HLT54115 Nursing Case Study: Cultural Safety for Indigenous Child

This nursing assignment presents a case study focusing on Shakira, a 7-year-old Indigenous child with Rheumatic Heart Disease. The assignment addresses the social determinants of health affecting Shakira, including environmental factors, nutritional status, and the impact of family decisions on her care. It emphasizes the importance of cultural awareness and sensitivity in providing holistic care that respects Shakira's values and preferences. The assignment also discusses the Aboriginal and Torres Strait Islander Act, its objectives, and the effects of racism and discrimination on Indigenous people's access to healthcare, education, and employment. Furthermore, it highlights the significance of involving Indigenous people in decision-making processes related to their healthcare and the role of enrolled nurses in creating a safe and comfortable environment for patients like Shakira, while considering their cultural and linguistic diversity. The assignment concludes by addressing potential questions and concerns Indigenous patients may have when seeking healthcare and emphasizes the need for culturally safe and competent care.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT CASE STUDY
Name of the study
Name of the University
Author note

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Answer 1
Rheumatic Heart Disease is the health condition in which both the heart valves are
damaged because of the prolonged acute rheumatic fever (ARF). The continuous onset of acute
rheumatic fever causes the inflammation of heart, which causes the extended starching of valves
and because of which normal blood flow is interrupted (Roberts et al., 2014).
Environmental factors and physical weakness are two social determinants of health
depending on which the heart status of Shakira could be justified. It is seen through researches
that streptococcus sp. is the primary reason behind the ARF and hence, environmental conditions
that enhances the exposure to such bacteria could be reason behind this disease. Besides that, it
was seen that Shakira is underweight and hence, her nutritional status could be the reason behind
his immune-weakness that lead to rheumatic heart disease (Gordon et al., 2015).
Physical weakness could be the determinant which could be affected with her family’s
decision of her care process because it was seen that her mother was unable to feed her children.
Further, due to her heart disorder, she had to go through a tedious and expensive care process,
which could affect her family’s decision (Watkins et al., 2017).
The treatment option for Shakira includes intramuscular application of penicillin every 4th
week for 10 years so that the growth of bacteria could be stopped and the future damage to the
heart valves could be prevented.
As per the data of Pmc.gov.au. (2019), it was seen that indigenous population is 5 times
more likely to be affected with rheumatic heart disease than the non-indigenous population.

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Further, the rate of mortality due to this disease was 6.6 times higher than that of non-indigenous
population.
Answer 2
Cultural awareness would be defined to the patient by providing her holistic care with her
values and preferences kept intact. Hence, by maintaining her cultural background and choices,
cultural value will be maintained (Mareno & Hart, 2014).
Cultural sensitivity is the aspect depending on which people learn about people who are
different and hence, becomes culturally awareness through the skills of cultural sensitivity.
In case of Shakira, care process will include the cultural preferences and values of the
patient so that the abovementioned aspects are maintained (Mareno & Hart, 2014).
Answer 3
3.1 The primary objective of this act is to include aboriginal and Torres Strait islander
people in the implementation and formulation of policies which affect their identity within the
state and develop their self-sufficiency and management abilities by enforcing economic, cultural
and social development (Legislation.gov.au, 2019).
3.2 Direct effect of physical racism and discrimination affected aboriginal and Torres
Strait islanders from achieving their fundamental needs related to education, healthcare and
employment. This is the reason behind their negative health outcome and excessive substance
abuse (Bombay, Matheson & Anisman, 2014).

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Answer 4
To make effective participation of aboriginal and Torres Strait Islanders in different
services would require their active participation in decision making process and hence they
should aware about their rights and responsibilities in the society for their inclusion within the
mainstream Australian community (Stephens et al., 2014).
This strategy will help the enrolled nurse, as the patient belonging to the community
would be aware of his/her role in the care process and he/she will be able to provide complete
support in the care process by developing a rapport with the enrolled nurse (Stephens et al.,
2014).
Answer 5
While caring for Shakira, enrolled nurse should be very polite and gentle as Shakira is
only 7 years old and suffering from developmental and physiological conditions. Hence, by
communicating in a polite and gentle way, enrolled nurse could develop a rapport with the
patient, influencing positive health outcome for the patient.
Answer 6
It should be mentioned that Shakira does not have access to adequate food, education,
permanent shelter due to her and her family’s economic and social condition. Therefore, this
present situation would affect her decision making abilities about her health condition, because
she will not be able to understand the way her present situation is deteriorating her health
condition.

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Answer 7
Employing culturally and linguistically diverse staff in the care process would help
Shakira and her family to feel comfortable within the health facility and communicate about her
health condition. This will help them to communicate in their own language to the staff and their
sense of familiarity would help them to improve the health of Shakira.
Answer 8
Being an enrolled nurse it is my responsibility to make my patients feel safe and
comfortable within the care facility and hence, I would prefer to re-shape my ideas and values to
understand my patient’s values and ideologies so that I can provide them with their needs.
Further, if I had to face such condition in my placement, I would be prepared to re-shape my
ideologies to understand the perspective of my patient.
Answer 9
The questions an aboriginal may ask themselves while attaining healthcare in facilities
are:
1. How will they communicate to the healthcare professionals if they don’t know
each other’s language?
2. Will the healthcare professionals be welcoming to their cultural or personal
preferences or they need to re-shape their ideologies to achieve healthcare?
Two indicators that could prevent indigenous people from attaining health would be:
 Not providing them with culturally safe and competent care

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 neglecting their cultural or personal preferences while care process and
communication gap present in the process

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References
Bombay, A., Matheson, K., & Anisman, H. (2014). Appraisals of discriminatory events among
adult offspring of Indian residential school survivors: The influences of identity centrality
and past perceptions of discrimination. Cultural diversity and ethnic minority
psychology, 20(1), 75.
Gordon, J., Kirlew, M., Schreiber, Y., Saginur, R., Bocking, N., Blakelock, B., ... & Kelly, L.
(2015). Acute rheumatic fever in First Nations communities in northwestern Ontario:
Social determinants of health “bite the heart”. Canadian Family Physician, 61(10), 881-
886.
Legislation.gov.au. (2019). Aboriginal and Torres Strait Islander Act 2005. Retrieved from
https://www.legislation.gov.au/Details/C2012C00258
Mareno, N., & Hart, P. L. (2014). Cultural competency among nurses with undergraduate and
graduate degrees: implications for nursing education. Nursing Education
Perspectives, 35(2), 83-88.
Pmc.gov.au. (2019). 2017 HPF Report - 1.06 Acute rheumatic fever and rheumatic heart disease.
Retrieved from https://www.pmc.gov.au/sites/default/files/publications/indigenous/hpf-
2017/tier1/106.html
Roberts, K., Maguire, G., Brown, A., Atkinson, D., Reményi, B., Wheaton, G., ... & Carapetis, J.
R. (2014). Echocardiographic screening for rheumatic heart disease in high and low risk
Australian children. Circulation, 129(19), 1953-1961.

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Stephens, A., Cullen, J., Massey, L., & Bohanna, I. (2014). Will the National Disability
Insurance Scheme improve the lives of those most in need? Effective service delivery for
people with acquired brain injury and other disabilities in remote Aboriginal and Torres
Strait Islander communities. Australian Journal of Public Administration, 73(2), 260-
270.
Watkins, D. A., Johnson, C. O., Colquhoun, S. M., Karthikeyan, G., Beaton, A., Bukhman, G., ...
& Nascimento, B. R. (2017). Global, regional, and national burden of rheumatic heart
disease, 1990–2015. New England Journal of Medicine, 377(8), 713-722.