Analysis of Professional Practice in Healthcare: A Case Study Report

This report presents an analysis of a case study focused on professional practice within a healthcare setting, examining the delivery of patient-centered care, cultural sensitivity, and effective communication strategies. The report addresses a scenario involving a midwife and a patient, highlighting the importance of respecting patient preferences, values, and beliefs, particularly within the context of Indigenous health. It critiques the initial violation of nursing standards and the subsequent improvements in care delivery, emphasizing the significance of building professional relationships and understanding patient concerns. The report also summarizes an article on the enduring dilemmas of Indigenous health, discussing barriers to participation in health promotion programs and the inherent tensions in implementing these programs within Indigenous communities. Finally, the report applies the 4 Es (Engage, Empathize, Educate, Enlist) to the case study to facilitate better physician-patient communication and improve patient satisfaction.

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Running head: INTRODUCTION TO PROFESSIONAL PRACTICE
INTRODUCTION TO PROFESSIONAL PRACTICE
Name of the student
Name of the university
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INTRODUCTION TO PROFESSIONAL PRACTICE
Part A-
Question 1:
When working in clinical settings, health workers like nurses and midwives, delivers care to the
patients irrespective of their culture, ethnicity, preferences, age and sex and provide a holistic
approach to care. While delivering care, the healthcare professionals must ensure to hold
integrity of the patients and do not indulge themselves in taking any actions that might lead to
the violation of the nursing standards. Patient centred care is directly linked with patient’s
satisfaction and an improved health outcome. Providing a patient centred care enhances patient’s
satisfaction by acknowledging the patient’s values, beliefs and preferences towards wellbeing
(Betterhealth.vic.gov.au, 2019). Patient centred care is characterised by respecting and treating
the patients with dignity. Healthcare professionals must ensure a patient centred approach to care
by respecting the preferences, values, beliefs and respect the decisions made by the patients.
Besides respecting the autonomy of the patients, the healthcare professionals must also educate
and make the patients aware of their health condition and give information on the treatment
approaches and options available. However, the case study shown in the video, is a perfect
illustration of the violation of nursing standard, patient centred approach to care, where the
midwife, Michelle, was found to have asking questions that are against nursing standards. The
midwife, Michelle should have adhered to behaviour influencing therapeutic communication and
promote professional relationship with her patient, Kaylene Matthews. To promote patient
centred care, health professionals must effectively communicate and build a professional
relationship with the patients to understand their beliefs, preferences, values and their concerns

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and address them by communicating effectively and deliver care by recognising the needs of the
patients which is found to be missing in the case of Kaylene Matthews.
Question 2:
It is seen in the third video that on realising there exists a gap between the midwife trying to
deliver care by accessing health information of the patient and the patient’s expectation from the
healthcare service, the midwife is seen to have improving the approach of care delivery by
building a professional relationship and understanding the patient’s concern. It is evident from
the video that if healthcare professionals communicate effectively and involve the patients in the
decision making process, it leads to an improved health outcome and increases patient’s
satisfaction (Betterhealth.vic.gov.au, 2019). Michelle behaved nicely with the patient and her
mother, and asked relevant questions aligning with professional nursing standards and
communicated effectively following patient centred care by understanding her concern and
respecting her decisions. Since, the patient had a negative experience with her past medical
service, it was natural for her to react and be overprotective of her unborn child. She was
distrustful and defensive and had an expectation of getting treated badly because of negative
experience she had in her previous pregnancy where she lost her twin babies. A major difference
can be noticed in both of the videos (First and the third), where at the initial stage, Michelle is
seen to behave abruptly and showed disrespect by asking irreverent questions. Being an
Aboriginal woman she always comes across discrimination, she is therefore concerned and
sensitive and must have dealt with care in the first place (Browne & Varcoe, 2006). However,
when the midwife realised it with the help of the health worker, she gave a cultural competent
care and respected her decisions. She offered the patient with information and educated her about

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the adverse effects of smoking that can have on the unborn child rather showing disrespect by
pointing out finger at her for her smoking habit, which noticed in the first video.
Part B
The article about “Enduring dilemmas of Indigenous health”, speaks on the researches carried
out within Indigenous people in remote Australia to construct a framework of delivering care and
wellbeing priorities. It is evident from the study that illness prevention and promotion of health
in Aboriginal and Torres Strait Islander communities is considered to be crucial in closing the
gap between the health outcomes of Indigenous and non-Indigenous and providing an equal
opportunity to receive care without any discrimination because of their culture and ethnicity. The
article speaks about how the National Indigenous Health Equality promote the wellbeing of the
Aboriginals by identifying the requirement for activities to promote health and wellbeing of them
by targeting smoking, chronic diseases, exercise and nutrition mental health. The article also
talks about the findings of Journal Taylor and colleagues from the study on Indigenous
participation in cardiac rehabilitation, which is an important form of secondary prevention. They
found that there exists many barriers for participation that includes the challenges faced with
extended responsibilities of the family, the inappropriateness caused due to the sociocultural
aspects of cardiac rehabilitation programs, and historical barriers to using mainstream services
that are recognized to be playing the central role in evaluations of health promotion of the
Aboriginals and the health services. For a variety of hospital, cultural and socioeconomic
reasons, and considering the conditions required for living a healthy life as defined by the
western culture, might be missing in the Aboriginals. Communities see this as a major problem
and these behaviors and conditions related to unhealthy practice and environments which are

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linked to good health care are seen as antithetical by other communities. The study by Taylor
suggests these behaviors may come due to social exclusion. Besides, social excusing, other
studies have also argues that the cultural difference plays a significant role in adopting western
culture and behavior. These findings suggests that health promotion change is required for the
social fabric of Indigenous communities. While some working in Indigenous health view this as
a positive and necessary change, others may fear the fact that certain cultural practices can be
compromised in the pursuit of good health (Kowal & Paradies, 2010).
Part C-
In the first video, the midwife was seem to violating the nursing standards and asked irreverent
question involving patient’s personal life that eventually lead to patient’s dissatisfaction. Patient
centred care is characterised by respecting and treating the patients with dignity. Healthcare
professionals must ensure a patient centred approach to care by respecting the preferences,
values, beliefs and respect the decisions made by the patients. The nurse in the first video seem
to have violating the nursing standards by not communicating effectively with the patient. Better
and effective communication is liked with increased patients satisfaction and lead to an improved
health outcome of the patients. Whereas, in the third video, it is seen that the midwife
communicated effectively with the patient and improved the approach of care delivery by
building a professional relationship and understanding the patient’s concern. The article shows
the application of 4Es in facilitating better physician patient communication necessary for patient
centred care (Tongue, Epps & Forese, 2005). The nurses and midwives must implement these 4
E’s in the care delivery process in order to get an improved health outcome and patient’s
satisfaction. The 4 E’s are as follows:

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1. Engage- The healthcare professionals must engage the patients in the decision making
process by understanding the values, beliefs and preferences and deliver care by
understanding their concerns.
2. Empathize- The health care professionals must put emphasis on the expectation and the
complexity associated with individual care needs and deliver care in accordance to their
preferences.
3. Educate- Healthcare professionals must educate and make the patients aware of their
health condition and give opportunity to make decisions.
4. Enlist- Enlist the health information required to proper diagnose and treat medical
condition of the patients and communicate effectively in order to facilitate proper care
delivery by accessing the required health information of the patients (Tongue, Epps &
Forese, 2005).

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References:
Betterhealth.vic.gov.au. (2019). Patient-centred care explained. Betterhealth.vic.gov.au. [online]
Betterhealth.vic.gov.au. Available at:
https://www.betterhealth.vic.gov.au/health/servicesandsupport/patient-centred-care-
explained [Accessed 7 Aug. 2019].
Browne, A. J., & Varcoe, C. (2006). Critical cultural perspectives and health care involving
Aboriginal peoples. Contemporary Nurse, 22(2), 155-168.
Kowal, E., & Paradies, Y. (2010). Enduring dilemmas of Indigenous health. The Medical
Journal of Australia.
Tongue, J., Epps, H., & Forese, L. (2005). RESEARCH-BASED, EASILY LEARNED
TECHNIQUES FOR MEDICAL INTERVIEWS THAT BENEFIT ORTHOPAEDIC
SURGEONS AND THEIR PATIENTS. THE JOURNAL OF BONE & JOINT SURGERY
· JBJS.ORG.