This assignment analyzes an interview with an Aboriginal Australian, exploring their cultural preferences, experiences, and social needs. It discusses the impact of colonization, cultural beliefs, and the importance of culturally safe worker-client relationships in healthcare.
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Running head: INTERVIEWING AN ABORIGINAL AUSTRALIAN INTERVIEWING AN ABORIGINAL AUSTRALIAN Name of the student: Name of the university: Author note:
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1 INTERVIEWING AN ABORIGINAL AUSTRALIAN Introduction: Being a nursing professional, it is important for an individual to provide skilled patient care which aligns with the cultural preferences and expectations of every service users. Cultural competence can be defined as the ability of the healthcare professionals to deliver healthcare services that meet the social, cultural as well as the linguistic needs of the patients. In the present days, nurses are seen to work with patients from different cultural backgrounds (Clifford et al., 2015). Nurses are expected to understand the differences of the patients in their demographics, beliefs, practices as well as norms and desires for medical care and also take the perspectives of patients into account while caring for them. Nurses need to overcome their cultural biasness and need to develop cultural knowledge so that they can provide quality care to patients that satisfy them (Goldman & Trimmer, 2019). This assignment would mainly be covering a critical analysis of the interview session conducted with an aboriginal individual of 65 years old. This would help in understanding the cultural preferences of the interviewee and would help the professionals to modify their care preferences accordingly. Description of the interviewee in relation to different cultural aspects: The consideration of the term “health” is not restricted to only living a life free from any disorder according to people with aboriginal origin. On questioning the Mr. Wullong about his consideration of good health, his answers were quite vivid and broad. Health is a traditionally holistic approach that encompasses the physical, social, spiritual as well as emotional and cultural well-being of the individual and also of the whole community. A “whole of life view” of the aboriginal was noticed while interviewing the individual and this also included the concept of life-death-life. It has been found that most of the traditional Aboriginal people still retain their
2 INTERVIEWING AN ABORIGINAL AUSTRALIAN traditional beliefs about the concept of life and death although such traditional cultures and beliefshavebeennowchallengedandinfluencedbymanydifferentfactorsoutwhich colonization and Christianity were the most dominant (Hunt et al., 2015). Another important observation was their belief on the concept of dreamtime or dreaming which is quite different in its principles from that of Christianity. This is a concept that is found among many clans of the Aboriginal people and is a concept which is not usually understood by the non-indigenous people. According to the concept, there are no afterlives in the Aboriginal religions without any preferences of the heaven or hell. This aspect is found to make them separate from the rest of the world religions. Studies have ventured into the concept and have stated that it is a source of life philosophyas well as morality and that it is intertwined with the Aboriginal stories of creation and explains that it is a constant state where both the past and present are seen to exist together. The elderly aboriginal was found to be quite excited when he was explaining how their ancestral spirits were originated from the earth and also down from the sky for walking the land (Power et al., 2018). They had shaped and created the land formations, rivers, mountains, forests and deserts. They also created people, animals and vegetables and combined with them when they traveled, hunted and fought. They believe that the ancestral spirits actually gave their codes of conduct and customs and they were the main source of songs, dances, designs, languages, and rituals that are the basic of Aboriginal religious expression. After the creation of the world, they were found to get back into earth, the sky and into the animals, land formation, and rivers. Therefore, they are of the opinion that ancestor beings are still alive in the spirit of the Aboriginal individuals (West et al., 2019). This differences from the beliefs of the Christianity can help nurses to be well aware about their beliefs and hence refrain themselves from ant actions that affect their cultural and religious beliefs
3 INTERVIEWING AN ABORIGINAL AUSTRALIAN Exploration of the life experiences of the interviewee: The interviewee had gone through pathetic and traumatic life experiences which had impacted his entire life and he was of the opinion that he was still suffering now because of the events. He referred to the scenarios of the stolen generation where he had been also a sufferer as a child who was forcibly removed from his family with the aim of providing him a better future by the colonizers.Between the years of 1910 and 1970, many of the Aboriginal children were forcibly removed from their families because of the government policies that were introduced by the colonizers (Mills et al., 2018). The generations of the children who were removed under these policies came to be called as the stolen generations and our interviewee was one of the unfortunate victims to these policies. These policies of child removal had left a legacy of trauma and loss that continued to affect the indigenous communities, families and even the individuals. This forcible removal of the children from their families was a part of the Assimilation project which was actually based on the assumption that the Aboriginals were of the black inferiority to that of white inferiority of the colonizers. It proposed that Aboriginal children should be either allowed to “die out” through a procedure of natural elimination or where possible should be assimilated in the white community. The interviewee was seen to become quite emotional during discussion of his life experiences where he stated that the colonizers used to force him to reject his indigenous heritage and was also forced to adopt their white culture. He revealed that his name was also changed and that he was forbidden to speak their traditional languages. He told that he saw many children adopted by white families and rests of the chilsren were placed in the institutions where they were abused and neglected. He also clearly revealed how these policies shad affected his entire life making him altogether a different person emotionally. His parents
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4 INTERVIEWING AN ABORIGINAL AUSTRALIAN were supportive of him when he came back but many other children were unable to bodn with the family after these policies were abolished. The reunions turned into another perceived hurt and rejection episodes when they could not bond with their parents or their parents did not accept them (Hart et al., 2015). He stated that he was 30 when he met his mother and he could never make the connection that exists between son and mothers. They could not connect to their aboriginal communities and often find themselves in a strange situation with missed cultures and traditions. Managing relationships became difficult in the families by such children (Isaacs et al., 2016).Theintervieweerevealedhesufferedfromlowself-esteem,lossofidentityand loneliness. However, his family mainly his father and grandfather supported him a lot, helping him to consume the Aboriginal customs gradually. His tone of speaking clearly revealed these factors as the main causes of deep distrust and hopelessness on the government. Exploration of the social needs of the interviewee: Some of the concerns that were noticed in the answers provided by the interviewee is the lack of various opportunities which are present among the non-indigenous people but not among the Aboriginal people. The interview revealed that very few people in their community get the scope of educating themselves to higher levels. This might be because they are forced to work for their families to overcome poverty or they could not face the pay the fees required for higher education (Sargeant et al., 2016). However, his casual approach helped me to understand that the importance of education is not known by them and how it can help them in getting better job opportunities. Moreover, he complained of living in small overcrowded houses as well and was seen to state that the government is not fulfilling their promises of providing better living accommodations. Another important issue that was also noticed in his discussion is his anger against the non-indigenous people. Not only because of more opportunities that the non-
5 INTERVIEWING AN ABORIGINAL AUSTRALIAN indigenous people get but because of the severe discrimination and stigmatization they had to face from those people. He stated that during the time of his employment in the urban regions, he had faced huge number of discrimination because he was from the indigenous origin where he was not either given jobs or was severely humiliated by co-workers because of his color (Jongen et al., 2018). This had resulted him to leave his attempts of trying for jobs in Australian firms and started working in his villages which did not provide him and his families with financial securities. He also fears of not visiting the healthcare centers with western mode of healthcare believingthatheorhisfamilymemberswouldbealsodiscriminatedanddisrespected. Therefore, from this interview, it was found that social needs required for well-being like good education, proper employment, appropriate healthcare facilities, social inclusion and others were all disrupted in his life. Social support available to them: The patient seemed somewhat satisfied how the present day government is trying to develop types of healthcare services where the forms of care and the communication procedures align with the culture needs and expectations of the interviewee. He had been found to be particularly happy about the initiative of AMS Redfern or the Aboriginal Medical Service Redfern. This is the first community controlled health service in the nation which had since then tried to improve the health standards in the different Aboriginal communities across Australia (Durey et al., 2017). He is also happy about the NACCHO also called the National Aboriginal Community Controlled Health Organization (NACCHO). He was satisfied who the State and Territory peak Aboriginal Community Controlled Health bodies were working collaboratively with that of the aboriginal communities for addressing their shared concerns on a national basis. He stated that his son had now admitted him in Healing Foundations where he is counseled in
6 INTERVIEWING AN ABORIGINAL AUSTRALIAN daily basis. This is actually an independent and national Aboriginal and Torres Strait Islander organization and helps in family and community healing from the effects of intergenerational trauma. Cultural factors required for the establishment of respectful, culturally safe worker-client relationships While interacting with the aboriginal Australian, I noticed a number of aspects that I need to consider while developing my communications style and caring manners with the patients of the indigenous backgrounds. Some of the important culture factors that I should take in consideration while developing my care plan is the fear and distrust of the mainstream health services and buildings by the Aboriginals as these can be threatening and alienating. They also feel a perception of extreme imbalance of power because of their history and disadvantage along withthefeelingsofvulnerability,shameanddisempowerment.Therearealsocultural misunderstandings along with severe stereotyping and disrespects that are experienced by the native people (Biles, 2018). They also suffer from financial burdens and accommodation difficulties. All these aspects need to be taken in consideration while planning for developing care plans and communicating with them. The first important aspect that I should be taking in consideration is the development of strong rapport with patients through informal discussions at first and gradually getting more involved when the patients feel comfortable. They are not comfortabletoinvolveindirectdiscussionabouttheirhealthwithstrangersandhence developing rapport is important. I also should keep in mind of not maintaining eye contacts with them. Unlike westerners, indigenous people do not prefer eye contacts as they believe that is
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7 INTERVIEWING AN ABORIGINAL AUSTRALIAN displays disrespect. Moreover, such people prefer silence in between their conversations unlike westerners and this should be also respected. They are not comfortable with touch and hence this gesture should be avoided. Moreover, kinship, family obligations as well as responsibilities tend to be of greater importance than their personal health and hence all these aspects need to be kept in mind while interacting and planning care with them (McGough et al., 2018).
8 INTERVIEWING AN ABORIGINAL AUSTRALIAN References: Biles,J.(2018).ThedevelopmentofIndigenousAustralianculturalcompetencein nursing.AustralianNursingandMidwiferyJournal,26(4),40. https://search.informit.com.au/documentSummary;dn=909207223084928;res=IELHEA 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.https://doi.org/10.1093/intqhc/mzv010 Durey, A., Halkett, G., Berg, M., Lester, L., & Kickett, M. (2017). Does one workshop on respecting cultural differences increase health professionals’ confidence to improve the care of Australian Aboriginal patients with cancer? An evaluation.BMC health services research,17(1), 660.https://doi.org/10.1186/s12913-017-2599-z Goldman, N., & Trimmer, K. (2019). Towards a Culturally Inclusive Model of Care: Quality Practice and Care Through the Lens of a Practising Nurse. InEnsuring Quality in ProfessionalEducationVolumeI(pp.123-149).PalgraveMacmillan,Cham. https://link.springer.com/chapter/10.1007/978-3-030-01096-6_6 Hart, B., Cavanagh, M., & Douglas, D. (2015). The “Strengthening Nursing Culture Project”–an exploratory evaluation study of nursing students’ placements within Aboriginal Medical Services.Contemporarynurse,51(2-3),245-256. https://www.tandfonline.com/doi/abs/10.1080/10376178.2016.1150190
9 INTERVIEWING AN ABORIGINAL AUSTRALIAN Hunt, L., Ramjan, L., McDonald, G., Koch, J., Baird, D., & Salamonson, Y. (2015). Nursing students' perspectives of the health and healthcare issues of Australian Indigenous people.Nurseeducationtoday,35(3),461-467. https://doi.org/10.1016/j.nedt.2014.11.019 Isaacs, A. N., Raymond, A., Jacob, E., Jones, J., McGrail, M., & Drysdale, M. (2016). Cultural desire need not improve with cultural knowledge: a cross-sectional study of student nurses.Nurseeducationinpractice,19,91-96. https://doi.org/10.1016/j.nepr.2016.05.009 Jongen, C., McCalman, J., Bainbridge, R., & Clifford, A. (2018). Health Organisation and System Cultural CompetenceInterventions.InCulturalCompetenceinHealth(pp.99-113).Springer,Singapore. https://link.springer.com/chapter/10.1007/978-981-10-5293-4_7 McGough, S., Wynaden, D., & Wright, M. (2018). Experience of providing cultural safety in mental health to Aboriginal patients: A grounded theory study.International journal of mental health nursing,27(1), 204-213.https://doi.org/10.1111/inm.12310 Mills, K., Creedy, D. K., & West, R. (2018). Experiences and outcomes of health professional students undertaking education on Indigenous health: A systematic integrative literature review.Nurse education today.https://doi.org/10.1016/j.nedt.2018.07.014 Power, T., Virdun, C., Gorman, E., Doab, A., Smith, R., Phillips, A., & Gray, J. (2018). Ensuring IndigenousculturalrespectinAustralianundergraduatenursingstudents.Higher EducationResearch&Development,37(4),837-851. https://doi.org/10.1080/07294360.2018.1440537
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10 INTERVIEWING AN ABORIGINAL AUSTRALIAN Power, T., Virdun, C., Sherwood, J., Parker, N., Van Balen, J., Gray, J., & Jackson, D. (2016). REM: A collaborative framework for building indigenous cultural competence.Journal of Transcultural Nursing,27(5), 439-446.https://doi.org/10.1177/1043659615587589 Sargeant, S., Smith, J. D., & Springer, S. (2016). Enhancing cultural awareness education for undergraduatemedicalstudents:Initialfindingsfroma uniqueculturalimmersion activity.AustralasianMedicalJournal(Online),9(7),224. https://search.proquest.com/openview/533aaecac96f029b51a5c473d7e8c11d/1?pq- origsite=gscholar&cbl=54991 West, R., Mills, K., Rowland, D., & Creedy, D. (2019). Impact of a discrete First Peoples health courseonstudents’experienceanddevelopmentofculturalcapabilities.Higher EducationResearch&Development,1-15. https://www.tandfonline.com/doi/abs/10.1080/07294360.2019.1603202 West, R., Mills, K., Rowland, D., & Creedy, D. K. (2018). Validation of the first peoples cultural capability measurement tool with undergraduate health students: A descriptive cohort study.Nurse education today,64, 166-171.https://doi.org/10.1016/j.nedt.2018.02.022
11 INTERVIEWING AN ABORIGINAL AUSTRALIAN Appendix: 1.Please tell us how you would explain your health beliefs? 2.What are important aspects of the source of your religion that would believe that western professionals should need to know? 3.Sinceyou haveintricatelyworkedwithdifferentpeoplefrom thenon-indigenous backgrounds as well, what are the important variances that you have found between Christianity and Aboriginal religions? 4.What are some of the life experiences that changed you as a person 5.Have you gone through any traumas that had reshaped your life in a different ways 6.What are the various impacts that the childhood trauma you have faced had impacted your childhood and also your adult age? 7.How have your family accepted you after your return? Do you face any issues with them? 8.Please describe your social experiences with other people in the nation apart from your own communities? How have you felt then? 9.Why do you think that there exists a health gap between the native and non-native people in the nation 10.Would you please mention some of the social opportunities that you have got or you felt deprived of? 11.Howwould you describe the differentsocialsupports availableto you and your community 12.What would you like to change about the healthcare system in the present era? Would you like more aboriginal health care workers in the remote healthcare systems
12 INTERVIEWING AN ABORIGINAL AUSTRALIAN 13.Do you feel that the government is trying to help the native people now having realized the impact of exploitation on them though several years 14.Did you even feel discriminated and stigmatized? What do you believe about such prejudices affecting the lives of the native people? 15.What do you feel about the western healthcare systems? 16.What are the specific suggestions you would want to give to the western healthcare professionals to provide more efficient care that aligns with you cultural expectations 17.What are the specific social support needs that have satisfied you?