Nursing Case Study on Social Determinants of Health and Cultural Competence

This nursing case study explores the impact of social determinants of health and the importance of cultural competence in healthcare. It discusses relevant policies, institutional racism, and cultural safety principles.

Running head: NURSING CASE STUDY 1
Nursing Case Study
Name
Institution

NURSING CASE STUDY 2
Nursing Case Study
Case Study #1
Question #1
Ideally, social determinant in health is often related to the economic aspect, social
conditions as well as their distribution among a particular population that tend to influence an
individual’s health care status in the society (Fleming, Creedy, & West, 2017). Notably, they are
the basic health promoting factor in either one’s living or rather working conditions. The social
determinants that are relevant in this scenario are residential segregation, social attitude, and
norms including segregation. Access to medical services is clear in this instance where Joanna
got access to medical services due to her pregnancy. The aspect of segregation has become
rampant in the contemporary health care system despite various interventions to reduce it. People
are segregated based on their races.
Question #2
In essence, there are various historical and current policies that have had a huge impact
on the overall health status of the aboriginal as well as the Torres Strait Islanders in the
Australian society. One clear policy that was set by the government is the engagement policy
where all the cultures could be integrated. For instance, through this policy the aboriginal could
be engaged in equal rights of receiving health care.
Question #3
Institutional racism is considered as a form of racism that is often expressed in the social
as well as a political institution in the societal settings. The aspect of institutional racism has no
doubt affected the overall well-being of a person as well as the delivery of health care services
(Usher, Mills, West, & Power, 2017). For instance, many people are discriminated based on their

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cultural alignment and sometimes they face isolation in the premise of health care facilities. In
the case study 1, Joanna feels comfortable attending a local health care center that is controlled
by the Aboriginal. In the hospital, she receives quality health care on the basis that she shares
cultural heritages with one of the nurses. Notably, this shows how some health facility offers
their services based on race and therefore putting an individual’s health at a risk.
Question #4
It is no doubt that the ever-increasing diversity in the health care system has brought
together opportunities as well as challenges to the entire healthcare providers, policymakers, and
the entire health care system in the society. Creating a cultural competence team of medical
practitioners is important especially the diversity that global community holds (Greenwood,
Lindsay, King, & Loewen, 2017).
Question #5
While medical practitioners are expected to relay information to patients, parents, and
caregivers, they are supposed to keep some level of secrecy in their work ethics (Richardson,
Yarwood, & Richardson, 2017). In the case study one, the midwife answers every question that
Joanna asks without keeping some level of secrecy. Although the midwife was to answer
questions as asked by the patient, it is imperative to understand what needs to be answered and
what has to remain a secret especially patient’s details.
Question #6
In Australia, cultural safety is no doubt an effective nursing attribute of any person or
rather family from another culture that is often determined by that person or even family.
Consequently, there are various cultural principles that are set to guide a cultural safe practice for
various individuals (Bryce, Foley, & Reeves, 2017). One cultural safety principle that is in

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practice in this case is the aspect of positive purpose policy where the midwife had to be
accountable with the type of information she was giving to her patient. Additionally, the
principle of process was showcased where Aboriginal were able to get equal right in employment
and basic services such as health services as evidenced by Joanna and the Aboriginal midwife.

NURSING CASE STUDY 5
Case study #2
Question #1
In this scenario, there are various social determinants that are valid in the health care
system. Some of these determinants include culture, language and literacy, access jobs and
education. For instance, the aspect of culture occurs where Gift’s mother adheres to her cultural
traditionally diet instead of what the doctors recommend. The aspect of language and literacy is
clear where Gift finds it difficult coping with others in school simply because he could not speak
in fluent English. Additionally, Language and literacy are clear where Gift acts as the interpreter
between her mother and the medical specialist.
Social determinants are no doubt paramount in the well-being of an individual as well as
their health status (Fraser, Waters, Forster, & Brown, 2017). One clear relevant determinant
aspect is the aspect of culture. In this light, medical practitioners are supposed to structure
policies that are culturally sensitive when dealing with people of different cultures. Additionally,
the aspect of language and literacy is important as it bridges the communication between
particular patients to the medical practitioners as it is in the case of Gift’s mother and the nurses.
Question #2
For many decades now the public health of the Aboriginal as well as that of the Torres
Strait Islanders has been significantly worse. As a result, various health policies have been set
aside to curb the situation in Australian society (West, Mills, Rowland, & Creedy, 2018). One
clear policy is the National policy on engagement that was established in the year 2011. Notably,
this policy encouraged fostering culture engagement as well as collaboration with the local
citizens. The policy also catered for the immigrants for a cultural sensitive engagement. In this

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light, the policy is relevant in the case of Gift’s mother cultural and traditional diet thus calling
for medical practitioners to consider the cultures of the patients in the treatment process.
Question #3
The aspect of institutional racism is clear in this scenario where Gift is unsure if he will
get a Job once he is through with his education. Notably this was because he had been neglected
and abused by his friends while in school due to his cultural alignment.
Question #4
Cultural competence helps in improving outcomes in healthcare systems. A person’s
belief is important when considering dealing with health care matters. For instance, Gift mother
has a strong belief in the traditional diet despite the fact that the medical practitioners keep on
advising her otherwise. Notably, the lack of cultural competence on the side of the medical
competence results to a negative outcome as clearly showcased by Gift’s mother. If the
practitioners had understood the importance of integrating the traditional diet that Gift’s mother
insisted on then there would be likelihood that a positive outcome could have been achieved.
Question #5
Gift Kubota is thought to have fled his country Sudan due to the civil war. As a result, he
had difficulty in coming up with the new environment as well as culture especially when he
attended school. Notably, this was because of the language barrier that lied between him and
what he was used to speaking. The fact that Gift had an experience of war in the past and fled his
country made him hesitant to attend social services that are school thus having a lot of difficulty
coping with new experience.

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Question #6
Some of the cultural safety principles include protocols, personal knowledge, partnership,
positive purpose, and process (Daly, Speedy, & Jackson, 2017). In case study 2, it would have
been important if the medical practitioners had practiced the aspect of protocols to well
understand the reason why Gift’s mother wanted to continue with her cultural diet instead what
the doctors were advising. Through the principle of protocol, they would have known the
significance of cultural consideration in getting a good outcome in the healing process.

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References
Bryce, J., Foley, E., & Reeves, J. (2017). Conduct most becoming. Australian Nursing and
Midwifery Journal, 25(6), 25.
Daly, J., Speedy, S., & Jackson, D. (2017). Contexts of nursing: An introduction. Elsevier Health
Sciences.
Fleming, T., Creedy, D. K., & West, R. (2017). Impact of a continuing professional development
intervention on midwifery academics’ awareness of cultural safety. Women and Birth,
30(3), 245-252.
Fraser, J., Waters, D., Forster, E., & Brown, N. (2017). Paediatric Nursing in Australia.
Cambridge University Press.
Greenwood, M., Lindsay, N., King, J., & Loewen, D. (2017). Ethical spaces and places:
Indigenous cultural safety in British Columbia health care. AlterNative: An International
Journal of Indigenous Peoples, 13(3), 179-189.
Richardson, A., Yarwood, J., & Richardson, S. (2017). Expressions of cultural safety in public
health nursing practice. The nursing Inquiry, 24(1), e12171.
Usher, K., Mills, J., West, R., & Power, T. (2017). Cultural safety in nursing and midwifery.
Contexts of Nursing: An Introduction, 337.
West, R., Mills, K., Rowland, D., & Creedy, D. K. (2018). Validation of the first people's
cultural capability measurement tool with undergraduate health students: A descriptive
cohort study. Nurse education today, 64, 166-171.