Reflection Assignment on Culturally Safe Communication in Nursing

This reflection assignment focuses on the experience of a nursing student while providing care to an elderly aboriginal woman suffering from chronic rheumatoid arthritis. The reflection takes the assistance of the Gibbs reflection cycle to describe the event, explore the feelings, evaluate the scenario, analyze the experience, and conclude with a plan of action. The reflection highlights the importance of culturally safe communication in nursing.

Running head: REFLECTION ASSIGNMENT
Reflection assignment
Name of the student:
Name of the university:
Author note:

1REFLECTION ASSIGNMENT
Introduction:
Reflection can be defined as the professional tool or framework that provides the
opportunity to the nursing students to analyse their practice quality, discover the strengths and
the weaknesses of competence (Paterson & Chapman, 2013). In this reflection assignment, I will
be focussing on the experience that I have gained while providing care to an elderly aboriginal
woman suffering with chronic rheumatoid arthritis. This reflection will take the assistance of the
Gibbs reflection cycle in order to describe the event, explore my feelings with this unit,
evaluation of the entire working scenario, and analysis of the experience concluding with a plan
of action.
Description:
As a part of my first working experience, I had been given the opportunity to care for an
aboriginal women suffering with chronic rheumatoid arthritis who presented in the health care
facility with acute pain, joint stiffness, unsteady gait and extreme fatigue. In order not to breach
the confidentiality of the patient under the health privacy laws, she will be addressed as Emily in
the reflection essay. Emily had been very weak, frantic and had been suffering with acute pain
when she had presented to the emergency department. I had been given the responsibility to
handle the patient and perform primary pain management. However, when I approached her for
the analgesia, she became very frantic and tried to shove me away from her. She had been
speaking in aboriginal and native language which I could not understand. I repeatedly tried to
calm her, however, she could not understand and she got increasing anxious and started
screaming. I had to inform my supervisors and I had been told by my supervisors that the manner
I approached the patient with had not been culturally competent. I had to leave the room.

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Feelings:
In order to reflect on the entire reflection scenario I would like to mention that I have
mixed feelings regarding the entire experience. First and foremost, this had been the first
opportunity for me to handle an aboriginal patient and I had no prior knowledge regarding how
to handle a culturally diverse patient. Along with that, when I approached the patient I had
attempted to greet her with a simple hello and went straight ahead to prepare the intravenous
analgesic to inject to the patient as instructed by my supervisors. However, the patient became
frantic by just looking at the syringe in my hand and she started profusely started refusing the
analgesic treatment that I had approached her with. While contemplating, I would like to mention
that I myself had been very nervous while handling a culturally diverse patient and as she
became frantic I lost my composure and rationale. Even after desperately trying to calm her
down, Emily became more and more frantic and as a result my supervisor had to cut in and ask
me to leave the room immediately. I had felt extremely demotivated and depressed at my first
encounter with a culturally diverse patient being so negative. Along with that I felt incompetent
as well as I had not been able to relieve the pain that the patient had been feeling and only added
to her discomfort and fright.
Evaluation:
It has to be mentioned that the evaluation can be considered as the most important step of
the entire reflection cycle, as it gives the opportunity to the nursing student to discover the good
and bad aspects of the experience (Paterson & Chapman, 2013). In my case, this experience had
been an eye opener for me while handling the aboriginal patients and what communication
approach to take. The bad part about the entire experience had been the fact that when the patient
had been in acute pain, I could not offer her any relief and I could not do justice to my

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responsibilities due to my lack of skills of cultural competence and cultural safety. The only
good part regarding the experience had been my realization regrading the skills i would have to
enhance. According to the cultural safety framework for aboriginals and Torres Strait islanders,
the care priorities will need to be aligned with the cultural norms and expectations of the
indigenous patients (Rix et al., 2015). I failed to diligently follow the cultural safety guidelines
while attending Emily, which she interpreted as negligence and discrimination directed at her. I
have understood that I would have to take cultural safety and communication training within this
unit to enhance my skills so that I can avoid such incidents.
Analysis:
In order to analyse the exact reason behind the errors that has occurred in the experience,
my lack of knowledge regarding culturally safe practice can be highlighted as the most
significant one. The aboriginals have a very different understanding of health and wellbeing.
Their traditional healing concepts are very different from the contemporary modern health care
techniques (Baker & Giles, 2012). Hence, it is very important for the care professionals to
communicate effectively the need for different care activities and attain consent before
approaching with any treatment procedure. Hence, I lacked knowledge regrading the need for
establishing a comfortable and mutually respectful therapeutic relationship with the patient
before proceeding with any care activities. I did not attempt to introduce myself to the patient
and engage in therapeutic communication to understand her issues and grievances before
approaching her with the pain medication. Along with that, key elements of culturally safe
communication, such as eye contact, gestures, use of silence and body language are crucial in
establishing comfort and respect in the therapeutic relationship between the nurse and the
culturally diverse patient (Raman et al., 2017). I had failed to appropriately and optimally use

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these components of culturally safe care and effective communication, which further aggravated
the patient.
Conclusion:
On a concluding note, it has to be mentioned that the reflection exercise gave a wonderful
opportunity for me to revisit the first encounter I had with the aboriginal patients. After this
experience I now realize that I should have engaged in a therapeutic and culturally safe
communication with the patient in the presence of a language expert in order to better understand
the ideas and expectations Emily had from the health care team. Along with that, with the help of
the translator, I should have clearly stated the need for the analgesic injection, how it could have
benefitted her, and taken her consent before approaching her with the medicine.
Plan of action:
Based on the discovery of my weaknesses and my lack of culturally safe communication,
I would attempt to discuss with my supervisor regarding my options with communication and
cultural awareness training within my unit as the first initiative of my development plan. Along
with that, I would also attempt to culturally competent communication courses and nonverbal
communication training programs to help enhance my nonverbal communication skills and my
better clinical reasoning within the next 3 months. Along with that, for a nursing professional
working in culturally diverse care setting, attaining a general idea regarding their cultural norms
and traditions is very important (Durey, Thompson & Wood, 2012). Hence, I would like to enrol
in a cultural awareness development program to better understand the traditional concepts of
healing and wellbeing to serve the culturally diverse patient with more effectiveness within the
coming 6 months.

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Reference:
Baker, A. C., & Giles, A. R. (2012). Cultural safety: A framework for interactions between
Aboriginal patients and Canadian family medicine practitioners. International Journal of
Indigenous Health, 9(1), 15.
Bertilone, C. M., McEvoy, S. P., Gower, D., Naylor, N., Doyle, J., & Swift-Otero, V. (2017).
Elements of cultural competence in an Australian Aboriginal maternity program. Women
and Birth, 30(2), 121-128.
Clifford, A., McCalman, J., Bainbridge, R., & Tsey, K. (2015). Interventions to improve cultural
competency in health care for Indigenous peoples of Australia, New Zealand, Canada and
the USA: a systematic review. International Journal for Quality in Health Care, 27(2),
89-98.
Durey, A., Thompson, S. C., & Wood, M. (2012). Time to bring down the twin towers in poor
Aboriginal hospital care: addressing institutional racism and misunderstandings in
communication. Internal medicine journal, 42(1), 17-22.
Paterson, C., & Chapman, J. (2013). Enhancing skills of critical reflection to evidence learning in
professional practice. Physical Therapy in Sport, 14(3), 133-138.
Raman, S., Ruston, S., Irwin, S., Tran, P., Hotton, P., & Thorne, S. (2017). Taking culture
seriously: Can we improve the developmental health and well‐being of Australian
Aboriginal children in out‐of‐home care?. Child: care, health and development, 43(6),
899-905.

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Rix, E. F., Barclay, L., Stirling, J., Tong, A., & Wilson, S. (2015). The perspectives of
Aboriginal patients and their health care providers on improving the quality of
hemodialysis services: a qualitative study. Hemodialysis International, 19(1), 80-89.
Shahid, S., Durey, A., Bessarab, D., Aoun, S. M., & Thompson, S. C. (2013). Identifying barriers
and improving communication between cancer service providers and Aboriginal patients
and their families: the perspective of service providers. BMC health services
research, 13(1), 460.