Discuss about the Communication Issues for Aboriginal Patients.
Health care is a basic human need, required a large number of times in the lifetime of an average human being. Every single human being i this world has a right to quality health care and assistance for as many number if times as they might need (Frolic and Drolet 2012). And it has to be considered that health care has advanced exponentially in the last couple of decades and has now become as patient friendly as it can get (Billings and Halstead 2015). However there still are different issues be it ethical, personal or communicational in the health care that poses different challenges in the path of delivering quality care (Jonsen, Siegler and Winslade 2015). This report will address the issues that arise in a health care scenario when dealing with the aboriginal population taking the example of a case study.
In the case scenario opted for this assignment a 55 year old male dealing with lung cancer was admitted to the health care facility after dealing with a fall that rendered him helpless and unconscious. The patient is dealing with immense pain and is in need for serious analgesic administration however when he was being administered morphine for his pain a controversy arose with the power of attorney in between his daughter and his son. Late4r on the patient declined morphine administration and demanded to be healed by the traditional healer of aboriginal community. Throughout the communication with the health care team and Tom and his family there were many communicational and dialect issues as well.
The very first communicational issues that arose with caring for Tom, was the misconception and chaos with the power of the patient. On a more elaborative note, the patient as being administered morphine to minimize the pain he was going through. However there are distinct side effects associated with the medication. In this situation, Carina came to the hospital demanding to have the medical power of attorney for her father and demanded for the morphine administration to be stopped and be replaced with something better than morphine and with lesser side effects. However, Jimmy, son to the patient Tom, declared Carina to be lying and informed the nursing attendant for his mother Cec to have the medical attorney for the patient under consideration. In order to evaluate this legal issue it is important to elaborate more about the concept of medical power of attorney.
A medical power of attorney can be defined as the legal document that allows any trusted person to the patient regardless of blood ties to make the important treatment related decisions on the behalf of the patient (Kodish et al., 2013). A person needs to be at least 18 years of age in order to attain the medical power of attorney and that person will be entitled to take all the important decisions related to the treatment options and health condition of the patient. The Australian legislations gives the agent the full power to take adequate decisions for the patient and their decisions will have to be followed (Kodish et al., 2013).
In this case scenario the major controversial issue is the fact that both Carina and his wife Cec, claimed to be the agent for the power o attorney for Tom. It can prove to be a very difficult situation where there is obvious conflict in the patient family. Moreover Jimmy explained to the caring nurse for Tom that his father did an advanced care paper that can override the authorization of the medical power of attorney but he was not very sure about it either. Such discrepancies in the patient family guardianship can prove to be a highly difficult situation for the patient (Munn-Giddings and Winter 2013).
The second issue that is highlighted in this scenario is the communicational gap between the nursing attendant and the patient and his family. From the video it was very clear that the patient was not very comfortable while communicating with the nursing attendant Sarah and their first round of interaction was not very successful when the patient stopped communicating with Sarah in between the conversation. Studies suggest that the majority of the aboriginals are uncomfortable around the health care facilities that are staffed with non-aboriginal population. The dialect problem is the major reason behind the communicational problem in the aboriginal population and that interferes with communicational comfort of the patient remarkably (Meltzer et al., 2014).
Lastly the patient wanted to be healed by a traditional healer of the aboriginal communities rather than medical staff of the health care facility. His son also consented by saying that any treatment pattern selected for Tom has to be run through by their traditional healer uncle Joe. Such delicate conflicts can seriously affect the health and well being of the patient as the dilemma can delay and interfere with the treatment procedure that the patient is in need for (Mauly, Varcoe and Storch 2012). The Australian health policies do not acknowledge the aboriginal healing traditions so incorporating a traditional healer in the heath care team of a facility can serve to be a legal conflict for this case scenario (Vertrees, Shuman and Fins 2013).
There are requirements to establish goals and actions for attaining better care and resolve the issues the case scenarios have presented. The first goal is to ensure that the patient is comfortable and confident to share his grievances to the nurse. An aboriginal patient can find it difficult to mingle with the health care facilities. Actions should include the assistance of aboriginal community’s liaison officer to reassure the patient and let him relax. The nursing professional should work on building a mutually respectable trusted relationship to ensure that the patient is able to approach the nursing professional without any apprehension. There are internal ethico-legal conflicts in the case scenario that needs to be resolved, the conflict that arose with the power of attorney could delay the treatment and administration of analgesia that can help relieve the pain. The issue with power of attorney should be resolved immediately with the legal team of the health care facility in the presence of the family members, the registered nursing attendant and the aboriginal community liason officer (Vertrees, Shuman and Fins 2013).
During the course of the case scenario the patient along with his family refused administration of morphine due to some preconceived notions about the medication. All of them were adamant that morphine will make the patient too drowsy to properly function and would miss his opportunity to be present for his yarn. The next goal should focus on educating the patient and his family about the benefits of low dosage morphine as an analgesia. In order to do that, the patient should be educated about the low dosage morphine administration and the advantages of this medication route with the help of the aboriginal liaison officer to ensure that he and his family understand the benefits associated with this medication and can shed the veil of superstitions (Wilcoxon, Remley Jr and Gladding 2013). The patients at most times are unaware of the pharmacological properties of the medication they are prescribed on and have misleading concepts about the efficacy or risks associated with them, hence, patient education helps to annul those misconceptions in the patents and allow them to be aware of their treatment procedure. The help of the aboriginal liaison officer should also be taken to ensure that he and his family understand the benefits associated with this medication and can shed the veil of superstitions (Wilcoxon, Remley Jr and Gladding 2013).
Aboriginal communities are characterized for the traditional belives they exercise in evry aspect of their lives; in health care as well their mental assurance is linked with traditional healing methods. The final goal for this case scenario should be incorporating the traditional healer should into the treatment planning procedure in a manner that does not violate the Australian regulations and the hospital policies, for instance, telephonically (Yoder-Wise 2014)
On a concluding note, it can be said that there can be a number of different ethical and legal issues that may arise in a health care setting that can potentially harm the health and wellbeing of the patent by delaying the treatment procedures that can help the patient. In a multicultural country like Australia, the issues can be even more complex and critical with different cultures and dialects and lifestyles mingling together. The society is still not attained a state where every single individual is treated as an equal regardless of their socio-economic status. This discrimination imparts a profound negative impact on the health care industry dealing with ethnic communities as well.
However it has to be considered that are a number of barriers, be it dialect, perception, communicational apprehension or the difference in culture and lifestyles, these barriers make it difficult to practice inclusive societal patterns. Although establishing equality in health care in the least has become essential in the current scenario. And it can be stated that with correct strategized actions addressing different barriers with specific approaches can help resolve the issues and can help in achieving the ultimate goal of delivering optimal care to the patients.
References:
Billings, D.M. and Halstead, J.A., 2015. Teaching in nursing: A guide for faculty. Elsevier Health Scie
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Frolic, A.N. and Drolet, K., 2012. Ethics policy review: a case study in quality improvement. Journal of medical ethics, pp.medethics-2011.
Jonsen, A.R., Siegler, M. and Winslade, W.J., 2015. Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine, 8E. McGraw Hill Professional.
Kodish, E., Fins, J.J., Braddock, C., Cohn, F., Dubler, N.N., Danis, M., Derse, A.R., Pearlman, R.A., Smith, M., Tarzian, A. and Youngner, S., 2013. Quality attestation for clinical ethics consultants: A two?step model from the American Society for Bioethics and Humanities. Hastings Center Report,43(5), pp.26-36.
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Meltzer, E.C., Ivascu, N.S., Acres, C.A., Stark, M., Kirkpatrick, J.N., Paul, S., Sedrakyan, A. and Fins, J.J., 2014. Extracorporeal membrane oxygenation in adults: A brief review and ethical considerations for nonspecialist health providers and hospitalists. Journal of hospital medicine,9(12), pp.808-813.
Pauly, B.M., Varcoe, C. and Storch, J., 2012, March. Framing the issues: moral distress in health care. In Hec Forum (Vol. 24, No. 1, pp. 1-11). Springer Netherlands.
Tapper, E.B., 2013. Consults for conflict: the history of ethics consultation.Proceedings (Baylor University. Medical Center), 26(4), p.417.’
Vertrees, S.M., Shuman, A.G. and Fins, J.J., 2013. Learning by doing: effectively incorporating ethics education into residency training. Journal of general internal medicine, 28(4), pp.578-582.
Wilcoxon, A., Remley Jr, T.P. and Gladding, S.T., 2013. Ethical, legal, and professional issues in the practice of marriage and family therapy. Pearson Higher Ed.
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