Cultural Health Care Needs in Nursing: Unique Needs of Different Cultures

This assignment explores the unique cultural needs of different cultures to increase the provision of culturally safe care plan. It highlights three different cultural needs that differ from the Australian healthcare needs, models or guidelines. It also discusses the role of RN professionals in implementing culturally safe and effective care plan.

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Introduction
Cultural safety presents the principal philosophical shift from delivering care to the
patient regardless of their difference in the cultural and spiritual values and this mainly take
into account of the unique needs of the patients (Hemberg & Vilander, 2017). The following
assignment aims to explore the unique cultural needs of the people in order to increase the
provision of the culturally safe care plan. The assignment will highlight three different
cultural needs that differ from the Australian healthcare needs, models or guidelines. This
will be followed by the analysis of the differing needs and the role of the registered nursing
(RN) professionals in order to implement culturally safe and effective care plan.
Cultural Health Care Need 1
Beginnings of Life and Parenthood: Contraception is not accepted in some
religions/cultures
There are many kind of contraceptive methods practiced in Australia like male and
female condoms, emergency contraception pills and intrauterine devices (copper and
hormonal). However, the concept of contraception is some-what complicated in the Islamic
culture. Muslims strive for building strong family and community bonds and they consider
children as a gift from Allah. The Qur’an does not specifically refer in favour of the family
planning or contraception however, is against infanticide. Qur’an warms Muslims not to kill
their children. Do not kill your children for fear of want." "We provide sustenance for them
and for you” (6:151, 17:31). This particular phrase is misinterpreted by few Muslims, and
thus, raising issues against contraception. Thus, the cultural healthcare need under this
context is promotion of the unregulated birth without any use of the birth control pills and
maintaining a bid family with many earning members. According to the Australian

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Healthcare and Hospitals Association (2016) the Australian healthcare needs mainly promote
community based health awareness program in order to reduce the chances of unwanted or
unplanned pregnancies and thereby helping to reduce the rate of spread of the chronic
diseases. Tigabu et al. (2018) are of the opinion that the lack of use of the contraception or
unprotected sex among the Muslim communities also increases the vulnerability of
developing sexually transmitted infections (STIs). Tigabu et al. (2018) further highlighted
that despite large-scale investment in the access of the contraceptives, unintended
pregnancies, uncontrolled population growth and sexually transmitted disease among the
population of the Middle East residing in Australia is posing a significant healthcare problem.
The cultural and religious influences restrict the use of the contraception. The Australian
Government, Department of Health (2011) has their own national strategies (2010 to 2013) in
order to prevent the spread of HIV, hepatitis B, hepatitis C, syphilis and herpes simplex virus
and Chlamydia infection. Australian Government also observes National STI Sexual Health
Campaign for over four years in order to prevent STIs.
In order to provide culturally safe healthcare for prevention of the STIs and
uncontrolled growth among the Muslim populations, it is the duty of the registered nurse
(RN) to conduct community based health education program. This kind of program will help
to raise awareness among the mass in the domain of the side-effects of the unprotected sex.
The community based health education program will be structured in the presence of the
culturally competent nursing professionals mainly from the Muslim origin. This will help in
framing of the educational program based in the religious and the cultural thoughts of the
Muslims. There will be separate health education program for the men and the women. This
is because, under the Muslim religion, people are not comfortable in discussing sex or
gynecological issues with opposite sex. Thus separate health education and awareness
program will be helpful in increase the spontaneous participation of both men and women

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while raising awareness about contraception and importance of protected sex. It would be the
duty of the Aboriginal nursing professionals to design the health promotion program in such a
way that it makes use of the colloquial language under the execution of the effective
communication skills (Vu et al., 2016). Shirazi, Shirazi and Bloom (2015) are of the opinion
that the use of the effective communication skills help in the development of the therapeutic
relationship with the client and thereby helping to increase the indulgence in the health
promotion program. The use of the power-point presentation (audio-visual presentation)
followed by the interactive sessions will be helpful in promoting health awareness. Under the
community-based health education program, the main motion of education will focus why
health is important for comprehensive well-being and who health is linked with attaining
supreme spirituality. This is popularly known as faith-based framework (Wolf et al., 2017).
Cultural Health Care Need 2
Medical Intervention: A person who identifies as a Jehovah's Witness unable to have any
blood products
A small group of patients refuse to undertake blood transfusion therapy and are
usually based on certain specific religious beliefs or faith known of Jehovah’s Witness (JW).
This group of people believes that Bible is the true word of God. They do not celebrate
birthday or Christmas and nor do they salute flags for vote in public elections. They nurture
the belief that since blood is the principal source of life, one must not eat or consume blood
(by the means of blood transfusion) and anyone to consume it, must be cut-off.

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(Source: Chand, Subramanya & Rao, 2014)
However, JW accepts all form of medical treatment and are keen to cooperate with
the medical professionals. Due to strong refusal of the blood transfusion among the JW, their
primary healthcare needs include lack of proper management of the anaemia or other blood
borne diseases. This is something difference from the Australia basic healthcare models.
Australian Commission on Safety and Quality in Healthcare (2005), work diligently in order
to promote better and safer blood transfusion process. Dixit and Sambasivan (2018) stated
that main Australian Healthcare needs improvement in the comprehensive health and well-
being of the population suffering from blood deficiency and blood borne disease by effective
transfusion of the blood. However, the blood grouped must be mapped thoroughly while
maintaining proper storage and aseptic storage condition in order to improve the overall
efficacy of care and reduces the chances of agglutination (Norfolk & Hartley, 2014).

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The main ethical issues that coincide while giving blood transfusion to the JW
population include hamper to the autonomy of the patients. The rejection of the blood
transfusion leads to the generation of the ethical dilemma between the freedom of the patients
to reject or accept the medical treatment even unto death (ethics of autonomy) while it is the
duty of the RN is to provide optimal care (beneficence and non-maleficence). Under the
emergencies, if the status of the JW is not known, the RN who is caring for patient is
expected to perform their best and this might include administration of the blood under the
supervision of the doctor in order to save life of the patient as it is the nursing priority.
Relatives or the family members to oppose the blood transfusion to the patient must be asked
to provide documentary evidence and in the absence of the same, the blood transfusion must
not be with held under life-threatening circumstances. It is the duty of the nurse to ask for
valid evidences for JW before taking any decision. However, if the RN knows that the patient
is JW, it is the duty of the RN to respect the competently expressed views of the patient even
if it amount to death. In case of the JW child, the legal and the ethical obligation of the
healthcare professionals rest with the child patient and not over the will of the parents. Other
alternative approaches that are undertaken by the RN professionals in order to promote blood
transfusion among JW while preserving the autonomy. Some of the approaches include
transmission of recombinant activated factor VII that is not produced from the human blood
or plasma, conduction of the blood less surgery and conduction of rigorous invasive
monitoring in order to optimize the process of the oxygen delivery (Norfolk & Hartley,
2014). Using such approaches help to maintain the autonomy of the patient while securing
the beneficence and non-maleficence. RN must also design proper diet plan (rich in iron
content) in order to increase the level of haemoglobin in the blood (Chand, Subramanya &
Rao, 2014).

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Cultural Health Care Need 3
Roles of Families and Extended Family Members: Large number of visitors among the
Aboriginal children
Aboriginal kinship and the stricture of the family are still regarded as the cohesive
factors that bind the aboriginal individuals together in different parts of Australia. The
Aboriginal family is regarded as a collaborative clan that is composed of fathers, mothers,
uncles, aunties, sisters, cousins and brothers. At present this family structure is known as
extended family. For the Aboriginal people, family is their principal pillar providing
psychological and emotional support and the same is important for the promotion of the
comprehensive health and well-being (Australian Institute of Family Studies, 2019). Due to
this extended kinship structure of the family of the Aboriginals, a large number o the visitors.
A large number of visitors under the hospital settings create a problem in delivering proper
care to the children. According to the Australian healthcare policy, the children who is 18
years and older are competent enough to provide consent for their own therapy planning. The
children who are 16 years of old are also held eligible for giving consent to their healthcare
therapy however, their critical thinking and the decision-making skills must be taken into
consideration like Gillick competence (Raman et al., 2017). The frequent visit of the family
members creates a barrier in delivering proper care to the children under the healthcare
settings. However, it is the duty of the nursing professionals to channelize proper information
to the family members in order to make informed decision making and this duty coincides
with the professional practice standards of the Nursing and Midwifery Board of Australia
(NMBA). In order to retain the cultural competency and not harming the emotions of the
family, the nursing professionals can provide detailed information about the therapy progress
of the children to the parents (father and mother) and request then to convey the information
to the other family members. During the visiting hours, all the family members must be

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allowed to visit the child in case of the in-patient settings. Under such circumstances, it is the
duty of the RN to allow member in one by one and in a time effective manner such that the
emotions of none of the members of the extended family is hurt (Raman et al., 2017). Clare
and Oakley (2017) are of the opinion that the there is a complex relationship between the
nurses and the indigenous Australians. The presence of the Aboriginal nursing workforce
helps in improving the approach of the informed decision making and at the same time
increases the acceptance of the care approach among the indigenous population. The
approach of the informed consent must be undertaken by respecting the dignity and ethical
values of the aboriginal parents. Kendall and Barnett (2015) state that in order to increase the
participation of the Aboriginals under the mainstream healthcare services like in the child
care and to reduce the unwanted visits of the extended family members and to prevent the
over-crowding, it is important to develop culturally appropriate healthcare services by the
RN. This approach is solely dependent on the use of the effective communication skills
(verbal and non-verbal communication skills), increase in the level of the cultural
competence among the nursing professionals and to increase the scope of the collective and
holistic healthcare approach.
Conclusion
Thus from the above discussion, it can be concluded that it is the duty of the RN to
respect the autonomy of the patient while securing the beneficence and non-maleficence.
There are certain cultural beliefs or the religious values that goes against the normal practice
guidelines of the healthcare. Under this circumstances the role of the nursing professionals
become crucial for maintaining culturally competent care plan while increasing the overall
acceptance of the care and reducing the health related threats to the clients.

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References
Australian Commission on Safety and Quality in Healthcare. (2005). Towards better, safer
blood transfusion. Access date: 18th September 2019. Retrieved from:
https://www.safetyandquality.gov.au/sites/default/files/migrated/bloodrept05.pdf
Australian Government Department of Health. (2011). Sexual and reproductive health.
Access date: 18th September 2019. Retrieved from:
https://www1.health.gov.au/internet/publications/publishing.nsf/Content/womens-
health-policy-toc~womens-health-policy-four~womens-health-policy-four-sexual
Australian Healthcare and Hospitals Association. (2016). A health system that supports
contraceptive choice. Access date: 18th September 2019. Retrieved from:
http://familyplanningallianceaustralia.org.au/wp-content/uploads/2016/07/
final_report_ahha_-_a_health_system_that_supports_contraceptive_choice_-
_results_and_.pdf
Australian Institute of Family Studies. (2019). Families and cultural diversity in Australia.
Access date: 18th September 2019. Retrieved from:
https://aifs.gov.au/publications/archived/3539
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Clare, M., & Oakley, A. (2017). 'Who's my mob'? Pro-active searching for the extended
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