Reflection On Clinical Experience With Indigenous Patients: A Study On Cultural Competence In Nursing

Using Gibb’s Model of Reflection, discuss your own attitude. Reflect on any biases or assumptions you might have had.

Reflection has been compared to be an extremely important tool that serves as a platform for the nursing professionals to evaluate their working experience. Reflection helps the nursing professionals in assessing their level of preparedness to handle critical clinical scenarios based upon real life situations (Bulman et al. 2013). The Gibbs Reflective model has been widely used by the nursing professionals to reflect upon their professional experience. It should be noted here that the model is broadly based upon six stages that encompasses description of an event, associated feelings, evaluation, analysing the processed information, conclusion and an action plan to rectify the mistakes and build up upon them so as to deliver better service.

This essay would reflect on the clinical experience gained by me while dealing with indigenous patients. It would further focus on how my attitude has changed and I have evolved as a nursing professional capable to delivering a culturally safe treatment. Knowledge on effective cultural competency is extremely important while dealing with the aboriginal set of population.  Through this subject, I have been able to understand the importance of cultural competence in the Australian context. I have assimilated knowledge regarding the fact that culturally safe treatment is built upon the standards of cultural competency guidelines.

Description: This semester had been a great learning experience. It taught me a lot of important factors that determine a holistic framework of providing culturally safe treatment. It has helped me understand in depth the social and cultural determinants that affect the well -being of the aboriginal population. The subject has enlightened me about the legislative policies in Australia for safeguarding the rights of the indigenous community. It has further helped me in gaining knowledge about the support organizations that offer aid to the members of the aboriginal community. During the semester there were a series of yarning circles that aimed at providing an insight into the aboriginal and Torres Islander health status. In this context, I would like to mention that I found the simulation workshop extremely informative. The workshop was conducted by two aboriginal experts, EBE1 and EBE2. EBE stands for experts by experience. The experts conducted the workshop by diving the class into two groups. The following session was an interactive one and one group was designated as the audience and the other as a group of registered nurse. One of the student was assigned the role of a manager. The two experts by experience, EBE1 and EBE2 acted as two aboriginal siblings Jennifer and Jack. The session proceeded with Jennifer elaborating on the disparity in the treatment procedure of her sister Judy. She mentioned that her sister was diagnosed with leg ulcer and the treatment intervention delivered to her was not at par with the treatment offered to other clients. Further, she critically pointed out that most of the decision related to the treatment intervention were taken by the brother Jack. Through this example, we were made aware of the treatment disparity and the fault in devising an effective care plan. In addition to this, the informative presentation on ‘Thursday island’ and card game helped in creating a realistic image about the present scenario in the indigenous context.  The informative debate sessions helped in developing a clear understanding about the Kagawa-Singer cultural assessment model as well as the Blackhall’s ABCD cultural assessment Model. On gaining through knowledge about these models, it helped me developing an appropriate care plan and maintaining effective communication while dealing with indigenous patients.

Feelings

Feelings: Throughout the semester the learning process had been intensive. The British colonization in Australia had a disastrous impact on the indigenous set of population. The members of the aboriginal community were exposed to brutal torture and were discriminated on the basis of their skin colour and culture (Loftin et al. 2013). This elicited a deep impact on my thought process. The brutal torture to which the children were subjected saddened me. I was further moved on knowing about the dark phase that the indigenous community members had to go through. According to statistical evidences furnished by research studies, it has been stated that more than 47% of the aboriginal children had been forcefully taken away from their parents and brutally tortured (Herring et al. 2013). The plight that the indigenous population base had to go through was a traumatizing experience and this has been the major reason why the indigenous community is lagging behind in terms of development. Recent welfare policies however have aimed at improving the outlook towards the aboriginal community members. The control the gap policy initiative taken by the Australian government aims at improving the social health determinants of the aboriginal health and enhancing the life expectancy within a time frame of 10 years. These policies are helping in creating a big difference.

Evaluation: The knowledge on the subject helped me in understanding the disparity that aboriginal and Torres strait islander population base is subjected to every moment. It thoroughly helped me in evaluating the major societal discrimination factors (Hovart et al. 2014). Studying the subject helped in reducing the stigmatized belief that had been existing in me. It further helped me in devising an effective care plan coupled with elements of emotional support. I was able to understand that as a professional I must provide culturally safe intervention and must also adapt a family centred approach while dealing with the clients. I also learnt that as a professional I must provide information related to hospital services and advocate patient rights whenever required. Hence, I could absorb the essentials to provide a family-centred, culturally safe and holistic care to the patients. In this context, I would like to mention an informative video that was shown to us during the semester. The video titled ‘Barbeq’ focused on the stigmatised societal belied related to the aboriginal community in Australia. It helped me in devising ways to counter the beliefs and provide an unbiased health care service delivery.

Evaluation

REM framework: The REM framework comprises of three major elements called the Respect, Engagement, Sharing and Moving Forward. This framework provides an overview about the indigenous culture and the awareness strategies that could be used to educate students and professionals about cultural safety practices (Power et al. 2016). It talks about different methods that are followed in order to deliver awareness education. Some of the examples include. Learning materials, informative sessions, workshops and seminars. In our case, the yarning circle method was used. The yarning circle method has been found to be effective in obtaining a positive response. For instance, the yarning circle during our semester helped us in developing a positive attitude and improve our professional practice standard. Further, it also helped us in knowing about the aboriginal history and the steps taken by the Australian government to address the societal stigma (Waldram 2014).

UTS graduate attributes: The UTS graduate attributes consists of a number of essential factors (University of Technology 2018). The first being the ability of the professionals to provide a patient-centred care that complies with the needs of the patient, families or communities (University of Technology 2018). The second attribute focuses on the maintenance of an effective communication between the patient and the caregivers (University of Technology 2018). The third attribute concentrates on the ability of the professionals to gather skills and provide evidence-based care (University of Technology 2018). The fourth attribute comprises of the professionals ability to deliver culturally safe care to the patient (University of Technology 2018). In addition to the listed attributes, the last attribute deals with the maintenance of a professional code, including patient confidentiality, maintaining cultural competency and safe working practices so as to deliver quality care to the patients (University of Technology 2018).

Hence, to conclude I would like to state that this subject has helped me tremendously in developing an insight about the indigenous history of the aboriginals. This subject has helped me in getting an idea about the effect of British colonization in Australia and the negative impact on the indigenous community members. Further, the interactive sessions and the knowledge about the various conceptual model has helped me in improving my professional capability to deliver a culturally safe intervention to the aboriginal. The subject has also helped me in developing an understanding about the ethical standards that must be stringently observed while designing an intervention plan. The informative presentation and academic resource materials on this subject helped me in developing a clear idea about the existing welfare government policies aimed at promoting welfare to the aboriginal community members. Therefore, I hope that with the absorbed knowledge I will be able to deliver culturally safe care to the patients. I believe that nursing students must understand the subject and have a clear conceptual understanding of the models in order to provide a holistic care to the indigenous patients. Effective training on cultural competency is well discussed and I believe the knowledge that I have gained would help in future to a significant extent.

References:

Bulman, C. and Schutz, S. eds., 2013. Reflective practice in nursing. John Wiley & Sons.

Herring, S., Spangaro, J., Lauw, M. and McNamara, L., 2013. The intersection of trauma, racism, and cultural competence in effective work with aboriginal people: Waiting for trust. Australian Social Work, 66(1), pp.104-117.

Horvat, L., Horey, D., Romios, P. and Kis?Rigo, J., 2014. Cultural competence education for health professionals. Cochrane database of systematic reviews, (5).

Loftin, C., Hartin, V., Branson, M. and Reyes, H., 2013. Measures of cultural competence in nurses: an integrative review. The Scientific World Journal, 2013.

Power,T.,Virdun,C.,Sherwood,J.,Parker,N.,Van  Balen,J.,Gray,J.,Jackson. 2016,’REM a collaborative framework for building indigenous cultural competence’,review,vol.27,no.5,pp.439-446.

University of Technology 2018, UTS graduate attributes, viewed 4 October 2018, < https://www.uts.edu.au/about/faculty-health/what-we-do/graduate-attributes>.

Waldram, J.B., 2014. Healing history? Aboriginal healing, historical trauma, and personal responsibility. Transcultural psychiatry, 51(3), pp.370-386.