A registered nurse faces different clinical situations

A registered nurse faces different clinical situations while working. Being a
professional senior registered nurse, I have witnessed several medical cases where race and
ethnicity played an important role. Judy, a 57 year old aboriginal widow suffering from Type
II diabetes and leg ulcer, lives alone in her house. She requires dressing for her leg ulcer and
as she has issue with mobility, the community nurse will attend her home. However, with
effective policies and strategies, it is possible to deal with all the issues in working settings.
Closing the gap (CTG) is one of the effective policies in this regard. Here, in this paper, the
benefits of CTG will be discussed along with its historical background. At the same time, a
case study will be considered to find its relation with the CTG strategy. Again, the paper will
also analyze the roles and responsibilities of Aboriginal Medical Service and Aboriginal
Liaison Officer in this context. Finally, the paper will conclude assembling all the main
points of the paper.
Closing the gap is a policy of Australian Government that targets to improve the
health status of all aboriginal and Torres Strait Islander Australians. On the December of
2007, The Council of Australian Government (COAG) committed to closing the gap strategy
which focuses to bring equality in the life expectancy rate of indigenous and non-indigenous
people of Australia (Australian Government Department of Prime Minister and Cabinet n.d).
COAG includes the leaders of state, federal, territory and local government and all of them
agreed to be accountable for reaching this goal. Earlier, closing the gap policy was mainly
formed in response to the call of the social justice report of the year 2005 (St Clair et al.
2018). The main initiative taken with this policy was to eliminate the gap in the healthcare
outcome of indigenous people and to improve their lives. The disparity in health among the
aboriginal Australians has been recognized for a long time (Johnston et al. 2019). Reason
behind such gap is complex as well as multi-faceted. Due to some social determinants of
health, the health outcome varies. The difference in environment, socio-economic factor,

socio-cultural status, accessibility and affordability to the healthcare and many other factors
are affecting the indigenous health. Previously, little progresses have been made to reduce the
inequality considering the social determinants. Indigenous people claims to receive poorer
health service and they are more likely to suffer from poor health status. All these facts
contributed to the development of closing the gap policy aiming to reduce the health
disadvantages among aboriginals. The impact of closing the gap policy on the lives of
indigenous people is quite significant. It not only confined to improve the health status of
indigenous but also works with other social determinants that affect the health status of those
people. The policy aims to enrol 95% aboriginal children in early childhood education by the
year 2025 (Durey et al. 2016). Also, it focuses to reduce the violence against the aboriginal
women and children. The policy will also ensure that 65% of the indigenous people will be
associated with training, education and employment by the year 2018 and 60% of 25-64 years
aged will be employed by the same time span (Freeman et al. 2016). Apart from all these, it
also targets in improving the living status such as, housing, judicial system, land and water
system, and others (Gould et al. 2015). In the health sector, the target of the policy is to close
the gap of life expectance and establish equality in health. The strategies of closing the gap
have made many improvements to the health of indigenous people since it was introduced.
However, in some studies it has been published that gap in the life expectancy increased
instead of getting closed. In this regard, more needs to be done for the success of the policy.
According to the case study, Judy is suffering from Type II diabetes along with the
leg ulcer as its consequence. This disease can create lot of long term issues for Judy due to
various social determinants of health. First of all, accessibility and availability is a social
determinant that affects the healthcare as well as outcome. Due to long distance, many people
cannot access or avail the facilities of healthcare provided by various health organizations. As
a consequence, they experience poorer health status than other people who are accessing all

the health facilities. In case of Judy, she lives in a place, where the closest health care centre
is 10 km apart. Also, she is facing issue regarding mobility due to her leg ulcer and thus, it is
not possible for her to visit health clinic regularly for her dressing purpose. Another social
determinant is inequality due to racial discrimination (Australian Indigenous HealthInfoNet
n.d). Judy is from aboriginal community and due to this reason, she might feel to receive
inappropriate care from the healthcare providers and thus she might be reluctant to visit any
health centre. It can be a major reason of her poorer health status as a long term effect of type
II diabetes. Also, another social determinant can be lack of education for self management.
Judy will require a follow up to maintain her diabetic issues and to manage her leg ulcer. The
CTG policies are focussed to address all these 3 social determinants (Askew et al. 2019). The
policies targets to provide healthcare facilities to the aboriginal people as per their need and it
also aims in providing proper education or training to the patients in this regard.
Closing the gap strategy is guided by the principles of self-determination as well as
empowerment. It has been considered as the best progress of last ten years where the
aboriginal community has led the design and implementation of any program from the
beginning. Closing the gap policy is highly determined to reduce health disadvantages and
inequality faced by the aboriginal people of Torres Strait Island. As per the policy of closing
the gap, all the aboriginal people, irrespective of their race will get the opportunity to access
and avail healthcare facilities equal to the non-indigenous people of the country. The policy
also focuses to educate all the aboriginal people and health literacy is also necessary in this
regard (Australian Government Department of Health n.d). The policies are relevant to
address the social determinants for the case of Judy as well.
The principle of self-determination contributes to the establishment of Aboriginal
Community Controlled Health Service (ACCHS). The fundamental concept of ACCHS is to
provide primary healthcare facility to the aboriginal people (McKenna et al. 2015). It also led