Cultural Safety

[Coop_696]

hi guys,

just need some clarification as to whether i'm on the right track for this part of a cultural safety assignment

this is the q: identify one (1) important systemic cultural factor in the australian health care system that could diminish, demean, or disempower clients and their families. support your explanation with an example that demonstrates how this factor might produce culturally unsafe care. draw from your own ideas and/or experience and from your reading and research.

and my incomplete answer: (this section is only supposed to be about 300 words)

low utilisation of appropriate services as a result of non compliance with referrals/prescriptions has developed into a systemic factor due to the lack of 'cultural appropriateness' of the interventions utilised by the practitioner in modern australia. cultural appropriateness puts cultural sensitivity in action via the tailoring of public health interventions for specific cultures. thus, health services, health behaviour change interventions, empowerment, and and occupational health approaches are adapted according to the target population to which they will be applied. however, these adaptions are often made to suit the stereotype of the culture they are targeting and may cause offence leading to lack of cultural appropriateness and development of a culturally unsafe environment. an example of cultural inappropriateness is that of the significantly low number of indigenous people who carry through with the interventions in place such as referrals. which, may be cited as inappropriate as they can often involve tearing an aboriginal family apart so one community member can travel for health care (miller).

according to coup (2001), lack of cultural appropriateness is an often cited cause for hesitation, including the degree of indigenous involvement in the facility, how aware and how trusted the health practitioners are, and of course language and gender issues. this is demonstrated by....

also, the practitioner may prescribe a course of treatment such as chemotherapy, or another powerful/invasive treatment with little regard for how the individual will cope in the community after, or indeed little regard for the persons' spiritual beliefs...

what do you think? is it an appropriate intervention? is it written ok thus far? :s it's such a touchy topic to be writing about

thank-you!

[Coop_696]

anyone? please?

[talaxandra]

I'd include a more specific example, and earlier in. I have to say that I found this section of your essay quite dense (as in solid, not stupid) and not very easy to understand.

A couple if things to think about - 1. "Indigenous" and "Aboriginal" should be capitalised if you're referring to a specific population than to indigenous populations in general (eg health care issues are more severe in the populations of indigenous people across Australia, Canada and the US). 2. Some of what you discuss applies to any culturally different population, while others are more specific to this population. That doesn't mean those points are wring, just that you might want to acknowledge this.

Although issues with Aboriginal and Torres Strait populations may come first to mind, think about other populations where cultural challenges exist. Also bear in mind your question - ]what is the one important, systemic cultural factor you've identified? If a sentence doesn't serve to answer that then nyou need to review whether or not to keep it.

Hope that helps - it soulds like a hard assignment and is certainly a thorny topic.

[Coop_696]

so would something like - the issue with the health care system is that people can't be treated the same as their needs vary based on health problem, culture, age etc i.e. equity vs. equality?

its made more difficult as the lecturer is an indigenous australian and has yet to acknowledge another culture exists outside of "white" and aboriginal *sigh* so as this is the only q that doesnt specify to talk about indigenous australians so it threw me off a bit.

thanks heaps for that input it was immensley useful!... i'll have another crack at it/simplify and probs repost again in the next few days :)

anyone else feel free to comment too! even if it's just on how one can handle a racist lecturer (she refers to us as young hitlers :s)

[talaxandra]

Young Hitlers? That's massively inappropriate! If it wasn't a lecturer I'd be so tempted to say that I was Jewish and insulted by the comparison. I'm not Jewish, and have the usual helping of middle class white guilt (I have Indigenous heritage but a way back and I certainly don't culturally identify as Aboriginal) and I still find it insulting.

That aside - I'm glad my comments helped. Your lecturer's bias would make me even more tempted to look at other aspects of cultural difference and difficulty, but bear in mind that s/he seems to have an agenda and bringing in other groups could be detrimental.

I think your second version is more intelligible and accessible - well done! One of the things I'd bear in mind is that there are two issues - practitioner bias or blindness to cultural difference (which encompasses the examples you initially gave), and community concerns about practitioners (eg distrust). You could discuss both or either aspect. Just remember that it's such a massive subject you could write a PhD thesis so don't expect to be able to cover everything :)

Good luck. I'm happy to offer another opinion in a few days if you like, and hopefully someone else will be comfortable to weigh in, too.

[Coop_696]

ergh well i have jewish blood and my grandfather was one of the pioneering health care workers out at an alice spring community... so it's all i can do to sit through the lectures :-/

anyways i don't want to include all of what ive written exactly as i've written it so those from my class trawling through websites for hints can't steal my work word for word

so below is a little bit:

: identify one (1) important systemic cultural factor in the australian health care system that could diminish, demean, or disempower clients and their families.support your explanation with an example that demonstrates how this factor might produce culturally unsafe care. draw from your own ideas and/or experience and from your reading and research.

recommended length for this answer is 300 words

the most significant issue within the health care system is that people are too wary of applying equity over than equality. it must be acknowledged that every presenting scenario is unique and thus not every patient requires the same (or equal care) as another individual.

without analysing each person on a case by case basis, the health care providers risk creating a culturally unsafe environment. this is noteably a multicultural issue as everyone entering the healthcare system faces the same dilemma of finding care tailored to suit them as individuals without being judged by another person as a result of the discourses they have formed (equity)

examples of this include yada yada (one from own ideas/experiece and one from the literature) and revolving around as you said, talaxandra "practitioner bias or blindness to cultural difference (which encompasses the examples you initially gave), and community concerns about practitioners (eg distrust)"

not sure whether to state how this may have been prevented/can be prevented in future as word count is limited. so mayve just give examples and identify points of treatmen in which there are problems

does the above nswer the q though or is it too nonspecific :s

now to fill out my evaluation of said lecturer

[talaxandra]

I like it, but I don't understand your opening sentence: "The most significant issue within the health care system is that people are too wary of applying equity over than equality." Part of that's because of the "over than" but I think you also need to explain what you mean more clearly. Also, be cautious about using generalisations ("most people are too wary") because your position can be disproved wth just one example to the contrary.

That aside, it all sounds good to me, but I'm not a freakish instructor! I definitely think you should include the "Hitler" reference in your evaluation, and say that you were culturally offended - true and relevant :)

Good luck and keep us posted

[Coop_696]

woops cheers!

i've changed the opening sentence to the most significant issue within the australian health care system is that people are unaware of the differences of equity over equality and how to apply equity strategies in everyday situations

and i later relate this to social justice and human rights (according to some articles on the aust. education system if you apply this criteria to everything you do it can determine if the situation is equitable).

thanks so much for all your input talaxandra! it's great having a forum to bounce ideas around in

my evaluation incorporated her comments and also the time/date they occured (all lectures are recorded (i doubt she knew this when the comments where made)) i also suggested that the class on multiculturalism and health should actually include just that as aboriginals aren't the only culture in existance plus we didn't learn a thing about health in other cultures :s

[DolceVita, ADN, BSN, RN]

So I am unclear. Does your response have to be about your indigenous population? I ask because I have seen some interesting documents produced by Australian states/territories (bah which is it? or is it both?) agencies on how to be culturally competent with other populations that I thought were very interesting. A couple were on this website:

http://www.health.qld.gov.au/multicultural/health_workers/support_tools.asp

Also, if your prof is touchy perhaps including Aboriginals could be a bit of a third rail. I get that that ship has sailed, now that you have more or less completed the assignment.

As an aside....For one of our cultural competency assignments I took published government guidelines for healthcare that were supposed to address the "needs" of different cultures and critiqued them. I found several of them were awash with recommendations based on myth and inaccurate stereotyping. I actually enjoyed doing it.

Good luck with your assignment.

[Coop_696]

Hi DolceVita

it's actually the one section of the assignment that doesn't explicitly say indigenous, so I'm going to assume I should apply it to all cultures. Which is why I chose to discuss equity over equality (even Europeans can experience this problem in the heath care system!)

Those guides are amazing! especially the cultural competency in health one! thank-you :-)

She only gets touchy when other cultures/races are discussed other than her own (she is part indigenous though identifies only as being an aboriginal)

I wish we had discussed much more diversity and heath related matters in class... it truly is an interesting subject!

Thanks again for your input DolceVita

[DolceVita, ADN, BSN, RN]

You are v welcome. I find all this stuff very interesting too.