Nursing Reflective

Cultural safety is one of the most important components in healthcare service provision. Nurses should ensure cultural safety in their practice. Nurses have to deal with health care users from diverse cultural background, thus, they need to show cultural competence to treat patients from diverse cultural background equally (Arieli et al. 2012). In this essay, I have selected the Muslim women in Australia, as my diverse group of care user. Identifying the barriers of providing culturally safe practice in health care, I would demonstrate my nursing skills to overcome those barriers. 

According to Mkandawire-Valhmu and Doering (2012) culture plays a major role in shaping individual’s health-related values, behaviors and beliefs. Poorly handled cross-cultural issues often affect the healthcare practices negatively, resulting in unsatisfactory health outcomes of the patient. There are several barriers of delivering cultural competent health care practices to Muslim women Australia. In my clinical practice, I have observed that, though Australia is a multicultural and multilingual society, the healthcare system is dominated by a mono-cultural Anglo Australian approach, which is oriented to English speakers (Kirmayer 2012). While practicing in Queensland, I understood that, as Islam places the responsibility on an individual to practice her religion, their cultural variations makes it difficult to provide definitive rules and regulations applied to all Muslim patients (Kirmayer 2012). They also have Intraculture difference. One common barrier is communication issues with Muslim patients. While working in Queensland, I have observed that more than 70 % of Muslim women belong from non-English background (Grossman et al. 2012). It can hinder the effective communication within nurse and patient, thereby enhancing the chance of misinterpretation and patient’s dissatisfaction. Another barrier is nutritional issue; the dietary needs of a Muslim woman are same as a non-Muslim individual, but some foods are not permitted to be eaten in their religion (Kirmayer 2012) Failure to meet their religious needs might lead to patient’s dissatisfaction. For example, Muslim women are not permitted to eat pork, which is very common ingredient in foods like bacon, ham or gelatine in western culture.

They have to follow only halal diet. It is also a challenge to bed bound patient to wash their hands before and after meal. As they are not permitted to consume alcohol, some drugs containing alcohol are also not suitable for the group of patients (Mkandawire-Valhmu and Doering 2012). In case of Muslim women, it is also not permitted to expose their body parts in front of others, especially if the person is of opposite gender. Thus, it is difficult to deal this patient, especially if they are having some issues related to sexual or reproductive health matters. Fasting is very common in Muslim culture, which is not permitted when a patient is severely ill or malnourished (Mkandawire-Valhmu and Doering 2012). It is another barrier of providing the patients their moral rights. Muslim is a male dominated religion. Women do not have the right to access healthcare without the permission of the male head of the family (Gerlach 2012). There is comparatively less cultural awareness within the Muslim women about health and health related issues. Thus, it is challenging for the practitioners to make them understand about the care planning. 

As a nurse, I have to demonstrate my excellent nursing competencies for handling this group of patients. I have always tried to address my patient’s unique choice, health and personal needs for satisfying them, while maintaining the health care rules and regulation. I believe in treating patients similarly, in spite of discriminating a patient based on cultural and sexual identity. However, I also believe in providing my best practice to ensure patient’s satisfaction. Thus, while dealing with the Muslim women, I show respect and dignity towards their religious view for enhancing trust. I have undergone a multicultural training during my clinical practice for ensuring cultural competence, as I have revealed that most of the Muslim women patients are not familiar with western English. Before establishing a therapeutic relationship with the patient, I believe in reviewing the patient’s background, which helps me to interact with the patient in a correct way.

I always attempt to demonstrate a culturally neutral attitude towards my Muslim women patients. Being a female nurse, I attempt to assist my patients in their ADLs, by showing respect and empathy towards their privacy. I believe that, showing cultural competence encourage patient’s adherence with the health care. Muslim patients have several religious beliefs, for example, they have to wash their hands before and after meal, they have to prayer 5 times a day (Jeffreys 2015). I use my non-verbal communication skills, if I address difficulties in communicating with a Muslim woman. According to the principle of Treaty and Waitangi, I believe that consumer’s right is very important for improving the quality of health care provision. 

Cultural safety can be defined as the effective nursing practice of a person from another culture, which is determined by that person. As a nurse I am responsible for keeping the patients culturally safe, while following all the rules and regulations regarding the nursing practice. I never allow any kind of discrimination in my workplace. While handling older Muslim female patient, I have found several times that the patients suffering from impaired mobility, needs assistance in bathing, but they refuse to take assistance from a nurse. At that situation, in spite of arguing with them or forcing them, I have always talked politely with them and helped them to understand that we understand their boundaries, but it is very important to take assistance from someone, as there is a risk of falling in bathroom, which can affect their health severely (Almutairi and McCarthy 2012).  I ensured the assistance of a female support worker and attempted to maximize their autonomy during bathing, as much as possible. With my problem solving skill I have resolved the cross-cultural issue successfully, several times. However, in one case, I had to administer a medication consisting alcohol, to a Muslim woman, as the medication was essential for her survival and recovery. Here, the patient’s cultural belief was not prioritized, as it was related to her severe health issue. I have also faced communication issue with a Muslim woman coming from remote area, where I used hand signs to communicate with her, instead of using an interpreter. 

At a population level, as a nurse or other health care professional, I would encourage the Muslim women to cooperate with the health care team through effective cross-cultural communication. Health advocacy is very important for adherence of the patients with the nursing and other medical intervention procedures. In addition, I would also prefer to advocate the patients about the importance of the interventions as well as the regulations they need to follow. In this context, I will advise my patient to go through the rules and regulations of the hospital and adhere to the health care practices. I will advise the Muslim women to participate in non-verbal communication with the health care professionals and behave neutrally. Initially, I would promote the awareness of cross-cultural communication and give them an assurance of being culturally safe in the organization. They are encouraged to show respect towards the medical professionals (Akhu-Zaheya and Alkhasawneh 2012). On the other hand, I will advocate other staffs to prioritize patient’s right and health needs. I will advise nursing staffs to respect and show support to patient’s religious belief. I always assist my patients to maintain religious attitudes, as I believe in prioritizing patient’s needs as a whole. In the health care team, I attempt to reflect my beliefs upon my colleagues, to assist other patients in a culturally safe way. Patient’s privacy is one of the key requirements for working with Muslim patients. Nevertheless, no gender or racial discrimination should be considered in health care context.

Being a nurse, I have demonstrated the best ways to provide culturally safe health care procedures to people who belong to diverse cultural group. In conclusion, it can be said that dealing with my selected group of service users, the Muslim women, I should show respect and dignity towards their cultural aspects and should prioritize their personal and health needs for satisfying them.   

Akhu-Zaheya, L.M. and Alkhasawneh, E.M., 2012. Complementary alternative medicine use among a sample of Muslim Jordanian oncology patients. Complementary therapies in clinical practice, 18(2), pp.121-126.

Almutairi, A. and McCarthy, A.L., 2012. A multicultural nursing workforce and cultural perspectives in Saudi Arabia: An overview. TheHealth, 3(3), pp.71-74.

Arieli, D., Friedman, V.J. and Hirschfeld, M.J., 2012. Challenges on the path to cultural safety in nursing education. International Nursing Review, 59(2), pp.187-193.

Gerlach, A.J., 2012. A critical reflection on the concept of cultural safety.Canadian Journal of Occupational Therapy, 79(3), pp.151-158.

Grossman, S., Mager, D., Opheim, H.M. and Torbjornsen, A., 2012. A bi-national simulation study to improve cultural awareness in nursing students.Clinical Simulation in Nursing, 8(8), pp.e341-e346.

Jeffreys, M.R., 2015. Teaching cultural competence in nursing and health care: Inquiry, action, and innovation. Springer Publishing Company.

Kirmayer, L., 2012. Rethinking cultural competence. Transcultural Psychiatry, 49(2), p.149.

Mkandawire-Valhmu, L. and Doering, J., 2012. Study abroad as a tool for promoting cultural safety in nursing education. Journal of Transcultural Nursing, 23(1), pp.82-89.