Promoting Aboriginal and/or Torres Strait Islander Cultural Safety in Nursing Homes

This written assessment for CHCDIV002 Promote Aboriginal and/or Torres Strait Islander cultural safety covers topics such as defining cultural competence and safety, identifying cultural differences, preventing cultural conflict, and providing additional support for Aboriginal and/or Torres Strait Islander families. The assessment also discusses resources, support, and interventions for effective partnerships in nursing homes.

HLT54115 Diploma of Nursing
CHCDIV002 Promote Aboriginal and/or Torres Strait Islander cultural
safety
Written Assessment Student Copy
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Instructions to Student
To successfully complete the assessment requirements, you need to follow the following
instructions.
Step 1
Read the study guide and the related resources.
Step 2
Read this assessment to gain an understanding of what you need to do to complete the unit.
Talk to your trainer or supervisor and ask for help if you need to.
Step 3
Complete all questions in this assessment. Please write clearly in pen (not pencil). You may
attach printed answers if you prefer. Do not remove any pages from this assessment.
Step 4
Complete the cover sheet and attach to this assessment. We recommend you make and keep
a copy of the entire Assessment.
Step 5
Submit for assessment.
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Question 1
The following website may assist with this question
http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129548151
Part A
Define cultural competence and cultural safety, and in your own words describe how you could
implement them in an aged care setting.
Cultural safety can be defined by the concept of implementing and engaging in the practices
that has no direct intention of harming or offending the cultural beliefs of any individual associated with
the practice or service
Cultural competence can be defined as ability of any care provider to delivery health care
services that are in accordance with the social, cultural, and linguistic needs of patients.
I would attempt to adhere to the cultural safety guidelines and exercise absolute inclusion while
valuing the beliefs and principles of all patients with equality and justice (Australian Institute of Health
and Welfare 2018)
Part B
Discuss resources that are available in the nursing home and the community to promote
understanding and promote partnerships?
The nursing practice standards, code of conducts, and code of ethics, either electronic or hard copies.
Part C
How are organisational policies and procedures devised and documented in the nursing home
to ensure that the care provided meets the needs of the residents?
The policies are devised in the board meetings with integrating the input from all of the stakeholders
and they are documented according to the evidence based practices both electronically and also
reserving the hardcopies in a secure and locked yet easily accessible location
Question 2
The following websites may assist with this question
http://australia.gov.au/about-australia/australian-story/austn-indigenous-cultural-heritage
http://www.multiculturalaustralia.edu.au/doc/shnukal_torres_strait.pdf
Aboriginal and Torres Strait Islander culture varies throughout the continent and islands, with
different areas having different language, traditions, foods, ceremonies and technologies.
Part A
Research an Aboriginal culture and a Torres Strait Islander culture and identify the specific
areas of cultural difference for each.
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Area of cultural difference Aboriginal Torres Strait Islander
Language Pidgin English Torres Strait Creole
Traditions Mainland oriented traditions
including Dreamtime
Traditions of Melanesian origin
Foods Australian native
plant foods include the fruits
quandong, kutjera, muntries,
riberry, Davidson's plum, and
finger lime.
Fish and shellfish are culinary
features of the Australian
coastal communities
yams, taro, wild yam, cassava,
fruits such as wongai, sorbie,
coconuts, sea almonds, and
meats such as pig, stingray,
turtles, dugong, shellfish and fish
Ceremonies Bora or Burbung, sacred
songs, dances, stories, and
traditional lore, Circumcision,
scarification, and removal of a
tooth
formal handover of title, new
houses and boats are blessed,
tombstones unveiled with
Christian ceremony
Technologies ie. To acquire
food, for art, for work etc.
Mobile devices, GPS, etc Mobile devices, GPS, etc
Specific location in Australia Anangu in northern South
Australia, and neighbouring
parts of Western Australia
and NorthernTerritory. Bama
in north-east Queensland.
Gunggari in South-west
Queensland. Koori (or Koorie
or Goori or Goorie) in New
South Wales and Victoria
Cape York and
Papua New Guinea
Part B
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How would you and your colleague support effective partnerships between you and the two
cultures?
We will incorporate cultural safety and competence by congruent behaviours and attitudes to honour
and respect the culture we both belong to and be able to make honest efforts to learn the traditional
beliefs and cultures of both of us to serve our culturally diverse patients with optimal efficacy
(Australia.gov.au, 2018)
Question 3
The following websites may assist with this question
http://www.community.nsw.gov.au/__data/assets/pdf_file/0017/321308/
working_with_aboriginal.pdf
http://www.australia.gov.au/about-australia/australian-story/austn-indigenous-cultural-heritage
Part A
Due to the diversity within and between Aboriginal cultures and Torres Strait Islander cultures,
protocols will vary and community care workers are encouraged to be aware of the sensitivity
surrounding these issues and to consult with appropriate local Aboriginal community members
and Torres Strait Islander community members to discuss any matters that arise.
List five or more cultural practices and issues that are sensitive to Aboriginal peoples and
Torres Strait Islander peoples.
The issues are: dispossession of land, family fragmentation, grief and loss, racism,
unemployment, poverty and social and emotional wellbeing
Part B
Identify cultural safety issues and practices in the nursing home. Discuss the strategies that are
implemented to ensure cultural safety and build effective partnerships between staff, Aboriginal
and/or Torres Strait Islander people and their communities.
There are many common issues that are prevalent in the care setting involving the aboriginals and/or
Torres strait islanders. These issues are associated with respect and sensitivity, use of appropriate
language, communication technique or approach, establishing therapeutic relationship and rapport,
bias and cultural participation. The strategies that are implemented include Brighter Futures and the
Aboriginal Maternal and Infant Health Strategy to improve their health, engagement and
communication strategies, NATISWA framework, etc. The strategies mainly focus on enhancing the
cultural safety and competence in communication, language and tone of voice, along with care practices
integrated with the traditional beliefs of health (Community.nsw.gov.au 2018).
Question 4
The following website may assist with this question
https://www.dss.gov.au/our-responsibilities/settlement-and-multicultural-affairs/publications/
connections-an-employers-guide
It is recognized and accepted that a suitably supportive and stable working environment for
Aboriginal and Torres Strait Islander people is likely to help redress the social injustices,
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exploitation and socio-economic and employment inequities especially affecting Aboriginal and
Torres Strait Islander people. Outline how you can support culturally diverse workers .
In order to support the culturally diverse workers, first and foremost, equality and justice is
needed to be implemented. It is very important for the culturally diverse workforce to feel included and
respected in the work environment; hence I will ensure to facilitate utmost respect and inclusion for the
culturally diverse workforce (Shah 2012). Additionally, I will take initiative to engage them in our
festivities and traditions and also celebrate their traditional festivities to promote a healthy inclusive
culture. As discrimination and bullying is considered to be one of the greatest contributors to workplace
related issues for aboriginals, I will ensure to implement a zero tolerance policy against any bullying or
discrimination. Along with that, I will have weekly feedback sessions to ensure that the culturally diverse
workforce has a chance to express their grievances or issues (Community.nsw.gov.au., 2018).
Question 5
The following website may assist with this question
http://sielearning.tafensw.edu.au/MCS/9362/Sterilisation%20disk%203/lo/7374/7374_00.htm
All people have the right to be treated with dignity and respect. When working in a health care
setting there is potential for cultural conflict and misunderstandings to occur which may result in
a person in need of assistance not accessing that assistance.
Part A
Identify ways that you as an Enrolled Nurse can prevent cultural conflict or misunderstandings
occurring.
An enrolled nurse will prevent or manage cultural conflict or misunderstanding by a series of steps
involving:
 Identifying issues that may cause conflict
 calculating the impact of impact of cultural differences
 sensitively resolve differences, taking cultural considerations into account
 Addressing any difficulties with appropriate people and seek assistance when required
(Sielearning.tafensw.edu.au 2018)
Part B
Who would you involve to evaluate and document the interventions?
I will involve the registered nurse and my nursing supervisor along with the HR or any other
administrative representative.
Part C
How would you evaluate and document the interventions?
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In order to evaluate and document the interventions I would conduct one to one private
meetings with the parties involved in the conflict and I will document them in the conflict management
register and in my personal reflection journals.
Question 6
The following website may assist with this question
https://childaustralia.org.au/Documents/IPSP-Section/Resource-Centre-Docs/cultural-book-
complete-WEB.aspx
You come out from the whitefella world, with your mind, and you going into a different country,
like Bali. Indigenous community like that. You gotta have that expectation – different culture,
different people, live in a different world. Like when you go on a holiday, you don’t rush, rush,
rush. You relax and enjoy yourself. Then you learn. Then people can accept you. Indigenous
early childhood educator.
Enrolled nurses need to be aware that their own values and beliefs can be passed on to co-
workers and others through language, interaction and the curriculum. Discuss how nurses can
have an understanding and show respect, diversity and cultural competency in the health
sector.
Personal values, beliefs and principles have a significant impact on the professional practice, especially
when it involves providing care to the different individuals. As a result it is crucial for the nurses have a
strong principle and values that respect the cultural differences and prioritizes compassion and justice
over anything else (Gerlach 2012). A nursing professional can easily develop understanding and show
respect by interacting with the different cultures or take up any cultural competence courses. Along
with that, there are various online resources available that provide information to help the nurses
develop a better understanding of cultural safety and competence and the nurses can develop their
understanding skills with the help of the resources (Jeffreys 2015).
Question 7
The following websites may assist with this question
http://www.mmigp.org.au/resources
http://www.healthinfonet.ecu.edu.au/key-resources/organisations?oid=1471
https://www.sa.gov.au/topics/community-support/resources-for-aboriginal-people
Enrolled nurses must ensure that Aboriginal and Torres Strait Islander people are partners in
their health care.
Research some resources / services in the community that can be used to assist Aboriginal or
Torres Strait Islander families in the community.
The resources or services that can be used in order to assist the aboriginal and Torres Strait
Islander families include:
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Indigenous Network Victoria that promotes leadership activities, support leadership
opportunities, develop leadership capacity, support leaders and improve existing Indigenous leadership
initiatives in the Indigenous community
Koori heritage trust and mail, a not-for-profit Aboriginal community organisation that aims to
protect, preserve and promote the living culture of Aboriginal people of south-eastern Australia, along
with the mail which is fortnightly distributed Australia-wide.
Other notable resources include Nganampa Health Council, aboriginal drug and alcohol council,
Reconciliation Australia, Aboriginal Family Violence Prevention and Legal Service Victoria, Aboriginal
Family Support Services, Australian Indigenous HealthInfoNet, etc (Sa.gov.au., 2018)
Question 8
The following website may assist with this question
http://www.redcross.org.au/aboriginal-and-torres-strait-islander-peoples.aspx
Some Aboriginal and Torres Strait Islander families need additional support for a variety of
reasons. Outline the support that workers can provide and organisations can implement.
The aboriginals might require a series of additional support services in order to learn and
implement the health promotional behaviours alike the rest of the mainstream society and hence the
health care workers often have to provide additional support to the needy. First and foremost,
counselling support is often the most abundantly used by the aboriginals and the Torres Strait Islanders.
The counselling support is often provided in both community setting and one to one setting (Kirmayer
2012)
The health literacy of these minority groups is often very low and hence along with mental
health support, they often require additional patient education which is provided by the care
professionals in accordance to evidence based culturally safe practice.
Question 9
The following website may assist with this question
http://www.carersaustralia.com.au/storage/2011Working%20with%20Aboriginal%20People
%20and%20Communities.pdf
“She just has this thing about her”
Indigenous Parent
Part A
Reflect on your studies to date. Describe the characteristics that you believe would be
important when working with Aboriginal and Torres Strait Islander clients, families, children and
colleagues.
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There are various characteristics that are needed to be taken into consideration while working
with the indigenous families, children and colleague. First of all, the nurses must respect the cultural
sensitivity issues and take a compassionate and respectful communication approach both verbal and
nonverbal (Funston 2013). Even gesture, tone of voice or lack of eye contact can seem rude and
disrespectful to an aboriginal or TSI. Cultural bias and building rapport is also a very important
characteristic feature that is needed to be adhered to with sensitivity while working with aboriginals
(Carersaustralia.com.au., 2018).
Part B
There may be times that a health care setting may require the expertise of external services.
Outline when you would use
1) A language interpreter
When the culturally diverse family has low English language proficiency
2) A cultural interpreter
When the culturally diverse client or family is demanding traditional healing techniques or is
expressing any cultural norm to be followed.
3) A translator
When the culturally diverse family or client cannot understand medical instructions at all
Part C
It is important to evaluate and measure programs against desired outcomes. How would you
evaluate and measure the success of using an interpreter?
I would use a feedback assessment tool to ensure that the communication between the care
team and the patient or their family is effective and both parties have understood the communication
clearly.
Question 10
The following websites may assist with this question
http://www.csu.edu.au/data/assets/pdf_file/0004/409459/Guide-for-Working-with-Indigenous-
Australian-Staff_-WEB.pdf
Even when we are thoroughly aware of all the barriers to effective cross-cultural communication
and make use of available aids and tools to assist us in communicating with people from
cultural and linguistic backgrounds different to our own, misunderstandings will occur.
“What do you do?”
In the dominant culture of Australia and indeed in Western cultures more generally, there is a
tendency to associate a person’s social value and worth with their occupation and to socially
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position them accordingly. “What do you do?” is often one of the first questions asked in social
situations.
“Who you is?”
When an Aboriginal person in Wilcannia asks ‘who you is?’ of another Aboriginal person, the
response being sought locates a person relationally—for example: ‘I’m X’s nephew’ or ‘my
Mother is A’ or ‘Y is my cousin’. In responding to questions such as this, Aboriginal people
explore kin relationships and social networks across towns and cities. This serves to socially
and geographically locate the people being met, thereby positioning them within recognised
frameworks and the kind of social intercourse that may or may not be entered into.
For many Aboriginal people, work and its rewards sit uneasily with the upholding of a distinct
identity. They recognise that regular employment affords some of the material things that many
would like to have, but are not prepared to forfeit other culturally perceived and culturally
attributed values, social obligations and desires (as well as the time to fulfil these). Family
illness, Nana’s need to do some shopping, the arrival of family or friends from out of town or an
unexpected occurrence of interest continue to be some of the causes of much non-attendance
at ‘work’.
Discuss how a health care service can support Aboriginal and Torres Strait Islander people to
fulfil all needs of cultural, family and work obligations.
In order to support the needs of cultural family and work obligations, Aboriginal and Torres
Strait Islander people often require the attention of a few resources. Firstly, the services can help the
ATSI individuals understand their obligations and their implications in life. It has to be understood that
the native communities are not much aware of the modern societal norms, and hence, helping them
understand the obligations and what they are required to do can be extremely helpful. Another way
they can be helped includes providing additional support or key resources so that they can fulfil their
obligations, including financial support as well (Brown et al. 2016).
Question 11
The following website may assist with this question
http://www.winnunga.org.au/
As an Enrolled Nurse in an inner city suburb you notice that more Indigenous families are
attending the community care centre than ever before. This has occurred because the
community care centre manager has actively engaged the Indigenous community and has
employed several Indigenous community care workers, and has now an external Indigenous
stakeholder group to refer to if needed and on an ongoing basis. There is a need for relevant
Indigenous resources to address cultural realities, and to support effective service delivery.
What are some ways that would contribute to meeting these needs?
Resources are undoubtedly a very important contributor to the evidence based practice, and
hence, the need for the resource delivery is needed to be addressed across all domains. The Winnunga
Nimmityjah Aboriginal Health Services can be a very important service that can be helpful for the
aboriginal community centre with culturally diverse staff that can better address the cultural realities.
They are a Aboriginal community controlled primary health care service that is run by the Aboriginal and
Torres Strait Islander community so that they can be able to address the care needs of the aboriginals
with much better understanding of the traditional health needs of the ATSI people. However, there are
other such services as well that are run by aboriginal staff and the community centre can benefit from
and can improve the care standards and delivery to the ATSI people.
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Question 12
The following website may assist with this question
http://www.carersaustralia.com.au/storage/2011Working%20with%20Aboriginal%20People
%20and%20Communities.pdf
A new Indigenous community care worker has just started and during her orientation she
observes the community care centre receptionist speaking disrespectfully to an Indigenous
cleaner. She is unsure what to do as she really needs the job and does not want to put her job
at risk or create a big problem. After some weeks when she understands her colleagues better,
she confides in you as the Enrolled Nurse, and asks what she should do. How would you
approach this problem?
As an enrolled nurse, I will ask her to formally report the issue and will conduct a private one-to-
one meeting or consultation session with her helping her understand the legal process of filing a
culturally safety complaint against a co-worker. After she has understood the legal procedure I will
assist her to arrange a meeting with my supervisor and take her guidance regarding how to proceed
with the complaint. With her guidance, I will proceed to instruct and help the new worker file a formal
complaint mail to the administrative department. Next, I will conduct a meeting with both of the parties
involved so that the receptionist can provide her side of the story or any justification for her actions.
Depending on her responses, she will be either left with a formal warning or a more severe punishment.
I would personally reassure the worker regarding the liberty for the workers to report any
unprofessional attitude or offensive behaviour of co-workers immediately following the protocol
(Carersaustralia.com.au., 2018).
Question 13
To provide culturally safe nursing practice, it is important to have an understanding of historical
and cultural backgrounds of Aboriginal and Torres Strait Islanders in Australia. Research
events from European invasion and discuss the impact of same on Aboriginal and Torres Strait
Islander people.
Part A
From research, outline the events and how they may have impact client’s social, emotional,
physiological and physical wellbeing.
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Part B
Considering your clients, what are the most common diseases experienced.
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Part C
How do you involve your clients in the planning and delivery of their health care?
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References:
Australia.gov.au 2018. Australian indigenous cultural heritage. [online] Available at:
http://australia.gov.au/about-australia/australian-story/austn-indigenous-cultural-heritage
http://www.multiculturalaustralia.edu.au/doc/shnukal_torres_strait.pdf [Accessed 31 May 2018].
Australian Institute of Health and Welfare. 2018. Reports & statistics - Australian Institute of Health and
Welfare. [online] Available at: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?
id=60129548151 [Accessed 31 May 2018].
Baker, A.C. and 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),
p.15.
Brown, A.E., Middleton, P.F., Fereday, J.A. and Pincombe, J.I., 2016. Cultural safety and midwifery care
for Aboriginal women–A phenomenological study. Women and Birth, 29(2), pp.196-202.
Carersaustralia.com.au. 2018. Working with aboriginal people and communities. [online] Available at:
http://www.carersaustralia.com.au/storage/2011Working%20with%20Aboriginal%20People%20and
%20Communities.pdf [Accessed 31 May 2018].
Community.nsw.gov.au. 2018. Working with aboriginal people and communities, a practice resource.
[online] Available at: http://www.community.nsw.gov.au/__data/assets/pdf_file/0017/321308/
working_with_aboriginal.pdf [Accessed 31 May 2018].
Family & Community Services 2018. All children deserve a safe and stable home for life.. [online]
Available at: http://www.community.nsw.gov.au/__data/assets/pdf_file/0017/321308/
working_with_aboriginal.pdf http://www.australia.gov.au/about-australia/australian-story/austn-
indigenous-cultural-heritage [Accessed 31 May 2018].
Funston, L., 2013. Aboriginal and Torres Strait Islander worldviews and cultural safety transforming
sexual assault service provision for children and young people. International journal of environmental
research and public health, 10(9), pp.3818-3833.
Gerlach, A.J., 2012. A critical reflection on the concept of cultural safety. Canadian Journal of
Occupational Therapy, 79(3), pp.151-158.
Jeffreys, M.R., 2015. Teaching cultural competence in nursing and health care: Inquiry, action, and
innovation. Springer Publishing Company.
Kirmayer, L.J., 2012. Rethinking cultural competence. Transcultural psychiatry, 49(2), p.149.
Sa.gov.au. 2018. SA.GOV.AU - Resources for Aboriginal people. [online] Available at:
https://www.sa.gov.au/topics/care-and-support/resources-for-aboriginal-people [Accessed 31 May
2018].
Shah, C.P., 2012. Increasing Aboriginal cultural safety among health care practitioners. Canadian Journal
of Public Health, 103(5), p.397.
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Sielearning.tafensw.edu.au. 2018. Resolve cross-cultural misunderstandings - Resolve cross-cultural
misunderstandings. [online] Available at: http://sielearning.tafensw.edu.au/MCS/9362/Sterilisation
%20disk%203/lo/7374/7374_00.htm [Accessed 31 May 2018].
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