Professional Issues in Nursing and Specialisation

Running head: PROFESSIONAL ISSUES IN NURSING AND SPECIALISATION
PROFESSIONAL ISSUES IN NURSING AND SPECIALISATION
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1PROFESSIONAL ISSUES IN NURSING AND SPECIALISATION
Introduction
It is well know that Australia has a rich cultural heritage comprising of Indigenous as
well as Non-Indigenous populations. Indigenous Australians or Aboriginal and Torres Islander
(ATS) communities are regarded as the ‘first peoples’ of Australia due to them being the native
populations residing in the nation, since historical times prior to colonization by the Europeans
(Henderson et al., 2018). The infiltration of their native lands by Europeans resulted in an a
history of discrimination, exploitation and perceptions of stereotyping and stigma towards
Indigenous Australians which continue to exist in the nation even at present. In alignment to the
same, a key issue of concern which has continued to exist, especially during healthcare-
associated inquiry and help-seeking behaviour demonstrated by ATS communities is the lack of
cultural competence across healthcare organizations (Thai et al., 2018).
Individuals and groups belonging to diverse ethnic and cultural backgrounds like the ATS
communities of Australia, posses cultural, spiritual, healthcare and social principles, opinions,
ideas and preferences which are diverse from their non-Indigenous counterparts. The concept of
‘Cultural Competence’ implies the skills of understanding, empathizing and effectively
interacting with individuals belonging to diverse cultural groups and backgrounds (Ralph et al.,
2017). The administration of skills of cultural competence across providers of healthcare service
and healthcare professionals are of utmost importance to ensure positive health outcomes across
Indigenous individuals (McCalman et al., 2017). Despite the growing concern of the need for
cultural competence, insensitive and discrimination continue to exist towards ATS communities
in the Australian healthcare sectors, which contribute greatly to accessibility, affordability and
acceptability of such services and resources across Indigenous individuals, further resulting in

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discrepancies in positive health outcomes as compared to non-Indigenous groups (Gwynne,
Jeffries & Lincoln, 2019).
To combat such initiatives, the ‘Closing the Gap’ (CTG) policy initiative and national
strategy was undertaken by the Australian Government (Ibiebele et al., 2015). The following
report will hence focus upon the issues of cultural competency within the Australian healthcare
scenario, the key concepts underlying the issue, the specifications of the CTG policy and
possible recommendations for future improvement.
Discussion
Issues of Concern
According to the Federation of Ethnic Communities’ Council in Australia (2019),
‘Cultural Competence’ implies the capability of understanding, communicating and efficiently
interacting across individuals belonging to various diverse ethnic and cultural backgrounds. It is
defined as a collection of attitudes, behaviours and policies which harmonize and work in
synchronization within an organizational environment in order to make it well-equipped to deal
with diverse, cross-cultural situations.
According to Gwynne and Lincoln (2017), while interacting and working with
Indigenous Australians for the purpose of healthcare, there is a need for healthcare professionals
to consider the diverse cultural, ethnic and spiritual needs of individuals belonging to these
populations. Considering their historical experiences of exploitation as well as possession of a
rich cultural heritage diverse from non-Indigenous populations, ATS communities have unique
demands in healthcare which must be considered. Such diverse differences must be considered in
a culturally competent manner for the purpose of ensuring deliverance of holistic healthcare

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services to Indigenous Australians. In addition to diverse linguistic practices, as researched by Li
(2017), such populations generally regard healthcare organizations as places of death and an
isolation from their homelands during the end of their life will prevent their passing to the
‘Dreamtime’. The lack of empathy towards such sensitivities in healthcare organization, results
in a loss of eagerness and non-compliance towards seeking or adhering to treatment further
contributing to the rising discrepancies in mortality and life expectancy rates across ATS
communities as compared to non-Indigenous individuals, which were clearly demonstrated in the
CTG policy (Grant & Draper, 2018).
Additionally, as researched by Jennings, Bond and Hill (2018), a lack of cultural
competence in the form of racial discrimination, stigmatization and stereotyping continue to
prevail towards Indigenous Australians, which comprises of healthcare workers largely
perceiving such communities to be non-compliant and difficult to work or interact with.
Prevalence of such misperceptions and misbehaviours towards Indigenous Australians are
largely associated with negative health outcomes in terms of loss of physical, mental, social and
emotional wellbeing in these diverse populations. As reported by the Department of the Prime
Minister and the Cabinet (2014), the underlying pathways linking racial discrimination to poor
health outcomes include decreased access to essential needs such as healthcare, employment,
housing and education in Indigenous Australians which further increase the exposure to risk
factors like dysregulation of cortisol and associated stress. According to Paradies (2016), such
increased exposure increase the acquisition of conditions like anxiety, depression and metabolic
symptoms like cardiovascular diseases in Indigenous Australians and hence the alarming
disparities in rates of mortality and life expectancy. Chronic and long term exposure to emotional
and social abuses such racism have further been linked to life threatening conditions like