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1.List any potential cultural reasons for May’s and the patient’s reactions.

2.Describe how you would approach May and the patient to apologise, and what you would say to them both that will bring healing to the situation

3.What strategies could you now put into place for promoting cultural safety for Aboriginal and/or Torres Strait Islander patients at your workplace and their communities?

4.How can you involve Margaret and May in the planning and delivery of services and programs when she is discharged 

5.Reflecting on how these 3 case studies have affected Margaret, how would you prevent this from happening to someone else?

6.As part of the discharge process Margaret is to attend an outpatient’s rehabilitation program at her local community health centre. Discuss the following points 
How can you as a nurse promote this program to Margaret and May? 

Who would you involve to ensure that Margaret participates? 

How can you assess if Margaret has the confidence to participate in this community program when she is discharged 

What follow up strategies can you put into place to assess and evaluate the effectiveness of the rehabilitation program?

Margaret has missed a few days of her rehabilitation, who would you communicate with in the healthcare setting and Aboriginal islander people to revise strategies to ensure that Margaret completes her rehabilitation 

How can you promote culturally safe services and programs to enhance participation?

The Influence of Cultural and Social Structures on Health and Well-being in Australia

Question 1:

A cultural and social structure such as race, religion as well as language and economic status has a major influence on the health and wellbeing of people in Australia. There may be some cultural tensions, which took place between May and the patient due to the difference in culture between Aboriginal and other cultures. It is a major fact in Australia that aboriginal Australian’s suffer from poor health in comparison to the general Australian community (Goodman et al., 2017). Therefore, these may be the potential reasons of culture for May and the reaction of the patient.

Question 2:

Some cultural conflicts and tension may take place between workers and the patients owing to the existing crisis and cultural issue. However, Rix et al., (2016) state that if this type of situation takes place in the hospital settings, it is the necessary duty of the supervisor to check up with the patients for clarifying the fact that if it would be a problem to deal with a person from another ethnic background. Similar to this, it is necessary to consult with May and the patient to apologise over the behaviour by taking a lead in trying to resolve the situation and accomplish a level of conciliation, so that the relationship in between them never suffers.

Question 3:

In order to promote cultural safety for the Aboriginal and Torres Strait Islander patients within the health care centre and the communities, it is required to establish relationships with different groups of people including co-workers, supervisors as well as management. Moreover, it is necessary to build a relationship with the individual's present within the care and in between their family members. According to Freeman et al., (2014) developing promotion and cultural safety lies in the way the individual care provider interact and behave with people. It is necessary to build fundamental requirements of shared respect and tolerance of diversifies culture within the workplace provided with additional safety standards for the aboriginal patients.

Question 4:

Planning of effective delivery of service is dependent on the appropriate kind of resources that are accessible to the people who work and provide care to the Indigenous Australian people. In this context, Forsyth et al., (2017) state that it is necessary for Margaret and May to be aware of the cross-cultural issues that are necessary for offering effective delivery of services. At the organisation level of planning and delivering services, it is necessary to involve May and Margaret in the policies and programs of procedures for the dealing with Indigenous Australian with the supportive requirement for enhancing the service delivery.

Promoting Cultural Awareness in Healthcare Settings

Question 5:

In order to protect the individual from the similar situation such as Margaret, it is necessary to plan and consult with the indigenous community members in Australia, leaders as well as workers for culturally establish suitable policies for offering direction to the workers. In this context, Kowal et al., (2015) state that it is also important for the care providers to acknowledge the presence of cultural diversity amongst the patients and they needs to support the care receivers with proper policies as well as procedures. Moreover, the community services workers are needed to be mindful while dealing with cultural bias and while engaging indigenous Australian people with support requires through negotiation.

Question 6:

Community centres of health are also known as outpatient rehabilitation centres that function across the state and the intent to offer a wide range of services and health promotion activities for the wellbeing of the local people, specifically for those who are the verge of poor health condition (Gwynne & Lincoln, 2017). However, being a nursing care provider after the discharge, the individual can help May and Margaret in understanding the general practices related to promotion of better health and prevention of disease as well as management of health. Encouraging people to actively take part in their own health frame these health promotions to enhance the health and wellbeing of the local community. Community health services need to work together with other primary health care providers to fill up the service gaps and promote the protection of lifestyle-associated diseases.

Question 7:

Margaret's Family members, her granddaughter May and the community centres supervisors will be involved to ensure that Margaret takes part in the outpatient's rehabilitation program after her discharge from the health care centre.

Question 8:

Through regular counselling and support services along with proper aged care services, the nursing care provider will be able to determine that Margaret has the confidence to take part in the community program after she is discharged. Moreover, after conducting an in the detailed physical examination of Margaret, it will be decided whether is she is ready to continue to take part in the rehabilitation program. According to Garneau & Pepin (2015), having gained confidence in the patient the nursing care provider will be able to plan to bring change in her and will be able to provide supportive care.

Question 9:

The strategies for evaluating the effectiveness of the rehabilitation program is by accessing the process of implementation and effectiveness in relation to the action plan created during the program. As stated by Brown et al., (2015) it is necessary to find out the changes that took place in the development of community and in the change of disability. Moreover, it is necessary to evaluate the cooperation in between the different sectors of the community, and the participating of the leaders, disabled and aged people with their family members.

Effective Delivery of Services for Indigenous Australian People

Question 10:

In the case when an individual misses first few days of the rehabilitation program, she is required to communicate with the service care provider within the healthcare settings and other members who were part of Aboriginal Islander program to ensure the completion of the rehabilitation program (, 2018).

Question 11:

In order to promote culturally safe practices and programs to increase participation of the cultural difference members the following is required:

  • Improving the understanding of the cultural principle and by enhancing links between legislation and practices
  • Offering prior intervention practices and health prevention assistance for the family members in different communities (Treloar et al., 2014).
  • Identifying and improving leadership practices through effective participation and decision making about the Aboriginal Torres Islander people.
  • Improving and increasing the recruitment possibilities and assistance for the care receivers.

Reference list (2018). Strategies for improving adherence to the Principle and strengthening outcomes for children. Retrieved from

Brown, S. J., Weetra, D., Glover, K., Buckskin, M., Ah Kit, J., Leane, C., ... & Yelland, J. (2015). Improving Aboriginal women's experiences of antenatal care: findings from the Aboriginal families study in South Australia. Birth, 42(1), 27-37.

Forsyth, C. J., Irving, M. J., Tennant, M., Short, S. D., & Gilroy, J. A. (2017). Teaching cultural competence in dental education: a systematic review and exploration of implications for Indigenous populations in Australia. Journal of dental education, 81(8), 956-968.

Freeman, T., Edwards, T., Baum, F., Lawless, A., Jolley, G., Javanparast, S., & 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), 355-361.

Garneau, A. B., & Pepin, J. (2015). Cultural competence: A constructivist definition. Journal of Transcultural Nursing, 26(1), 9-15.

Goodman, A., Fleming, K., Markwick, N., Morrison, T., Lagimodiere, L., Kerr, T., & Society, W. A. H. R. (2017). "They treated me like crap and I know it was because I was Native": The health care experiences of Aboriginal peoples living in Vancouver's inner city. Social Science & Medicine, 178, 87-94.

Gwynne, K., & Lincoln, M. (2017). Developing the rural health workforce to improve Australian Aboriginal and Torres Strait Islander health outcomes: a systematic review. Australian Health Review, 41(2), 234-238.

Kowal, E., Gallacher, L., Macciocca, I., & Sahhar, M. (2015). Genetic counselling for indigenous Australians: an exploratory study from the perspective of genetic health professionals. Journal of genetic counselling, 24(4), 597-607.

Rix, E. F., Moran, C., Kapeen, R., & Wilson, S. (2016). Building cultural bridges and two-way understanding: working with Australian Aboriginal people within mainstream renal services. Renal Society of Australasia Journal, 12(1), 12.

Treloar, C., Gray, R., Brener, L., Jackson, C., Saunders, V., Johnson, P., ... & Newman, C. (2014). “I can’t do this, it’s too much”: building social inclusion in cancer diagnosis and treatment experiences of Aboriginal people, their carers and health workers. International journal of public health, 59(2), 373-379.

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