Critical Reflection of the Cultural Respect Framework - Case Study Example

Running Head: CRITICAL REFLECTION OF THE CULTURAL RESPECT FRAMEWORK Critical Reflection of the Cultural Respect Framework Name Institution Date Introduction Increased need of the health services that are culturally appropriate to the Aboriginal people has been considered as the main factors contributing to the improvement of Aboriginal health results. As a result, the Cultural Respect Frameworks exists to provide the relevant guiding principles in the development of policies as well as initiatives that improve the required cultural competencies in mainstreaming the health services. Cultural Respect involves the recognition, continuous protection of the inherent rights, traditions and cultures of the Aboriginal people (DHAC, 2001). The shared Cultural Respect is achieved especially when the Aboriginal health system environment is protected. Cultural Respect is aimed at upholding the rights of Aboriginal people so as to develop, maintain, and protect their culture as well as enable them to attain equitable health results. The Framework for the Cultural Respect recognizes such principles as the holistic approach, responsible health sector, communal control in the provision of health care services, collaborative work, localization of the decision-making, promotion of good health, development of capacities for health services, communities and accountability for the health results (Giroux, 2004). The study examines the reflection of the Cultural Respect Framework in the health situation of Roy an Aboriginal man who is middle aged, critical evaluation of the impacts of policies and the practices as result of the application of such principles with particular interest in the health condition of Roy and how the increased collaboration as well as cultural respect contributes to the achievement of better health results for the Indigenous Australians with Roy as the case of study. Roy decided to visit the Medical Centre in his small rural town of Australia for medical check up. The Cultural Respect Framework principles application The principle of localized decision-making is very applicable in the health situation of Roy who appears to be reluctant in walking to the Medical Centre and he is not certain of the four doctors who to visit. In addition, Roy has never had a chance to visit the centre before hence not seen any doctor in the rest of his previous life. The health authorities are required to devolve the decision-making capacities to the local Aboriginal people such as Roy in their communities. As a result, Roy and other people with health problems will be able to define their various health needs as well as priorities for effective planning and meeting them in a culturally appropriate manner. Such an attempt should be in the collaboration with Aboriginal based and mainstream in health services (Browne, Smye & Varcoe, 2005). A holistic approach that recognizes the health status of the Aboriginal people for instance Roy whose health conditions are very painful is required. Such approach to the health status of Aboriginal people, must to take the physical, cultural, social, spiritual and emotional wellbeing into consideration in collaboration to the community capacity and control. Rather than people glancing and have a quick turn away from Roy due to the unpleasant oduor from him, which made him quite uncomfortable in the waiting room, they could have attended to him with an emotional and spiritual heart. Promotion of the good health is considered as the fundamental component under the broad primary health care, as a result it needs to be the core activity in mainstreaming the health services. The female doctor who attended to Roy’s health situation decided to ask him several questions and release Roy on tablets rather than carrying out some medical tests. Later on during the day Roy’s health conditions becomes worse, semi-consciously sick that he was to be rushed to the hospital. After examining him, it was discovered that level of blood sugar in his body was very high and he was diagnosed with diabetes mellitus. The female doctor who previously attended to Roy would have promoted the good health by diagnosing and preventing his diabetes mellitus illness. The responsible health sector principle which considers the health improvement of the Aboriginal and communities as being the core responsibility, high priority for the entire health sector, is reflected when the nurse realized that extra education needed if Roy was to manage his diabetic health condition at home. She as a health care nurse worked in collaboration with very strong team comprised of the Indigenous Health Workers that immediately enabled in sorting their pieces of advice. The principle of community control for the various health care services, emphasizes on the need to demonstrate the effectiveness of appropriates as well as accessible health services. Supportive community decision-making, control and participation are considered as the core component of a health care system that supports the holistic, culturally sensitive health services for the Aboriginal people (DHAC, 2001). Such a principle is reflected when the nurse and Indigenous Health Workers emphasized on the significance of communicating with Roy himself, his family and the entire community. They discovered that the route course of Roy’s diabetes illness was a result of the loneliness and depression after his wife’s death. Capacity building of the health services as well as communities principle which focuses on the need to strengthen the health services, build the community expertise is reflected in Roy’s diabetic health attendance. Effective respond to the various diabetes health needs of Roy and responsible actions for health results are suggested. The nurse and Indigenous Health worker pointed out that Roy’s health situation require support so as to manage his financial needs, loneliness, grief situation that concerns the death of his wife and the confidence in managing his diabetic health conditions. Accountability for the health care outcomes is reflected when the nurse and Indigenous Health workers decided to visit Roy, his family and the entire community regularly. Eventually, they discovered that Roy, his family and the whole community trusted them by telling more issues that concerns their lives. As a result, they acknowledged the importance of not rushing, but going with the pace for the needs of Roy and his family. The Cultural Respect Framework and its various applications in the nursing practice Culture and nursing education is considered to have undergone a reflective metamorphosis within the past decades. Studies indicate that initially, the nursing students acquired their education through the apprenticeship model formed as a result of framed instructions creating a focused paradigm (Blackford, 2003). However, due to the shift of nursing education from the inclusive clinical background into the colleges as well as university settings, there was the adoption shift to the humanities was considered as a holistic paradigm. Such a holistic approach to the health care service is required in diabetic health condition of Roy as it involves the physical, cultural, emotional, and social wellbeing. The paradigm focused nursing education is coupled with the humanistic, and the critical social principles that offer the ultimate cultivation of neophyte nurses. Such nurses are empowered with the necessary principles in health care service provision that is salient to the various health needs of different individuals. Paradigm focused education in nursing promotes the principle of capacity building in health services as well as communities. As a result, the community expertise are created to strengthen the health services and effectively respond to the health needs such as the diabetes needs of Roy. The experts who are equipped with the relevant cultural and clinical knowledge for responsive health outcomes in Roy’s blood sugar levels and his entire community (Blackford, 2003). The culture taught within the nursing schools, reflective practices conflicts of health care systems among the various institutions and health service empowerments, makes the practitioners of health care nursing to experience the discrepancies. Such discrepancies exist between the ideal cultures introduced in school, compared to the manifested culture involved in hospital as well as community settings. Way of knowing The nursing practitioners are taught various tactics of knowing such as personal knowing, so as to have holistic plan for the provision of comprehensive health care to the patients. The management of Roy’s diabetic illness requires the holistic planning by both the nurse who takes care of him and the Indigenous Health workers, this is because the complications of diabetes re-occur and very expensive economically, psychologically and physically(Locsin, 2002). Since the personal knowing is achieved through the therapeutic application of the self, there is promotion of integrity as well as wholeness in any personal encounter between the patients and among the nurses who are practitioners. As a result of the creative blending of personal knowing in relation to the empirical, ethical and the socio-political approaches, aesthetic, the nurses acquire the necessary skills that help them to perform in a caring culture which is very therapeutic, holistic and salient enough to the various health conditions that are in need of recovery. Cultural socialization Through cultural socialization, the nursing practitioners learn on how to effectively navigate within a variety of overwhelming health tasks, and the hospital ward rules as well as cultures (Locsin, 2002). Socialization process involves the enculturation so as the nurses can be in a position to identify themselves with own professional culture, acculturation that enable such nurses to easily assimilate some other professional cultures. Cultural socialization is a reflection of the principle of capacity building for health services as well as communities of the Cultural Respect framework (Browne, Smye, & Varcoe, 2005). As a result of cultural socialization, the nurses are trained on how to manage the various cultural rules as they perform their duties, similarly within the principle of capacity building to promote health services, an emphasis is put on the need to strengthen the health services through community development of health expertise who can effectively respond to the various health needs and undertake some responsive measures for health outcomes. Intention for nursing Professional valuing is an ideal part in the nursing culture since it prepares the nurses with knowledgeable skills for nursing practice. The rationale to nurse is a unifying concept that underlies the nursing practice as well as culture. Promotion of the nursing values, aspiration of the positive experience and the need to facilitate human health, are the major intents to nurse. Studies indicate that nursing practitioners are acculturated so as to develop the nursing connoisseurship (Benner, 1984). She argued that meditative thinking enables the nurses to learn more about the culture as well as nursing profession compared to the calculative thinking. This implies that nurses are basically introduced to the nursing culture and their profession through several lived experiences during their clinical practice exposed to. The Cultural Respect framework principle of having a responsible health sector is reflected in the idea of intent for nursing among the nursing practitioners. Improving the various health needs of the Aboriginal people such as Roy with his diabetic health status and the entire community, should be the core responsibility as well as high priority for the entire health sector. A culturally safe health care The nurse leadership debate on the nursing practice is greatly focused on topics such as cultural competence, culturally congruent interventions to health care and cultural safeties. Several contributions from various authors suggest the significance of understanding such overarching concepts within the Indigenous culture, and how they relate to each other in the nursing practice. Cultural competence is related to the model of cultural development based on the recognition of cultural awareness, cultural competence and cultural sensitivity. Such cultural aspects have not reached the intended level of cultural development needed by the health care professionals, institutions so as to effectively meet the various health needs within diverse population. Within the cultural development model, cultural competence has been considered as the relevant routine application of cultural health care approaches and practices (Ahuarangi, 1996). Health is perceived as the vital human right within the various UN frameworks of human rights. He argues that human right to health comprises of the right to access health care and right to an effective cultural health care system (Ahuarangi, 1996). Traditional knowledge or use of medicine is considered as the most significant aspect within a culturally appropriate kind of health care intervention for the Indigenous people. The principle of working together is represented in the culturally safe health care aspect of nursing practice. The need to combine a variety of governmental, private organizational and non-governmental efforts both within as well as outside health sector is greatly emphasized. This should be achieved in partnership with Aboriginal people for instance Roy who really needs a comprehensive health care to control his expensive diabetes complications. Collaborated health sector also provides the relevant opportunity for the improvement of broader health determinants that are comprised in the UN frameworks of rights that significantly perceive the human right. The impact of Cultural Respect policies and practices among Australian Indigenous people The policies and practices of the Cultural Respect framework have great impacts to the Indigenous people of Australia as they access the health care services. The colonial experiences as well as its aftermath, is related to the Indigenous people’s health especially on the aspects of health status. As a result, much attention is put on the need to involve nursing in the critical social, political conscious of the entire nursing practice. Shift from cultural sensitivity to the cultural safety Critical consciousness shift from cultural sensitivity to full participation in the cultural safety has been considered very important. Several authors argue that without the strategies of critical thinking on the cultural issues, race, and the discriminatory policies as well as practices within the health system, are highly ignored by a large number of health professionals (Downey, 2006). Consequently, the various differences such as community, kinship ties, and strong family in mainstream understanding between the Indigenous health and respective nurse attendants are largely ignored by a group of health authorities. Therefore, continuous lack of examining institutions for health care, policies as well as practices, greatly discourses the social practice operation making it a reinforced status quo. The challenge becomes to discover the nursing responsibility so as to eliminate the status quo (Papps & Ramsden, 1996). The intervention to nurse within the socio-political structures is considered as the essential attempt in the promotion of health, the prevention of illness through the activities of nurses on their respective patients. In addition, the locus shift within the nursing practice from individualistic approach to the uncovered focus and critique social structures oppression that largely constrain the Indigenous people’s health, has been reformed through the Cultural Respect framework principles of working together, good health promotion and communal control of the services of primary health care (Browne, et al, 2009). Critical engagement fostering in Nursing As a result of the unchecked brutality evident of Aboriginal unemployment, anomic conditions and social exclusion, great concern on the health of Aboriginal, non-Aboriginal individuals would be catastrophic. Consequently, the responsibility of nursing in the creation of a conducive environment for health care through which the Indigenous poverty and social malaise is greatly valued. Such social issues have led to the cultural safety theory embedded in the postcolonial ideas that can enable the nurses to be critically connected to their nursing practices (Browne, et al, 2009). Therefore, cultural safety a conceptual relationship that is initiated by the nurse who is supposed to reflect on self social location so as to understand his or her contribution in relation to the nursing encounters. For the nurse to understand the patient’s culture, such a nurse is required to recognize as the holder of culture as well as learning how that particular culture contributes to the health care provisions (Ahuarangi, 1996). This has led to the existence of nurse-patient relationship that commonly known as bicultural. Promotion for good health outcomes as the principle of Cultural Respect framework has been reflected in this aspect of critical engagement in nursing. Since the principle recognizes health promotion as well as prevention of illness as being the fundamental component within the comprehensive basic health care, the accountability of nursing in their creation of a supportive environment for the provision of health care through which the Indigenous poverty and social malaise, is an ideal responsibility. Currently, the nurses are increasingly in the discourse of understanding cultural safety, this is aimed at analyzing the various complexities in delivering Indigenous health care. Contributing historical barrier factors to health care accessibility by Indigenous people A number of studies reveal the various barriers to proper utilization of health care. Such barriers greatly contribute to health disparities that exist between the minorities and majority of the population in Australia. For the Indigenous people within Australia, issues of rural location, poverty as well as communication and isolation, greatly contribute to the various health care disparities (Gruen, R.L. et al, 2002). Rural location Indigenous people who live in rural locations have limited accessibility to adequate health care service. The facilities for health care provision in the rural areas are understaffed; rarely find time to involve in the recruitment of health care practitioners who can live as well as work in the remote communities. Such remote areas are faced with poor health care accessibility. Rural location in collaboration with urban centre isolation increases the gap for health care disparity between majority and the Indigenous population. Studies indicate that Indigenous population in Australia continuously experience high health disparities compared to the majority of the population. In addition, the expenditures for health care among the rural Indigenous societies (Gruen, R.L. et al, 2002). Communication barriers Language barriers contribute some formidable obstacles that hinder accessibility to the utilization of adequate health care. Differences in community languages have reflected an enormous barrier within the various cultural as well as ethnic groups. Although, the health care providers and respective patients may speak similar language, their cultural values and patient experiences greatly determine how to communicate the prevailing symptoms. As a result, how such individuals perceive the feedback concerning their particular health status provided by careers differ. Identification with a majority of the white culture, largely affects the health perception of Indigenous population and how such group seek out their medical services. Socio-economic status The economic disadvantage rates as well as poverty level among the Indigenous people are very high compared to the majority of the populations. The socio-economic status also affects the medical services accessibility among the Australia’s Indigenous individuals. Conclusion The Cultural Respect is greatly required in upholding the rights of Aboriginal people with an intention to develop, maintain, and protect their culture as well as enable them to attain equitable health outcomes. The paradigm focus in nursing practices is largely coupled with both humanistic and the critical social principles focused on the provision of ultimate cultivation among the neophyte nurses. Personal knowing practice of nursing is achieved through therapeutic application of the self. As a result, there is promotion of integrity as well as wholeness in any personal encounter between the patients and among the nurses who are practitioners. The Australian Indigenous population, continuously experience high disparities in accessing the health care services compared to the majority of the population. References Ahuarangi, K., (1996). Creating a safe cultural space, Kai Tiaki. Nursing New Zealand 2(10): 13-15. Browne, AJ, Smye, V & Varcoe, C., (2005). The relevance of postcolonial theoretical perspectives to research in Aboriginal health. Canadian Journal of Nursing Research 37(4): 16-37. Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing. Menlo Park, CA: Addison-Wesley Browne, J. A et al, (2009). Cultural safety and the challenges of translating critically oriented knowledge in practice. Nursing Philosophy.Vol.10, No.3, 167-179. Blackford, J. I. (2003). Cultural frameworks of nursing practice: Exposing an exclusionary healthcare culture. Nursing Inquiry. 10 (4), 236 - 244. Department of Health and Aged Care, (2001). Better Health Care, Studies in the Delivery of Primary Health Care Services. 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