NRS20006 - ATSI Population Health: Social Determinants & Nursing Care

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This essay examines nursing care for Aboriginal and Torres Strait Islander (ATSI) peoples in Australia, focusing on the impact of social determinants of health (SDH) on this population. It highlights challenges such as lack of education, unemployment, social environment, and access to healthcare, which contribute to health inequities and lower life expectancy. The essay discusses the impact of these factors on nursing practice, emphasizing the importance of cultural competency and addressing communication barriers. It also references the Registered Nurse Standard for Practice (RNSP) and AHPRA guidelines, which emphasize cultural safety and respect in providing care to ATSI patients. Strategies like cultural education for healthcare workers, employing ATSI candidates, and awareness programs are discussed as means to improve healthcare access and outcomes for this population. The essay concludes by reinforcing the need for culturally sensitive and equitable healthcare practices to address the unique health challenges faced by the ATSI community.
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Running head: NURSING CARE IN ABORIGINAL AND TORRES STRAIT ISLANDER
NURSING CARE IN ABORIGINAL AND TORRES STRAIT ISLANDER
Name of the Student:
Name of the University:
Author Note:
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1NURSING CARE IN ABORIGINAL AND TORRES STRAIT ISLANDER
Australia is a culturally diverse country, which is a home for a diverse group of
population. Every population have some specific area of needs and different social
determinants of health in the context of nursing and healthcare. The field of nursing and
healthcare in Australia is focused on delivering appropriate care to all those populations and
thus, there are different guidelines for every population in the registered nurse standard
practice to address their specific needs. This paper aims to discuss a selected population in
the context of nursing and healthcare. The paper will be selecting a particular population for
this discussion, and then the social determinants of health associated with the selected
population will be discussed. After that, the discussion will focus on the impact of care and
the process of providing care for the selected population. Finally, the paper will refer to the
Registered Nurse Standard for Practice to describe the guidelines for care.
The Aboriginal and the Torres Strait Islander (ATSI) population of Australia are also
known as the first nation people of Australia due to their ancient origin in this country. The
population consists of several hundreds of different cultural groups, who speak about 250
different languages. The population is also known as the indigenous population.
Unfortunately, the population group have to suffer discrimination in every field of their life
compared to the non-indigenous population, including the field of healthcare. There were
about 3250 death in this population was reported in the year 2017, which consisted of about
2% of death events in the whole country (Healthinfonet.ecu.edu.au., 2018). The population
also suffer from a wide variety of disease, which has a huge impact on their life. There are
many social determinants of health (SDH) responsible for impaired health and decreased life
expectancy in the ATSI population. The first one of them can be identified as a lack of
education. A statistical study reported that only 47% of the young adults between the age
ranges of 20-24 years had completed their year 12 education. The second SDH can be the
lack of employment. There were about 53% of people in the population who had no
employment (Healthinfonet.ecu.edu.au., 2018). The third SDH was the social environment,
where the practice of smoking, drug abuse and drinking alcohol is a common practice. The
other SDH can be their lack of access to healthcare services and cultural difference along
with racial discrimination. The social determinants of health are the factors that are
responsible for the health and well-being of an individual or in a particular population.
Education, income, habitual practices, access to healthcare and cultural backgrounds are
important SDH since they significantly affect both physical and mental well-being of an
individual (Markwick, Ansari, Sullivan & McNeil, 2015).
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2NURSING CARE IN ABORIGINAL AND TORRES STRAIT ISLANDER
The impact of these social determinants ensures a low quality of life and a low life
expectancy in the ATSI population. The lack of education lowers their chance of
employment, and a lower income can be directly associated with impaired mental health
(Calma, Dudgeon & Bray, 2017). Impaired mental health is associated with the habit of
smoking, drinking alcohol and drug abuse, which in turn increase the risks of cardiovascular
diseases, renal diseases, cancers and various other lifestyle diseases such as diabetes (Lovett,
Thurber & Maddox, 2017). Additional to that limited access to healthcare services and social
discrimination contribute hugely in the matter of impaired health and life expectancy in the
ATSI population. However, the Australian government is focusing on improving the
conditions and the quality of life in the selected group of the population at present. There is a
policy known as “Closing the Gap” policy at place for this purpose. The policy is focused on
improving the quality of life in the ATSI population by addressing all the SDH separately
(Altman, 2018).
The matter of impaired health and low life expectancy in the ATSI population has a
huge impact on the nursing practice in Australia. The nurses have a responsibility of ensuring
the health of the community like every other healthcare workers. For fulfilling the purpose,
the nurses are supposed to provide quality care to all their patients, including the ATSI
population. However, they often face various challenges regarding their duty to this group of
population. One of the principle barriers is the cultural difference and the language barrier.
The problem of miscommunication is one of the principal resulting event of those challenges
(Fredericks, Lee, Adams & Mahoney, 2020). As a result, the quality of care provided to the
ATSI population is low, and the factor often clashes with the ethical and moral principles of
the nurses and other healthcare workers.
An improvement in this condition is being approached by the Australian government.
The strategies like providing appropriate cultural education to all the healthcare workers,
employing the candidates from the ATSI population as healthcare staff, improving the
cultural competency in the nursing staff and various others are being implemented for
improving the quality of life in the ATSI population. The cultural education to the healthcare
student will ensure a culturally competent generation of healthcare staff in future, who will be
able to provide a better quality of care to the patients from the ATSI population (Watt, Abbott
& Reath, 2016). The employment of candidates from the ATSI is not only for solving the
employment issue faced by the population but also in the hope that their employment in the
healthcare field will be an effective buffer in resolving the discrimination issues. The
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3NURSING CARE IN ABORIGINAL AND TORRES STRAIT ISLANDER
healthcare staff from the ATSI population can also play the role of a translator to minimize
the risk of miscommunication with the ATSI people (Gwynne & Lincoln, 2017). The
importance of cultural competency training in the present employees in the healthcare field
lies behind the fact that it is ensuring high-quality care for the ATSI people at present
(Larkins et al., 2016). There are also attempts for making access to healthcare services easier
for the ATSI people. An attempt for making the trend of education popular is being practised
among the ATSI population. There are also various awareness programs are being arranged
to make the ATSI people aware of the risks of their habitual practices (Schembri et al., 2016).
The awareness programs are aiming for increasing the awareness of the people about the
harmful effects of smoking, drinking and drug abuse; the mortality risks associated with
various disease conditions and also the strategies for improving their quality of life. There are
also measures like free immunisation is being provided among the ATSI population in order
to lower the risks of them encountering infectious diseases.
The NMBA guideline for the Registered Nurse Standard of Practice (RNSP)
acknowledges the people form the ATSI population separately (Nursing and Midwifery
Board of Australia., 2018). The practice guideline also acknowledges the possible impact on
the people from the population resulting from the colonisation effect on the patients.
Australian Health Practitioner Regulation Agency (AHPRA) acknowledges the knowledge of
history and science in the ATSI population and predicts that there will be a strengthening
impact on the healthcare practice in Australia if two cultures are combined (Australian Health
Practitioner Regulation Agency., 2003). The Registered Nurses (RN) are expected to
understand the cultural, social and spiritual lives of the people from the ATSI population in
order to work with appropriate collaboration with them. The RNSP also acknowledges the
health inequity in the ATSI population and expects the RN to address the problem
appropriately. The guideline advises the RN to display proper respect for the culture to ensure
a better health outcome in the patients from the ATSI population (Nursing and Midwifery
Board of Australia., 2018). According to another AHPRA guideline, all the healthcare staffs
including the RN are expected to incorporate a culturally safe practice in their professional
practice, which can be achieved by acknowledging the impact of racism, colonisation and
other socioeconomic factors on the health of the ATSI people first. Then the staffs must
acknowledge their own biased and prejudiced opinions to improve their thinking process.
After that, the workers must recognise the importance of collaboration, partnership and self-
determined decision making with the community, family and other workers to invite an
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4NURSING CARE IN ABORIGINAL AND TORRES STRAIT ISLANDER
improved health outcome. Finally, an appropriate application of leadership must take place to
support the dignity and the rights of the ATSI population (Australian Health Practitioner
Regulation Agency., 2003).
Hence it can be concluded from the above discussion that the Aboriginal and the
Torres Strait Islander population is one of the oldest population in Australia, who is also
known as “first nation people” or “indigenous population”. Unfortunately, the people of the
population suffer from a wide variety of disease, which has a huge impact on their lives and
the entire population health. Various SDH is responsible for this phenomenon, such as lack of
education, lack of employment, habitual practices, access to healthcare services and cultural
backgrounds. The matter of impaired health and low life expectancy in the ATSI population
has a huge impact on the nursing practice in Australia since they often face various
challenges regarding their duty to this group of population. However, the strategies like
providing appropriate cultural education to all the healthcare workers, employing the
candidates from the ATSI population as healthcare staff, improving the cultural competency
in the nursing staff and various others are being adopted for improving the practice. The
Registered Nurse Standard of Practice also acknowledges those strategies to improve the
quality of care.
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5NURSING CARE IN ABORIGINAL AND TORRES STRAIT ISLANDER
References:
Altman, J. (2018). Beyond closing the gap: Valuing diversity in Indigenous Australia.
Canberra, ACT: Centre for Aboriginal Economic Policy Research (CAEPR), The
Australian National University.
https://openresearch-repository.anu.edu.au/handle/1885/147808
Australian Health Practitioner Regulation Agency. (2003). Australian Health Practitioner
Regulation Agency - Aboriginal and Torres Strait Islander Health Strategy. Ahpra-
search.clients.funnelback.com. Retrieved 13 April 2020, from https://ahpra-
search.clients.funnelback.com/s/redirect?collection=ahpra-websites-web&url=https
%3A%2F%2Fwww.ahpra.gov.au%2FAbout-AHPRA%2FAboriginal-and-Torres-
Strait-Islander-Health-Strategy.aspx&auth=mai
%2F53X4LNEO0lnuCcE9Yg&profile=nursingmidwifery&rank=1&query=aboriginal
+and+torres+strait+islander.
Calma, T., Dudgeon, P., & Bray, A. (2017). Aboriginal and Torres Strait Islander social and
emotional wellbeing and mental health. Australian Psychologist, 52(4), 255-260.
https://doi.org/10.1111/ap.12299
Fredericks, B., Lee, V., Adams, M., & Mahoney, R. (2020). Aboriginal and Torres Strait
Islander health. Professional Nursing and Midwifery Practice [Custom Edition for
Monash University], 264. https://books.google.co.in/books?
hl=en&lr=&id=X9PWDwAAQBAJ&oi=fnd&pg=PA264&dq=aboriginal+and+torres
+strait+islander+health+impact+on+nursing+practice&ots=IH7SiIburQ&sig=P5VcR
bZ6sfVutEdO25Q2iPgEchY#v=onepage&q=aboriginal%20and%20torres%20strait
%20islander%20health%20impact%20on%20nursing%20practice&f=false
Gwynne, K., & Lincoln, M. (2017). Developing the rural health workforce to improve
Australian Aboriginal and Torres Strait Islander health outcomes: a systematic
review. Australian Health Review, 41(2), 234-238.
https://www.publish.csiro.au/ah/AH15241
Healthinfonet.ecu.edu.au. (2018). Summary of Aboriginal and Torres Strait Islander health
status 2018. Healthinfonet.ecu.edu.au. Retrieved 13 April 2020, from
https://healthinfonet.ecu.edu.au/healthinfonet/getContent.php?
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6NURSING CARE IN ABORIGINAL AND TORRES STRAIT ISLANDER
linkid=621156&title=Summary+of+Aboriginal+and+Torres+Strait+Islander+health+
status+2018&contentid=36479_1.
Larkins, S., Woods, C. E., Matthews, V., Thompson, S. C., Schierhout, G., Mitropoulos,
M., ... & Bailie, R. S. (2016). Responses of Aboriginal and Torres Strait Islander
primary health-care services to continuous quality improvement initiatives. Frontiers
in public health, 3, 288. https://doi.org/10.3389/fpubh.2015.00288
Lovett, R., Thurber, K. A., & Maddox, R. (2017). The Aboriginal and Torres Strait Islander
smoking epidemic: what stage are we at, and what does it mean. Public Health Res
Pract, 27(4), e2741733. https://doi.org/10.17061/phrp2741733
Markwick, A., Ansari, Z., Sullivan, M., & McNeil, J. (2015). Social determinants and
psychological distress among Aboriginal and Torres Strait islander adults in the
Australian state of Victoria: A cross-sectional population based study. Social Science
& Medicine, 128, 178-187. https://doi.org/10.1016/j.socscimed.2015.01.014
Nursing and Midwifery Board of Australia. (2018). Nursing and Midwifery Board of
Australia - Registered nurse standards for practice. Nursingmidwiferyboard.gov.au.
Retrieved 13 April 2020, from https://www.nursingmidwiferyboard.gov.au/Codes-
Guidelines-Statements/Professional-standards/registered-nurse-standards-for-
practice.aspx.
Schembri, L., Curran, J., Collins, L., Pelinovskaia, M., Bell, H., Richardson, C., & Palermo,
C. (2016). The effect of nutrition education on nutritionrelated health outcomes of
Aboriginal and Torres Strait Islander people: a systematic review. Australian and
New Zealand journal of public health, 40(S1), S42-S47. https://doi.org/10.1111/1753-
6405.12392
Watt, K., Abbott, P., & Reath, J. (2016). Developing cultural competence in general
practitioners: an integrative review of the literature. BMC family practice, 17(1), 158.
https://link.springer.com/article/10.1186/s12875-016-0560-6
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