awareness of different colleagues, better will be their knowledge regarding the cultural preferences and inhibitions of employees from various backgrounds and hence they will be able to work collaboratively without creating any conflicts and issues.

In order to provide culturally competent care and ensure cultural respect in the practices of the healthcare professionals to the Aboriginal and Torres Strait Islander people, several norms are followed. One of the most important is eye contact. One of the norms is that Aboriginal and Torres Strait Islander people do not prefer eye contact when they interact with others. It is customarily considered as a gesture for respect. In the western culture, such gesture can be taken as being dishonest, rude as well as showing lack of interest. Therefore, healthcare professionals who maintain eye contact with Aboriginal and Torres Strait Islander people may make them feel uncomfortable and disrespectful. Therefore, I tend to follow this norm and never communicate with them with direct eye contact. Another important norm that is also followed is the questioning procedures (Wain et al. 2016). It is mainly seen that the Aboriginal and Torres Strait Islander people prefer the indirect questioning. Therefore, if the non-native professionals maintain direct questioning, it may lead to the creation of misunderstandings thereby discouraging participations. This may make it difficult for the professional to get important information mainly in cases when the patients are communication in the non-standards English. Still, professionals should utilize indirect and round about approaches to ask questions to the patients to ensure that they are providing cultural respect while caring for them.

A cultural broker can be defined as the person from the Aboriginal and Torres Strait Islander people group as well as a professional who has developed an understanding of the worldviews and cultural values, practices and beliefs of both parties. One of the most important issues that are faced by the professionals is the language barriers. However, many of the Aboriginal and Torres Strait Islander people are nowadays been able to understand English and can also speak in non-standard Australian English which are understandable to a certain extent by the professionals. This is not the case of the elderly persons of the community. They are not at all knowledgeable about the English language (Durey et al. 2017). They do not prefer disrespecting their culture by communication in a language that is not their mother tongue. In this situation, one can never force the elderly patients of the community to speak in English and on the other hand, they cannot understand what the native elders say to them. Therefore, in such situation cultural brokers of native colleagues or interpreters need to be summoned for clearly understanding the demands and needs of the patients and thereby providing care that aligns with their cultural norms.

One of the best ways by which healthcare professionals can develop effective partnerships with the Aboriginal and Torres Strait Islander people is by building rapport. Researchers are of the opinion in many traditional cultures like that of the Aboriginal and Torres Strait Islander people, a high sense of value id put on the development and maintenance of relationships. “Taking a business” approach will help the professionals to make the patients feel satisfied and comfortable and this will in turn ensure formation of rapport and building of relationships. Thereby developing rapport with the patients is the best way to make them participative about their own decision-making in their treatment. Another important procedure is to make them feel respected showing that their autonomy and dignity is respected through the maintenance of the bioethics of “justice”. When the Aboriginal and Torres Strait Islander people will see that fairness, entitlement and equality are maintained, they would feel comfortable and satisfied seeing that the professionals are genuinely respecting their culture (Freeman et al. 2014). Ensuring fair distribution of resources, respecting their rights and respecting their morally acceptable laws would help the professionals to gain trust and this will make them collaborative and participative in the care processes.


In order to develop effective partnerships with the Aboriginal and Torres Strait Islander people, it is extremely important for the professionals to develop rapport and strong relationships with them. These should be based on development of strong bonds and trust. The patients will gain trust on professionals when they see that the professionals care for their cultural traditions, norms, preferences and inhbtions and they are included in decision-making. For these, they have to be culturally competent and develop cultural awareness and cultural knowledge. Therefore, it becomes extremely important to have resources that provide them with such knowledge. Effective evidence based journal articles with high level of evidences along with different interest articles discussing about different aspects of cultural norms of the native people are the best resources (Hart et al. 2015). Besides, effective training sessions for development of culturally competent skills and verbal and non-verbal communication is also required. Therefore, when such resources are easily available, the professional can make themselves competent and hence can successfully encourage Aboriginal and Torres Strait Islander people in effective collaborative sessions helping them to provide person centered care.

National Aboriginal and Torres Strait Islander Health Workers Association also called the NATSIHWA have developed their cultural safety framework in the year 2013. This framework was developed to increase the capability within the healthcare systems for delivering effectively the culturally safe as well as the responsive health and well being services for Aboriginal and Torres Strait Islander people. The PDF document comprises of eight important domains which when followed sincerely by the healthcare workers, recorded, and documented accordingly will help to ensure development of a culture of safety within the workplace. The domains according to increasing orders are country and community, understanding local cultural contextuality, recognizing & valuing the role of Aboriginal and Torres Strait Islander health workers, individual domains, systemic reflection, equity and sustainability, collaboration and cooperation followed by monitoring and evaluation (Laverty et al. 2017). I would be mainly taking the role of monitoring and evaluation to check whether documentation of the case of patients, reporting of errors, improper service delivery, poor cultural practice knowledge and others are conducted effectively or not. Following this, I would be preparing a report from the documentation that would mainly be containing the needs and requirements of the professionals to ensure cultural safety in workplace.

The term self-determination can be defined as the process and the collective rights that are exercised by the Aboriginal and Torres Strait Islander people. Researchers are of the opinion that by the term right to self-determination means right to take decisions and the practical exercise of self-determination is central to the aboriginal health. Aboriginal self-determination as well as responsibility is mainly seen to lie at the heart of the Aboriginal and Torres Strait Islander people community control in the provision of primary healthcare services. Researchers are of the opinion that meaningful self-determination in the shape and form of the greater individual as well as communal life control is the contributing factors to improved levels of physical and mental health of the Aboriginal and Torres Strait Islander people (Hunt et al. 2015). Again, control and dominations by others in such aspect may lead to ill health and elevated levels of mortality in the indigenous communities. Therefore, to make them more expressive and allowing those to reveal their needs, the main resources that are required by healthcare professionals are community engagement. To develop community engagement, healthcare professionals can engage in health promotion campaigns that will follow the five priority areas of the Ottawa charter. The main resources required are allocation of funds for arranging the discussion sessions, development of primary care services and engaging them effectively through health literacy sessions. Human resources are also required for proper health promotion program plans. Besides, pamphlets with pictures, brochures and others would be provided which would help in developing their knowledge about health issues and help to get access to healthcare services when required. Proper training would be given to professionals to ensure success of the health promotion programs and effective discussion sessions.


After implementing of the different interventions for the development of cultural safety, it is extremely important to evaluate the outcomes. This is important to find out whether the outcomes that are developed are bringing out positive results and helping to achieve the goals or not. Therefore, seeking agreement is extremely important from experienced and knowledgeable stakeholders to find out that the proposed interventions would bring out positive outcomes or not. Therefore, in order to ensure success of the outcomes, two important people should be included. This would be the elder head of the community of the Aboriginal and Torres Strait Islander people who would be mainly examining that the interventions are at par with their cultural traditions and norms (McKenzie and Brown 2017). This would help to modify accordingly if any mistakes are made and the outcomes would be successful. Secondly, another culturally competent stalwart healthcare professional should be consulted. Such professional had high level of experiences and he will be able to judge the effectiveness of the interventions and at the same time can

Aboriginal and Torres Strait Islander people are highly sensitive to their culture and want that non-native people provide them their right to self-determinations and treat them with justice and respect. In such situations, in order to involve them in decision-making, evaluation and negotiations, first rapport should be built with them ensuring that they start trusting the professionals and develops a bond with them (Townsend et al. 2018). Therefore, my first motive is to engage them in culturally competent effective communication and then develop a therapeutic relationship with them based of values of empathy, compassion and trusts. The elders and other members of the family would be requested to put forwards their needs and demands and also clarify the cultural preferences and inhibitions .making them involved in decision making and putting them in the central part of the care interventions maintaining their uniqueness and cultural respect would help them to feel that professionals care for them genuinely. These will make them feel more involved in every step of the care services.

The best way to evaluate the programs and services is to take interviews of the Aboriginal and Torres Strait Islander people and their communities and trying to know how they are perceiving the new approaches that are involved in the programs. Both broad question interviews and short question surveys would be conducted. Broad questions interviews would ensure that the healthcare professionals become well aware of the quality of the services that are provided, how satisfied the patients are, the services that need to be altered and modified, the services that are still required and others (Smith et al. 2015). The questionnaire-based survey would help to understand the extent of the services, how many people are satisfied, how many people are dissatisfied, number of people who wants more services, the quality of care provided by professionals and many others. All these would ensure effective evaluations of the programs and services.

The statistical data that would be provided from the questionnaire-based interviews would help me to understand the success rates of the programs and services. Those services that have high success rtaes would be kept and those who have low success rates should be altered and modified with the help of the information of the broad ended interviews. With these information and suggestions of elders of the Aboriginal and Torres Strait Islander people and community and stalwarts professionals in healthcare, new evidences would be search and accordingly new interventions, programs and services would be provided (Phillips 2015).

References:

Brown, A.E., Middleton, P.F., Fereday, J.A. and Pincombe, J.I., 2016. Cultural safety and midwifery care for Aboriginal women–A phenomenological study. Women and Birth, 29(2), pp.196-202.

Couzos, S. and Thiele, D.D., 2016. Aboriginal peoples participation in their health care: A patient right and an obligation for health care providers. Aboriginal and Islander Health Worker Journal, 40, p.6.

Cox, L.G., 2016. Social change and social justice: cultural safety as a vehicle for nurse activism, presented at 2nd International Critical Perspectives in Nursing and Healthcare, Sydney Nursing School, Sydney Australia. October 31st-November 2nd.

Durey, A., Halkett, G., Berg, M., Lester, L. and Kickett, M., 2017. Does one workshop on respecting cultural differences increase health professionals’ confidence to improve the care of Australian Aboriginal patients with cancer? An evaluation. BMC health services research, 17(1), p.660.

Freeman, T., Edwards, T., Baum, F., Lawless, A., Jolley, G., Javanparast, S. and Francis, T., 2014. Cultural respect strategies in Australian Aboriginal primary health care services: beyond education and training of practitioners. Australian and New Zealand journal of public health, 38(4), pp.355-361.

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Raman, S., Ruston, S., Irwin, S., Tran, P., Hotton, P. and Thorne, S., 2017. Taking culture seriously: Can we improve the developmental health and well?being of Australian Aboriginal children in out?of?home care?. Child: care, health and development, 43(6), pp.899-905.

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