Bridging The Gap In Health Status Between Native And Non-Native People: Lessons Learned From A Patient Care Experience

The persistent gap in health status between native and non-native people in the healthcare system

Discuss about the Incidence and Prevalence of Chronic Pulmonary.

One of the longstanding challenges that have been identified in the healthcare system of the nation is gap in the improvement in the health status of the native and non-native people. Researchers who have conducted statistical studies have indeed stated that gap in the health status between the two groups of people have always been unacceptably wide (Thomas et al., 2017). United Nations have therefore intervened in the situation and has identified this issue as one of the human rights concern. The government of the nation has also acknowledged this.  They are also trying their best to overcome the issue by taking different strategies. There is an estimated gap of about 17 years between the life expectations between the natives and non-natives (Nicholson et al., 2015). Moreover, the age specific death rates are also seen to be twice in the natives in comparison to the non-natives. The relative socio-economic disadvantage that the native face in comparison to that of the non0natives are the main reason resulting them to have poor quality health. The assignment will mainly reflect on an incident that I have experienced with the help of Gibbs cycle. It will also show how this situation had helped me to gather knowledge about the issue effectively.

When I was on clinical placement in the healthcare organization, I had to attend an aboriginal patient who was suffering from chest pain. After thorough analysis, I came to know that he smokes tobacco throughout the day and is highly addicted to this habit. Therefore, I provided him different therapies like nicotine replacement therapies, referred him to counseling sessions to a substance abuse counselor so that he can overcome his feelings of smoking, and adhere to the plans prescribed for him. However, when I discussed the case with my mentor, he criticized my ability; he told me that I had not provided significance to the social determinants of health that mainly shape the health of the individuals. I was very upset that I could not provide the best care to the patient and could not advice the best care recommendations that would help him to lead better quality lives.

I became quite upset when I came to know that the diagnosis of the patient was not done in the proper way. I was feeling bad that the interventions that I developed might be costlier for him as he is not from a non-native background. I was feeling bad that I failed to provide him high quality service that every patients expect from healthcare professionals. My mentor had criticized me about my approach stating that I have not developed proper knowledge of treating the aboriginals. I was deeply hurt but it also motivated me to work much harder and be an expert professional.

A patient care experience that highlights the importance of social determinants of health in developing care plans for native patients

The bad part of the entire event was that I, as a health care professional, failed completely in providing best care to the native patient. Researchers are of the opinion that every healthcare professional should first determine the social determinants that are resulting patients from developing habit (McMurray & Clendon, 2015). Moreover, professionals should only plan interventions that are possible for patients to achieve (Nicholson et al., 2015). The intervention I prepared may not be possible for the native patient to achieve, as he might not have the social and economic advantage to fetch the resources. However, the good part of the incident was that it helped me to understand the importance of considering the gap in health status of the individuals. It helped me to understand the fact that how social determinants of health had resulted him in developing this habit of smoking. If I had cared for his social determinants of health and helped him in maintaining his social determinants of health in addition to the nicotine replacement therapies, the interventions would have been effective (Registered nurse standards for practice, 2016). This showed me that I needed to develop knowledge on the social determinants of health of the aboriginals and understand the gap in health status. Then only I would be able to develop high quality care plans for them.

There are large numbers of social determinists that are stated by researchers to take an active part in development of smoking behavior among the native people. Lack of education and health literacy is found to be common among the native people that make them adopt many unhealthy practices as they do not have any idea about the effects of nicotine and tobacco on their health, due to lack of education, they are seen to be more prone to develop this smoking habit (Smith et al., 2016). Only about 62% of the native people are seen to complete 12^th year of education in the 2014 in comparison to non-natives where the percentage is 86%. Moreover, many of the researchers also state that employment also has huge role in taking up smoking behaviors. Lack of jobs causes frustration and depression among patients that make them take up smoking behavior. Moreover, it is also found that employment rate in the aboriginals are only 48% compared to 75% of the non-indigenous people (Ospina et al., 2015). Moreover, the culture of the community supports smoking and many individuals take up smoking to feel included in the society. I was not aware of any of the factors and never thought that the gap in heath status can affect them in such nervous ways. I should have planned the care of the patient in ways by which all social determinants of health would be addressed.

Social determinants of health that contribute to smoking behavior among native people

As the aboriginal patient was the first native patient whom I was attending, I should have summoned my senior nurses and would have conducted the diagnosis and the care plan in front of her only. As she is quite experienced and knowledgeable about the different health aspects of the native people, she would have easily guided me in caring for the patient. This would have helped me develop a plan that would address the social determinists of health, nicotine therapies and counseling sessions and help the patient develop a better quality life (Mackey et al., 2018).

When such situation would arrive once again, I would first try to understand the health literacy and education level of the patient. Following this, I would educate him about the negative effects of smoking so that he can successfully leave the smoking behavior. Secondly, I would try to develop idea about hi employment aspects. If he does not have any job, the care plans that I make should not contain any costly interventions (Thomas et al., 2017). I should also refer him to services that work free so that he does not face economic constraints. This is according to standard five registered nurse standards of practice where nursing professionals need to develop option priorities, care plans, outcomes and similar others (Registered nurse standards for practice, NMBA, 2016). Moreover, I should also advocate for his rights and should provide him sources where he can go for employments. This would also prevent him to indulge in smoking with peers and would keep him safe. According to standard four of the codes of professional conduct, I should respect the dignity, culture, values and ethnicity of the native people and therefore provide the best care to them that are culturally competent (Code of professional conduct for nurses in Australia, NMBA 2008).

Conclusion:

From the above discussion, I have been able to recognize the mistakes in made through Gibbs reflection cycle. I have also been able to develop ideas about how to handle such situations effectively so that best quality care can be given to them.

References:

Mackey, S., Kwok, C., Anderson, J., Hatcher, D., Laver, S., Dickson, C., & Stewart, L. (2018). Australian student nurse’s knowledge of and attitudes toward primary health care: A cross-sectional study. Nurse education today, 60, 127-132.

McMurray, A. & Clendon, J. (2015). Community health and wellness:primary health care in practice. (5th ed.).Retrieved from https://www-clinicalkey-com-au.ezproxy.uws.edu.au/nursing/#!/content/book/3-s2.0-B9780729541756000177 

Nicholson, A. K., Borland, R., Davey, M. E., Stevens, M., & Thomas, D. P. (2015). Predictors of wanting to quit in a national sample of Aboriginal and Torres Strait Islander smokers. The Medical Journal of Australia, 202(10), 26-32.

Nicholson, A. K., Borland, R., van der Sterren, A. E., Bennet, P. T., Stevens, M., & Thomas, D. P. (2015). Social acceptability and desirability of smoking in a national sample of Aboriginal and Torres Strait Islander people. The Medical journal of Australia, 202(10), 57-62.

Nurses and Midwifery Board of Australia. (2016). Registered nurse standards for practice. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx 

Nursing and Midwifery Board of Australia (2008). Code of professional conduct for nurses in Australia. Retrieved from https://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD10%2f1353&dbid=AP&chksum=Ac7KxRPDt289C5Bx%2ff4q3Q%3d%3d

Ospina, M. B., Voaklander, D., Senthilselvan, A., Stickland, M. K., King, M., Harris, A. W., & Rowe, B. H. (2015). Incidence and prevalence of chronic obstructive pulmonary disease among aboriginal peoples in Alberta, Canada. PLoS One, 10(4), e0123204.

Smith, J. D. (2016). Australia’s Rural, Remote and Indigenous Health. (3rd ed.). Chatswood, Australia: Elsevier Australia

Thomas, D. P., Panaretto, K. S., Davey, M., Briggs, V., & Borland, R. (2017). The social determinants and starting and sustaining quit attempts in a national sample of Aboriginal and Torres Strait Islander smokers. Australian and New Zealand journal of public health, 41(3), 230-236.