Understanding Different Types of Racism and the Importance of Cultural Safety in Healthcare

This document discusses the differences between personal and institutional racism, the importance of cultural safety in healthcare, and the impact of racial disparities on health outcomes. It also explores the role of nurses in addressing cultural differences and promoting equality in care.

Step 1
a) Among different types of racism, personal and institutional racism are the most
common types. There are some significant differences between these two types of
racisms. Individual or personal racism is a kind of racism where the actions, beliefs as
well as attitude of a person are recognized as different from the majority group of
people. It generally occurs when an individual holds the attitude of prejudice and
engages in similar or discriminatory behaviour. Discriminatory treatment during
interpersonal contact, use of derogatory names, threat, and using acts of violence is
alleged to be racially inferior. Institutional racism generally occurs when the policies
of any institution lead to the discriminatory outcomes for some people of minority
groups which ignore the need of ethnically diverse society (Atkin, 2018). Again,
individual racism can also lead to another type which is institutional racism. This kind
of racism also occurs when a certain set of rule is created within an organization
which tends to be racist towards a certain group or community of people. These two
types of racism can be derived from each other based on the situations. However, the
main difference is, in individual or personal racism, a person is treated unequally by
another person but, in institutional racism, a policy treats a group of people unequally
(Richardson, 2010).
b) Power is a concept that enables a person or a group to achieve goals. Power in nursing
is also important as well as a controversial topic that involves various kinds of
interpretations. Power helps nurses to seize opportunities and this concept is
associated with the concept of whiteness as well (Mansouri, Jenkins & Walsh, 2012).
Whiteness is depicted as a socially constructed category of race and it creates racism
issue in contemporary nursing practice of Australia. The racial controversies arise
when it is noticed that the power is dependent on the “whiteness” of the nurses.

According to literatures, black nurses while working in white space or simply while
working with white nurses confront various cultural challenges that reflect racism in
nursing practice (Papps & Ramsden, 1996). Black nurses confessed to face
differences in their powers while providing care to the patients. The power in most of
the cases is controlled by the white nurses and blacks are more likely to be the
sufferer.
c) Cultural competence is basically the ability of interacting effectively with the people
from different cultural beliefs and values. It also defined as the complex integration of
knowledge, skill and attitude in order to enhance the cross-cultural communication in
healthcare service (Henderson, Horne, Hills & Kendall, 2018). It refers to be
responsive as well as respectful to the health beliefs and practices irrespective of the
cultural and linguistic needs. Developing the cultural competence in the nursing
practice is also an evolving as well as dynamic progress which takes time. Practicing
the cultural competence throughout the program planning of an organization always
ensures that all the members from different communities and groups are involved.
Lack of cultural competence may lead to the dissatisfaction of the patients. If the
healthcare providers are not working together to provide culturally competent care
then it might produce negative health consequences. Again, cultural safety in the
healthcare practice involves empowerment of the healthcare providers (Laverty,
McDermott & Calma, 2017). It is mainly based on the experience of the recipients of
care and it aims to enhance the delivery of healthcare services by specifically
identifying the relationship between the patient and the medical practitioner. The
cultural safety always supports the patient from aboriginal community by giving
power to comment on the care provided. Cultural safety always helps in recognizing
the inequality present in the care provided by the healthcare professionals. However,

the main difference between cultural safety and cultural competency is, cultural safety
is all about trust and genuine partnership, but, culture competency is the sensitive and
effective healthcare behaviours (Pager & Shepherd, 2008).
Step 2
Report: The prescribed readings of week 15 were on various topics and among them the
wellbeing of Aboriginals and people of Torres Strait Islander was also a part of these
weeks reading which dragged my interest more. The reading clearly discussed how
indigenous people suffer from issues regarding inequality in care.
Response: I feel that this knowledge helped me to have a deep knowledge about the
importance of equal health services irrespective of the races. I think integrating cultural
safety into the nursing practice is highly necessary in order to overcome challenges in
healthcare regarding racial discriminations.
Step 3
Aboriginal health in Australia has been reported by the researchers as poor when
compared to non-aboriginal people. Even, literatures indicated that life expectancy at
birth is 21 years less for men and 19 years less for women of aboriginal community of
Australia (Arieli, Friedman & Hirschfeld, 2012). Institutional racism is the discrimination
against the minority groups within any organization. It has been claimed by the
researchers that institutional racism is embedded in most of the institutions of Australia.
Even, racism in Australian institutions is sometimes unrecognized by the agents
associated with it. The world is concerned regarding the issue of racism and in the history
of Australia, institutional racism has been found more than 50 years ago (Muise, 2019). A
number of rich as well as varied literatures have been developed in this regard. In recent

years, both the concept as well as practice of racism has been found in many institutions.
However, the institutional racism has a contribution in the gap of healthcare. The well-
documented discriminations and disparities in health outcome for racial groups in some of
the societies have been attributed to institutional racism. The presence of racial issue not
only affected the healthcare system but also the education as well as employment
situation of the people of Australia (Hole et al., 2015). The stress due to racism affects the
learning process and hence, it contributes to the poorer learning outcome which in turn
deteriorates the education environment of any institute. Persistent racial discrimination in
employment is also big issue for the organizations of Australia. Due to the social
conception regarding the superiority of whiteness is the main reason behind such
disparities. The existence of discrimination causes conflicts in the workplace and it also
impacts the mental wellbeing of the minority people and it results in poor employment
outcome. Due to racial discrimination action the privileges goes to the white people in
this way. In a study of Australia with the people from minority group, eleven different
racial behaviours were introduced to them and 7.1% among the participants reported
experiencing at least one kind of racial behaviours from the list (Denison, Varcoe &
Browne, 2014). The literatures on the racism of Australia suggested a growing of
mainstream concern over the racial mix in Australia. The panic associated with the people
experienced racism impacts always produces a poor mental health outcome impacting the
education and employment. In order to remove the institutional barrier regarding racism
to the Aboriginal people of Torres Strait Islander, in the year 2014, the Anti-
Discrimination Commission worked with CHHHS (Marrie, 2017). In Australia there is
considerable evidence regarding the existence of racial discrimination in the institutions
which affects the aboriginal people of Torres Strait Islander and it causes failure in many
aspects of education, healthcare and employment. Even, the studies showed that the

failure rate is as high as 70% in Australia due to racial disparities (Smith & Plunkett,
2019). However, in the year 2008, Australian government committed to work with
Aboriginal and Torres Strait Islander people in order to achieve equality in healthcare
(Australia, 2013).
Step 4
Cultural safety in the healthcare process is important in order to address the
dissatisfaction of the people from Maori communities. In Australia, nurses are now
expected to provide a culturally safe care to all the people in need of care. Australia is a
multicultural country and therefore a culturally safe nursing practice is most essential in
order to produce a good health outcome (Lin et al., 2014). A culturally appropriate
nursing care has been widely discussed in various literatures and it was developed in the
concept of nursing theory. Also, it has been discussed in terms of healthcare. During the
1990s, the cultural safety concept was integrated into the nursing practices of New
Zealand (Baum, Freeman, Lawless & Jolley, 2012). A culturally safe nursing practice
incorporates optimal communication and at the same time it also helps in building strong
relationships in cultural preferences (Uptin, Wright & Harwood, 2013). Literatures
indicate that professional nurses should value the social justice and in this purpose,
cultural safety should be incorporated in their working practice (Mkandawire‐Valhmu et
al., 2019). Clear, open and respectful communication between patients and healthcare
providers is fundamental in acknowledging the requirement of the patients. For example,
it can be said that communicating with the people of different language can cause issues
while providing care but establishing an effective communication strategy can help in
understanding the problems of the patients effectively and it also supports a culturally
safe care. Culturally safe care is consistent with caring qualities and it takes into account
the life experience of the person receiving care (Baak, 2019). In Australia, the existing

healthcare safety and quality standards are not sufficient as aboriginal people and people
form Torres Strait Islanders report to get inappropriate care due to cultural differences
(Competition, 2010). Therefore, cultural safety is an active manner which reconfigures
healthcare to possess appropriate health interventions and strategies of providing care
irrespective of the racial disparities. Needless to say, cultural safety requires embedding
not only to the course of accreditation but also in the standards governing clinical
professionalism as well as quality (Phiri, Dietsch & Bonner, 2010). The development of
trust and positive relationship is important on care and hence, a culturally safe nursing
practice helps in having better health outcome of the people from minority group.
Step 5
According to the 5Rs of reflection framework, here I’m reflecting my understanding
regarding the role of nurses in order to address the health needs of Aboriginal and Torres
Strait Islander people in a culturally safe way.
Reporting: Indigenous people of Australian minority community reports to receive
inequality in care by the healthcare professionals and especially, from the nurses. This
disparity in care is one of the greatest reasons of poor health outcome. Nurses play a
major role in the quality of care and hence, they are more likely to ensure cultural safety
in their working practice. Even, reports stated that due to discrimination in healthcare, the
life expectancy of the aboriginal people is comparatively lesser than the non-aboriginal
people. However, my knowledge has been transformed in understanding the role of
nurses in order to address the issue regarding cultural safety.
Responding: I also feel indigenous people are more likely to suffer from the issues causes
by the cultural differences in healthcare practices. In fact, I think, nurses are amongst the
people who first come in contacts with the patients while encountering them. In order to

understand the needs of the patients, nurses are first to communicate with them. If a
strong and faithful relationship between the nurses and the patients is not built, then it
directly hampers the process of care which in turn causes dissatisfaction of the patients. I
have also observed nurses deal with people from different cultures and communities
while providing care and literatures indicated gap arises in the care when there is a
difference in the culture.
Relating: My understanding to the topic culture safety and aboriginal healthcare also
states due to cultural or language issue, people from minority community face lots of
problems. I also have an experience of observing such situation where the patient is
unable to communicate in English as he is from an indigenous community and the nurse
is white who speaks English. Due to this communication gap, the patient is unable to
explain the actual health issue properly to the nurse. This situation has a direct connection
with the issue as it reflects how people from minority group face difficulties while
receiving care from the healthcare providers.
Reasoning: The above described situation is quite common in healthcare and apart from
this several other consequences are there due to inequality. Even, people from Torres
Strait Islanders always report not receiving proper care and they claimed many times that
white people get more facilities than them while receiving care. However, I think,
incorporating effective communication strategy as well as integrating cultural safety into
the nursing education and working practice can be helpful in overcoming the gaps of
healthcare. Racial discrimination act should be incorporated in the nursing education to
enhance their knowledge in this regard as many nurses are not aware of the existence of
such acts.

Reconstructing: The understanding regarding the need of maintaining cultural safety and
role of nurses in this regard has helped me in gaining knowledge with a deep insight into
the topic. I also think this knowledge is going to help me in future while working as
professional nurse in healthcare organizations. However, I strongly believe that there is
need to maintain the quality in care irrespective of the culture and races. This deeper level
of understanding about the topic will help me to have a successful career as a professional
nurse by providing a quality of care to all the patients.

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