CHCDIV002: Promote Aboriginal and/or Torres Strait Islander Cultural Safety

SCENARIO:
Shakira is a 7 year old girl living in a remote Indigenous community in the Northern Territory. She has 2 brothers and 2 sisters between the ages of 3 to 12 years. She is now cared for by different family members in communities scattered over a large area of the NT as her family frequently travels. Her mother Jasmine is 27 years old and has recently lost custody of her children as she was frequently found to be drinking in town and not caring for or feeding her children. Her father cannot be located.
Shakira was diagnosed 2 years ago with Rheumatic Heart Disease and is required to have injections every 3 weeks for at least 10 years as well as follow up cardiac tests. These tests include Echocardiography which can only be done in city hospitals. Shakira started her life underweight at birth and has suffered many middle ear infections leading to decreased hearing which has affected her speech.
Shakira frequently misses school but when she does attend she is fed breakfast to start her day as often food is scarce within the family. She is still underweight for her age.
2
Research and then provide the following information about Shakira:
Q1. Briefly discuss Rheumatic Heart Disease and the cause, including factors that may have led to Shakira contracting the disease.
Identify and explain two social determinants of health that may have made Shakira more susceptible to the disease.
Explain how one of these determinants may have affected Shakira’s families decision-making around her care.
Include the standard treatment required
Include relevant Indigenous statistics for RHD compared to the mainstream population. (150 words)
Q2. Explain how you will provide culturally safe care as an Enrolled Nurse by defining and giving one example of the following terms:
(a) Cultural awareness
(b) Cultural sensitivity (100 words)
Q3. By acknowledging the impact of events and issues throughout the history of Australian and Torres Strait lslander people it helps the Enrolled Nurse gain insight into the current physical, mental, social, economic and political situations affecting Australian and Torres Strait lslander people and their engagement with community services and health systems.
3.1 Research via the link: https://www.legislation.gov.au/Details/C2012C00258
In your own words briefly explain the objectives of The Aboriginal and Torres Strait Islander Act 2005. (50 words)
3.2 Considering the health generally of Aboriginal and/or Torres Strait Islander people provide an explanation in your own words of the significance of one the following and briefly explain how they may be affecting the day to day health and wellbeing of these people.
(a) The impact of European settlement/Colonisation
(b) Loss of land and culture
(c) Kinship/skin system
(d) Mabo case/ Terra Nullius
(e) Forced removal of children (‘Stolen Generations’) (100 words)
Q4. Successfully working in partnership with Australian and Torres Strait lslander people requires effective communication. Gaining their full participation by consulting with them and involving the individual and at times the community in their health care decisions is essential to providing culturally safe nursing care.
Select one of the following strategies and discuss how this strategy can assist the Enrolled Nurse to improve communication and build a rapport to provide culturally safe care

Answer 1

Rheumatic Heart Disease (RHD) is a condition related to strep throat. A group ‘A’ bacteria known as Streptococcus causes this condition. The bacterium causes throat infection and if not detected and treated early, it can cause permanent damage to the heart leading to stroke or even death. In cases where a child experiences recurring or untreated throat infections, it can cause rheumatic fever. RHD is caused by overcrowding, poor sanitation, and air pollutions just to mention a few. Therefore, Shakira might have contracted the condition from this kind of environment. Other than the environment, the environment can also be inherited. In this case, Shakira might have inherited this kind of gene from her father or mother. Early diagnosis and treatment are essential (O’Sullivan, 2013). In Shakira’s case, she needs a daily dose of antibiotics until she is 25 years of age to prevent recurrence of the condition and to prevent the development of heart infections and other bacterial endocarditis.

Answer 2

(a)   Cultural Awareness

Cultural safety in health care delivery involves placing substantial consideration to cultural sensitivity and cultural awareness to all the patients (Nursing council of New Zealand, 2012). In this case, practicing nurses are expected to provide quality and safe health care by considering the issue of cultural diversity; this can be achieved by recognizing and respecting cultural diversities. Further, enrolled nurses should respect the rights of individuals from other cultures in order to meet their needs and expectations (Faculty of Health, 2013)

(b)   Cultural Sensitivity

According to the American Council of Gynecologists and Obstetricians, cultural sensitivity is the code of conduct whereby a practicing nurse has the knowledge and interpersonal skills that enable them to understand, appreciate and work with individuals from a culture different from their own. A good example of cultural sensitivity is the Amish couple who come from a minority group in America who do not consider enrolling for any kind of medical insurance because of their culture. After the couple went through a cesarean, is when a nurse advised them to enroll in Medicaid. In such a case, the nurse was culturally sensitive; this enabled her to recognize that the couple was not using the government aid. Therefore, by helping the couple enroll in Medicaid, the nurse will be in a position to reach the community (McGough, Wynaden & Wright, 2017).