Guided Reflection: Nursing Practice and Indigenous Communities

This report presents a guided reflection on a nursing student's experiences and learning related to Indigenous healthcare. The student initially believed that culture played a limited role in nursing but gained a deeper understanding of its importance through the course. The reflection utilizes Gibb's reflective model, describing encounters with diverse patients, particularly Aboriginal and Torres Strait Islander peoples, and challenges in providing culturally appropriate care. The student highlights the significance of the ABCD cultural assessment tool, discussions, and yarning circles in enhancing their understanding. Feelings of difficulty in communication and the impact of stereotypes are discussed. The evaluation reveals the student's increased awareness of the disparities in Indigenous health and the role of nurses in addressing them. Analysis identifies the need for improved cultural competency training and multidisciplinary teamwork. The conclusion emphasizes the importance of effective communication and cultural sensitivity in nursing practice, advocating for a culture-based nursing framework. The action plan outlines how the student will apply these learnings, emphasizing teamwork and cultural considerations in future practice, and advising new learners on the importance of cultural competence. The report references several scholarly articles to support the student's reflections.

Guided Reflection

TABLE OF CONTENT
REFLECTION ................................................................................................................................1
REFERENCES................................................................................................................................5

REFLECTION
I used to believe that within nursing and health care profession there is very limited role
of culture and nurses and other health professionals must not undergo deeper into it. However,
the wide gap between health outcomes and safety of indigenous health and other communities
developed an interest within me to assess the different factors which influences the poor health
of aboriginals. The learnings from this subject have been very useful in improving my
professional efficiencies and understanding. As per the standards of registered nurse the safety
and well-being of patient is highly essential (Taylor and Guerin, 2019).
However, nursing practices and safety standards can be improved by taking culture into
account for the better understanding of the patient. During the learning I came to know the
significance of culture in the assessment of patient. I always used to believe that culture affects
practices of individuals only and nursing practices are not affected by it. However, nurses are
also required to understand the culture and perspective of people of Torres Strait islander people.
In order to understand the health status and nursing approaches for improving there health I
participated in different learning practices.
The three most influential practices which significantly affected my learning process are
ABCD cultural assessment tool, discussion on various articles and yarning circle. One of the best
approach to enhance the learning through reflection process is to incorporate a reflective model
such as Gibb's model of reflection. I can well evaluate my experience using following reflection
model.
Description:
During placement, I encountered patients from diversified cultures. Sometimes it was
easy to communicate with them and to provide care. However, there were instances when I have
to treat aboriginal people and Torres strait islanders because I always found it difficult to develop
care plan acceptable to patients and their family members. However, as per nursing standards it
is mandatory for me to assure that both patients and carers equally participate in the decision-
making for the safety and well-being of patient.
The learning of ABCD approach was helpful to resolve this issue. I tried to explore and
understand the culture and ethical perspective of indigenous community. It helped me to develop
understanding that which care practices are not appreciated by them and how they perceive death
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and dying. Using the learning from this I try to adopt practices which encourages patient health
as well as cooperation from the family.
The spiritual and religious belief of the patient and specific communities influences the
decision-making and family care based approaches of the patient. In the discussion and analysis
of various articles I learned that even nurses provide effective care but if suitable support from
families is not provided then it may not deliver qualitative health outcomes for the patient. I also
witnessed that many indigenous people do not have any access to health care services or the
services which promote the negative health consequences. There are some professionals who do
not provide equal treatment to indigenous people. Thus, in my opinion all nurses must be trained
so that they respect the dignity, feelings, culture and beliefs of indigenous community.
Feelings:
In my opinion the huge difference in the education, culture and social interaction one of
the major factor leading to poor indigenous health. The language and lack of compatibility is also
one of the reason which affect the decision-making of patients as well as service providers
(Power and et.al., 2018). When I used to interact with the indigenous people many times
especially the elderly people find it difficult to understand my language. The stereotypes related
to religion and gender also make it hard for them to take services from people of other cultures.
In such situations I usually feel like that there is need to communicate with them so that they can
start receiving care with positive perspective.
Evaluation:
As learning part everything went well in my opinion. Though there were events when I
was critically analysing the findings so that I can discover actual causes of the issue. For instance
prior to my nursing practice and the learning I was not much concerned and aware of cultural
and health aspects of indigenous community. However, when I participated in the discussion and
analysis of various articles then I came to know the seriousness of the issue and how nurses can
play a significant role in changing the situation. Through yarning circle and discussion with my
patients I also evaluated that indigenous people also desire to live a healthy life. However, they
have been separated from the main stream and are often discriminated. The unavailability of
health care services, nutritional food, drug addiction, lack of education and poverty has been key
driving force in poor indigenous health.
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Analysis:
One of the key issue which I identified is the lack of awareness among indigenous
communities as well as ineffective training programs for the nursing professionals. The patients
requires health care professionals which not only understand their physical needs but also their
spiritual, psychological and emotional concerns. The evidence based practices cannot be
accomplished without multidisciplinary teams. Thus, effective coordination is required among
various nursing professionals. The root cause among various clinical complications or the
diseases is the lack of awareness (Best and Fredericks, 2017). Thus nurses must consider the
cultural and traditional perspective of aboriginals as well as other communities to develop
interventions along with the medications and physical therapies.
In the transition period I used to belief that providing medications or the psychological
therapies is sufficient to improve the health outcome of patient. However, with practice I observe
that for individuals their own perspective, beliefs and assumptions towards health care approach
is also one of the important part of care services. Through my interaction with the aboriginals I
also analysed that they are usually not aware with the adverse consequences of addictions or
poor living and nutritional needs. Thus, as a nurse I can act as health promotion professional and
must provide necessary emotional and knowledge support to my patients along with the care
services.
Conclusion:
The communication has been one of the integral part of health care profession. The
interaction with patients and families reveals a lot of significant clinical information. There are
people who claim that the nursing care provided to them does not suit or fits to their cultural
perspective. This issue becomes more critical while providing home care or palliative care to
patients of chronic diseases or long term illness. The indigenous health quality and social
inequalities makes them more vulnerable to illness and ineffective care services. In order to deal
with such situation it is recommended that registered nurses must communicate with the patients
effectively. The interaction will help nurses to develop trust among their patients.
In my opinion I immediately report to the senior authorities when any of such patients are
identified. For example there is majority of aboriginals who are addicted to drugs or oral
diseases. However, they do not realize the consequences of these diseases. On the other there are
many patients who desire to overcome these adverse health consequences, but they are not aware
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of any kind of rehabilitation services or health care institutes (Hunt and et.al., 2015). Thus, in my
opinion there is need to create a culture based nursing framework so that all nurses can learn to
improve their practices but considering the cultural implications into their practices.
Action plan:
The experience has proven to be one of the most effective learning approach in terms of
improving my professional expertise. The learning gained from the analysis of articles and
yarning circle helped me to come across the concepts which were not known to me earlier. Since
the discussion involved individuals from different cultures and background I used to get an
understanding of different perspectives on the subject. It also gave me an opportunity to identify
my various professional skills as well as to explore the skills which I must improve. For instance
during yarning circle I was very confident in putting my point of views and strategies for
indigenous health.
As an attentive listener I was also paying attention to what other participants are saying.
In the nursing profession the skill is very important as it helps to make accurate clinical
assessments and to develop safe nursing interventions. While providing treatment to patient I
always find it hard to analyse that if I will be able to properly communicate with them or not.
However through the ABCD model I learned to overcome the cultural implications effectively.
In future also if I will face similar situation then I will take the culture of patients into accounts
as well. To the new learners or the qualified nurses I will advise that effective patient care cannot
be provided without team work. Thus, group discussion, case reviews, yarning circles and all
learning activities promoting team work and coordination learning are recommended (Clifford
and et.al., 2015). From the learnings achieved through these activities I will be able to develop
more interactive bond with other professionals working in team as well as carers and patients.
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REFERENCES
Books and Journals
Best, O. and Fredericks, B., 2017. Yatdjuligin: Aboriginal and torres strait islander nursing and
midwifery care. Cambridge University Press.
Clifford, A., and et.al., 2015. Interventions to improve cultural competency in health care for
Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic
review. International Journal for Quality in Health Care. 27(2). pp.89-98.
Hunt, L. and et.al., 2015. Nursing students' perspectives of the health and healthcare issues of
Australian Indigenous people. Nurse education today. 35(3). pp.461-467.
Power, T. and et.al., 2018. Ensuring Indigenous cultural respect in Australian undergraduate
nursing students. Higher Education Research & Development. 37(4). pp.837-851.
Taylor, K. and Guerin, P., 2019. Health care and Indigenous Australians: cultural safety in
practice. Macmillan International Higher Education.
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