Reflection on Improving Aboriginal Health: A Nursing Perspective

This reflective writing assignment explores the author's experience with an Aboriginal patient and the gap in health status. Using Gibbs' reflective cycle, the author analyzes a clinical placement incident where they initially failed to consider the social determinants of health contributing to the patient's smoking habit. The reflection covers the author's feelings, evaluation of the situation, and analysis of the social determinants impacting Aboriginal health, such as education, employment, and cultural factors. The assignment concludes with an action plan for future practice, emphasizing the importance of culturally competent care, health literacy, and addressing social determinants to provide equitable healthcare to Aboriginal patients. The author acknowledges mistakes and outlines steps for improved patient care in similar situations, aligning with registered nurse standards of practice and professional conduct.

Running head: GAP IN HEALTH STATUS
GAP IN HEALTH STATUS
Name of the student:
Name of the university:
Author note:

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GAP IN HEALTH STATUS
Introduction:
One of the longstanding challenges that have been identified in the healthcare system of the
nation is gap in the improvement in the health status of the native and non-native people. Researchers
who have conducted statistical studies have indeed stated that gap in the health status between the two
groups of people have always been unacceptably wide (Thomas et al., 2017). United Nations have
therefore intervened in the situation and has identified this issue as one of the human rights concern. The
government of the nation has also acknowledged this. They are also trying their best to overcome the
issue by taking different strategies. There is an estimated gap of about 17 years between the life
expectations between the natives and non-natives (Nicholson et al., 2015). Moreover, the age specific
death rates are also seen to be twice in the natives in comparison to the non-natives. The relative socio-
economic disadvantage that the native face in comparison to that of the non0natives are the main reason
resulting them to have poor quality health. The assignment will mainly reflect on an incident that I have
experienced with the help of Gibbs cycle. It will also show how this situation had helped me to gather
knowledge about the issue effectively.
Gibb reflection cycle:
Description:
When I was on clinical placement in the healthcare organization, I had to attend an aboriginal
patient who was suffering from chest pain. After thorough analysis, I came to know that he smokes
tobacco throughout the day and is highly addicted to this habit. Therefore, I provided him different
therapies like nicotine replacement therapies, referred him to counseling sessions to a substance abuse
counselor so that he can overcome his feelings of smoking, and adhere to the plans prescribed for him.
However, when I discussed the case with my mentor, he criticized my ability; he told me that I had not
provided significance to the social determinants of health that mainly shape the health of the individuals. I

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was very upset that I could not provide the best care to the patient and could not advice the best care
recommendations that would help him to lead better quality lives.
Feelings:
I became quite upset when I came to know that the diagnosis of the patient was not done in the
proper way. I was feeling bad that the interventions that I developed might be costlier for him as he is not
from a non-native background. I was feeling bad that I failed to provide him high quality service that
every patients expect from healthcare professionals. My mentor had criticized me about my approach
stating that I have not developed proper knowledge of treating the aboriginals. I was deeply hurt but it
also motivated me to work much harder and be an expert professional.
Evaluation:
The bad part of the entire event was that I, as a health care professional, failed completely in
providing best care to the native patient. Researchers are of the opinion that every healthcare professional
should first determine the social determinants that are resulting patients from developing habit
(McMurray & Clendon, 2015). Moreover, professionals should only plan interventions that are possible
for patients to achieve (Nicholson et al., 2015). The intervention I prepared may not be possible for the
native patient to achieve, as he might not have the social and economic advantage to fetch the resources.
However, the good part of the incident was that it helped me to understand the importance of considering
the gap in health status of the individuals. It helped me to understand the fact that how social determinants
of health had resulted him in developing this habit of smoking. If I had cared for his social determinants
of health and helped him in maintaining his social determinants of health in addition to the nicotine
replacement therapies, the interventions would have been effective (Registered nurse standards for
practice, 2016). This showed me that I needed to develop knowledge on the social determinants of health
of the aboriginals and understand the gap in health status. Then only I would be able to develop high
quality care plans for them.

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Analysis:
There are large numbers of social determinists that are stated by researchers to take an active part
in development of smoking behavior among the native people. Lack of education and health literacy is
found to be common among the native people that make them adopt many unhealthy practices as they do
not have any idea about the effects of nicotine and tobacco on their health, due to lack of education, they
are seen to be more prone to develop this smoking habit (Smith et al., 2016). Only about 62% of the
native people are seen to complete 12th year of education in the 2014 in comparison to non-natives where
the percentage is 86%. Moreover, many of the researchers also state that employment also has huge role
in taking up smoking behaviors. Lack of jobs causes frustration and depression among patients that make
them take up smoking behavior. Moreover, it is also found that employment rate in the aboriginals are
only 48% compared to 75% of the non-indigenous people (Ospina et al., 2015). Moreover, the culture of
the community supports smoking and many individuals take up smoking to feel included in the society. I
was not aware of any of the factors and never thought that the gap in heath status can affect them in such
nervous ways. I should have planned the care of the patient in ways by which all social determinants of
health would be addressed.
Conclusion:
As the aboriginal patient was the first native patient whom I was attending, I should have
summoned my senior nurses and would have conducted the diagnosis and the care plan in front of her
only. As she is quite experienced and knowledgeable about the different health aspects of the native
people, she would have easily guided me in caring for the patient. This would have helped me develop a
plan that would address the social determinists of health, nicotine therapies and counseling sessions and
help the patient develop a better quality life (Mackey et al., 2018).

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Action plan:
When such situation would arrive once again, I would first try to understand the health literacy
and education level of the patient. Following this, I would educate him about the negative effects of
smoking so that he can successfully leave the smoking behavior. Secondly, I would try to develop idea
about hi employment aspects. If he does not have any job, the care plans that I make should not contain
any costly interventions (Thomas et al., 2017). I should also refer him to services that work free so that he
does not face economic constraints. This is according to standard five registered nurse standards of
practice where nursing professionals need to develop option priorities, care plans, outcomes and similar
others (Registered nurse standards for practice, NMBA, 2016). Moreover, I should also advocate for his
rights and should provide him sources where he can go for employments. This would also prevent him to
indulge in smoking with peers and would keep him safe. According to standard four of the codes of
professional conduct, I should respect the dignity, culture, values and ethnicity of the native people and
therefore provide the best care to them that are culturally competent (Code of professional conduct for
nurses in Australia, NMBA 2008).
Conclusion:
From the above discussion, I have been able to recognize the mistakes in made through Gibbs
reflection cycle. I have also been able to develop ideas about how to handle such situations effectively so
that best quality care can be given to them.

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References:
Mackey, S., Kwok, C., Anderson, J., Hatcher, D., Laver, S., Dickson, C., & Stewart, L. (2018). Australian
student nurse's knowledge of and attitudes toward primary health care: A cross-sectional
study. Nurse education today, 60, 127-132.
McMurray, A. & Clendon, J. (2015). Community health and wellness:primary health care in practice. (5th
ed.).Retrieved from https://www-clinicalkey-com-au.ezproxy.uws.edu.au/nursing/#!/content/
book/3-s2.0-B9780729541756000177
Nicholson, A. K., Borland, R., Davey, M. E., Stevens, M., & Thomas, D. P. (2015). Predictors of wanting
to quit in a national sample of Aboriginal and Torres Strait Islander smokers. The Medical
Journal of Australia, 202(10), 26-32.
Nicholson, A. K., Borland, R., van der Sterren, A. E., Bennet, P. T., Stevens, M., & Thomas, D. P.
(2015). Social acceptability and desirability of smoking in a national sample of Aboriginal and
Torres Strait Islander people. The Medical journal of Australia, 202(10), 57-62.
Nurses and Midwifery Board of Australia. (2016). Registered nurse standards for practice. Retrieved from
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards.aspx

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Nursing and Midwifery Board of Australia (2008). Code of professional conduct for nurses in Australia.
Retrieved from http://www.nursingmidwiferyboard.gov.au/documents/default.aspx?
record=WD10%2f1353&dbid=AP&chksum=Ac7KxRPDt289C5Bx%2ff4q3Q%3d%3d
Ospina, M. B., Voaklander, D., Senthilselvan, A., Stickland, M. K., King, M., Harris, A. W., & Rowe, B.
H. (2015). Incidence and prevalence of chronic obstructive pulmonary disease among aboriginal
peoples in Alberta, Canada. PLoS One, 10(4), e0123204.
Smith, J. D. (2016). Australia's Rural, Remote and Indigenous Health. (3rd ed.). Chatswood, Australia:
Elsevier Australia
Thomas, D. P., Panaretto, K. S., Davey, M., Briggs, V., & Borland, R. (2017). The social determinants
and starting and sustaining quit attempts in a national sample of Aboriginal and Torres Strait
Islander smokers. Australian and New Zealand journal of public health, 41(3), 230-236.