Aboriginal Nursing At Flinders Medical Centre: Analysis Of Cultural Safety And Primary Healthcare

Unsafe practices and cultural safety at Flinders Medical Centre

Discuss about the Aboriginal Nursing for Flinders Medical Centre.

This essay analyzes as well as discusses the perception of the cultural safety regarding aboriginal policy. The paper also assesses its significance as a way of developing and designing Government related policy and also delivery of services. This seeks to illustrate using different sources of literature in the assessment and the applicability of cultural safety in the context of Flinders Medical Centre. The main aim is to understand things that facilitate the hindrance of the indigenous participation in the decision making, another aim of this analysis is to understand those communities at risk and also the usefulness of particular programs which have been put in place to address the indigenous issues related to cultural safety (Couzos and Murra,  2008). While the focus is on the issue of the cultural safety, this paper has been broadened to also consider several other connected issues, as well as major determinants of the history of cultural safety.

For instance, In Flinders Medical Center where I undertook my placement, Aboriginal people experienced social assimilation throughout the Medical Centre, leading to trauma which led to the loss of their cultural cohesion. The resultant policies undermined and still continue to undermine, the responsibility of the Aboriginal individuals within the healthcare sector and their own treatment. Therefore, this paper will critique Flinders Medical organisation at which I undertook a placement for elements of cultural safety and principles of primary healthcare (Brown,et al. 2005)

It is an assumption that individual understands their values because it helps in knowing the relationships with employers, co-workers and clients. The most significant thing is a person’s ability of identifying those values that are of importance to him/her. For example, being conscience of values helps us to: keep asking ourselves why we always do things we do, Identification of the consequences of other peoples’ actions as well as ours and also consider other options which are better.

Having knowledge of your values is not enough, but also you should understand that values underpin beliefs and those beliefs underpin your behavior. However, we should behave in a manner that our beliefs reflect our values. In the context of cultural safety of the aboriginal people at Flinders Medical Centre, there are unsafe practices that have affected the values and beliefs of such indigenous people (Maddocks and Rayner, 2003) such unsafe practices have been defined to mean ‘any particular action that demeanor, diminish the cultural well-being and identity of individuals’. As the definition suggests, ‘cultural safety’ applies to areas such as service and government policies. In this particular scenario, the idea of cultural safety is a potential aspect in developing and delivering of services and policies in relation to indigenous people.

Cultural safety and primary healthcare for indigenous people at Flinders Medical Centre

The status of indigenous people at Flinders Medical Centre can be synopsized as follows: The health status of indigenous persons and their participation in decision making at Flinders Medical care is poor when compared to other healthcare organisation such as Aboriginal-controlled health services. At Flinders Medical Centre, there is a large gap between the ingenious and the healthcare providers. The estimated gap is approximately 17years between the non-indigenous and indigenous life expectation and decision making at Flinders Medical Care. For instance, the lack of participation in decision making by the indigenous persons at Flinders Medical Care has resulted to the increase in death rates where the death rate is twice compared to no-indigenous people.

In terms of cultural safety and principles of primary health care, indigenous persons do not have equal accessibility to healthcare services because of their lack of participation in decision making at Flinders Medical Care. The indigenous are at risk of being exposed to environmental health and behavioral risk due to their disadvantaged experience I terms of social-economic. The indigenous at Flinders Medical Care do not easily have an access to primary healthcare because of their lack in participation in decision making.

The Flinders Medical Centre never undertook any little progress to reduce this gap of inequality between the ingenious and the non-ingenious, for example when relating to long term objectives like life expectance. Their lack of participation in the decision making when it comes to cultural safety and primary healthcare have affected reduced their life expectance this because some of them have died with the diseases which could have been treated if only they shared it to the health professionals at Flinders.

As much as there has been an improvement in terms of primary healthcare for indigenous at in terms of cultural safety at Flinders Medical Centre, such improvement never matched with the rapid health received by the general population at Flinders Medical Centre. For instance, when the death rate of both the indigenous and the general population, that of the general population reduced whereas that of indigenous persons appear not to have made any significance in the reduction of death rates in terms of cardiovascular disease over the period I undertook placement at Flinders Medical Centre (Morgan,Slade and Morgan, 1997)

The scope of the issues currently experienced by the indigenous people at Flinders Medical Healthcare, this means that the issues are expected to increase since there is no participation in decision making which can help in the reduction of such issues. For there to be an increase in the participation in the decision making at Flinders Medical Centre, there will be a requirement in significance increase in programs and services just to keep the pace in the maintenance of the status quo, hence resulting in the reduction of inequality in the healthcare sectors.

Issues experienced by the indigenous people at Flinders Medical Centre

The inequality experienced by the indigenous people at Flinders Medical Centre such as lack of participation in decision making is linked to the systematic discrimination. In history, the indigenous never had the same chance to be healthy compared to non-indigenous (Browne and Varcoe, 2006) This was shown at Flinders Medical Centre, where the aboriginal people were not accessible to health care services, including cultural safety and primary healthcare. They were not exposed to good infrastructure. These health inequities have been described by Physicians at Australia College as   “Both systematic and Avoidable’’. This has remained fully addressed and it is a barrier to the enjoyment of social cultural safety and primary health.

There are several things that hinder indigenous participation in the health decision making at Flinders Medical Centre (Barratt, 2008). These hindrances in the decision making include the following:

Training is essential when it comes to the participation in the decision making, but there is existence of limited training at Flinders Medical Centre both for the practicing clinicians and the students who are under placement.

Shared in the decision making at any particular Medical Centre, is dependent on those clinicians who have access to evidence of high-quality, which is already synthesized. This can be helped by decision support tools, but these tools only assist the minority of the healthcare decision makers, this is because they vary in quality, scattered and also difficult to access. This has also affected the indigenous people at Flinders Medical Centre in terms of participation in the decision making.

Sharing in the making of the decision in terms of cultural safety and primary health is important especially for the health of indigenous people, but there have been challenges at Flinders Medical Centre due to availability of less research that enhance implementation in that particular area (Durey, 2010)

Flinders Medical Center is considerably lagging behind in terms of indigenous participation in the health care decision making as compared to other health care sectors such as Aboriginal-controlled health services. There is a lot of discrimination of the indigenous people at Flinders Medical Centre; this discrimination hinders indigenous people in the participation in decision making. This is because there is absence of coordination within the health care sector. This healthcare centre (Flinders Medical Centre) is supposed to encourage clinicians to start incorporating the idea of indigenous people to participate in the health decision making. But it has failed in that particular area because of their discrimination towards indigenous people.

Hindrances to indigenous participation in health decision-making

In order to facilitate the idea of shared decision making, Flinders Medical Centre should urgently start to prioritize and plan to ensure that shared decision making is a reality at Flinders Medical Centre (Berryman, et al. 2013). Another thing that hinders shared decision making at Flinders Medical Centre, is the aspect of discrimination of the indigenous people. This has widened the gap between the healthcare providers and the Aboriginal Persons, this kind of behavioral discrimination has affected the values and beliefs of the Aboriginal persons because they see themselves as less fortunate and this contribute to their  suffering in terms of  cultural  safety and primary healthcare.

Aboriginal people at the Aboriginal-controlled health services get involved in decision making than those Flinders Medical Centre who do not take part in decision making. Therefore, there is a bigger difference between the two healthcare centres.

There are aspects that make Aboriginal-controlled health services more suitable in terms of decision making as compared to Flinders Medical Centres. These aspects include; There is a developed program by the commission at Aboriginal-controlled health services; this program is supportive to aboriginal patients by involving them in the decision making (Walker Jane and Dewar, 2001) This program ensures reduction of unwarranted health services and also appropriateness at the health care.

The patients and clinicians at Aboriginal healthcare services make decisions together regarding patients’ management unlike Flinders Medical Centre, only the non-indigenous people are allowed to get involved in the decision making.

The aboriginal healthcare centre in partnership with the aboriginal people, they are encouraged to understand the available screening processes, management options and also communicate preferences and help in the selection of an action that is best suited (Curran et al.2008)

Medical Education Network signed a contract with National Aboriginal Controlled Health Organisation which sought to increase placement for the Aboriginal Students, this helped to increase participation in healthcare services resulting to involvement in decision making. Unlike at Flinders Medical Centre where non-indigenous people were the only people allowed to participate in decision making (Ben-Tovim et al. 2008).

At Aboriginal Healthcare Services there is the idea of involving aboriginal people in decision making whereby the works are trained and the introduction of Aboriginal health worker has helped in the standardization of the quality of the work force (Martin and Kipling, 2006). This has resulted to a greater impact in the healthcare decision making.

Access to services at Aboriginal HealthCare Center has been made easier both the workers and the Aboriginal people because people have been exposed to information which helped them to get involved in the decision making (Stiggelbout et al 2012). Unlike at Flinders Medical Centre where non-indigenous people are ones who get involved in the healthcare decision making.

The researchers have argued that shared decision making in any healthcare sector increases interest of the patients in the participation in making decisions in terms of prevention and controlling of diseases unlike where there is no shared decision making in health centres  such as Flinders Medical Centre, the people are not willing to share issues hence they get affected negatively.

The most current research indicates that participation in decision making increase interest to policy makers to cooperate with the healthcare sectors and patients in sorting out issues that are shared. But where there no involvement of people such as Aboriginal people in the decision making, there is a likelihood of people suffering and dying with the diseases because they fear sharing out their suffering.

Shared decision making improves satisfaction among the aboriginal people (Edwards, A. and Elwyn, 2009) this leads to pro vision of better quality in terms of services in the healthcare sectors. For instance in Queensland, tobacco users has remained 49%, 70% are obese, 25% have got hypertension and those who have diabetic mellitus are 18%. These problems when shared among the healthcare providers, there is a likelihood of reduction of this problems because proper decision may be made to eradicate such problems.

There was an improvement in the provision of healthcare services at Aboriginal Health Services as compared to Flinders Medical Centre because, Aboriginal people were involved in the making of the decisions at Aboriginal Health Services, this heightened the services at that particular health centre because after being involved in decision making action was taken as per issues raised (Elwyn et al.2012). Unlike at Flinders Medical Centre the Aboriginal People never participated in the decision making hence resulting to the provision poor health care services.

Conclusion

In conclusion, shared decision making is one of the key players when it comes to both the indigenous and non-indigenous people. Allowing aboriginal people to participate in decision making at the healthcare sectors improves their health and help them take responsibility in action (Heisler, et al. 2002).  Setting up frame works to underpin change to a healthy community should be the objectives of the healthcare sectors. Therefore, the healthcare systems should continue to support aboriginal people to participate in the healthcare decision making. 

References

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Heisler, M., Bouknight, R.R., Hayward, R.A., Smith, D.M. and Kerr, E.A., 2002. The relative importance of physician communication, participatory decision making, and patient understanding in diabetes self?management. Journal of general internal medicine, 17(4), pp.243-252.

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