Cultural Safety

HLTHIR403C

Work effectively with culturally diverse clients and co-workers

Five principles of cultural safety in Indigenous health

2016

Aged care and Disabilities, Hunter TAFE

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Presentation Title

• The effective practice/care from a person or family from another culture, and is determined by that person or family

• Culture includes, but is not restricted to, age or generation, gender or sexual orientation, occupation or socioeconomic status, ethnic origin or migrant experience, religious or spiritual belief and disability

Cultural Safety

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Presentation Title

• The person delivering care should reflect on their practice and their own cultural identity

• Recognise that personal culture has an impact on professional practice

• Unsafe cultural practice compromises any action, which diminishes, demeans or disempowers the cultural identity and well-being of a person

Cultural Safety

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Presentation Title

• Cultural safety is achieved when the recipients of care believe the care being given to them meets their cultural needs

• Cultural competence is a process, not an endpoint, in which the carer can continuously strive to achieve the ability to work within the cultural context of an individual, family or community from a diverse cultural/ethnic background

Cultural Safety

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Presentation Title

8 ways of learning

Non Linear methods“We put different ideas together for new knowledge”

• Learning occurs by putting different ideas together to make new ideas

• Discuss different cultural view points• Find common themes in different cultures

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8 ways of learning

Symbols and Images“We keep and share knowledge with art and objects”

• Communicate without words• Use symbols and diagrams to help give a picture

and use as a memory aid• Recognise difference symbols in cultures

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8 ways of learning

Story Sharing“We connect through the stories we share”

• Yarn and tell stories as a way into the learning• Tell personal stories/experiences• Invite community members to share experiences

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8 ways of learning

Community Links“We bring new knowledge home to help our mob”

• Group activities that support group collaboration and exploration

• Find ways to make new knowledge benefit the community

• Make content meaningful to the local community

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8 ways of learning

Deconstruct/Reconstruct“We work from biggest to smallest, watch then do”

• Watch first, then do• Look at the big picture before getting down to

details• Model an activity step by step

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8 ways of learning

Learning Maps“We picture our pathways of knowledge”

• Create a shared image of the pathway the learning is going to take

• Construct a map together• It gives purpose and direction to activities

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8 ways of learning

Non Verbal“We see, think, act, make and share without words”

• Use non-verbal methods: reflection, demonstration, hands-on

• Communicate without words• Body language, sign language, facial expressions

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Presentation Title

8 ways of learning

Land Links“We work with lessons from land and nature”

• Use natural metaphors from the local landscape to reinforce the learning

• Incorporate direction during teaching• Locate the knowledge – where is it from?

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Reflect on your own practice

• Cultural identity

• Assumptions about health, illness and people

• Definitions of health

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Try to minimise power differences

• Power imbalance my be intentional or unintentional

• Accept combined therapies for Indigenous peoples

• Acknowledge Indigenous practices

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Engage in conversation with clients

• True client engagement

• Use language that is easily understood

• Listen and communicate appropriately

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Allow self-determination

• Allow clients to make their own decisions

• Appreciate the value of traditional practices

• Be open to other ways of knowing, being and doing

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Do not diminish, demean or disempower

• Be receptive to and respectful of the voices of Aboriginal society

• Understand your own beliefs, values and attitudes

• Consider how they can affect other people

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Presentation Title

Case study of a real client experience

• A Nursing Director was admitted to a hospital as a patient. She was diagnosed with a double ear infection and needed IV antibiotics and pain management

• She was prescribed Morphine for pain relief

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Presentation Title

• When she was admitted to hospital she was not asked whether she identified as Aboriginal. She was also not asked about her occupation.

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Presentation Title

• Four hours after she was admitted to a ward, her pain started to get worse. She requested Morphine from the Registered Nurse (who had not introduced himself at the beginning of the shift).

• He looked at the medication chart and offered her two Panadeine.

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• The patient questioned him about the medication and he explained “These are Panadeine”. She stated that her Doctor had ordered Morphine.

• The nurse replied “We don’t give Morphine out willy nilly and Panadeine should hold your pain”.

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Presentation Title

• The patient’s pain became much worse and she became highly agitated.

• The nurse avoided the patient.

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• Shortly after this event, an Aboriginal liason officer arrived.

• The patient asked how she knew to come and see her in the ward, and she explained that in the

Emergency Department a box had been ticked.

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• The patient rang a friend who worked as an Anaesthetist. He came to review the chart and asked the nurses why she was not receiving adequate pain relief as written up by the Doctor.

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• Within moments a nurse appeared with the Morphine.

• The Registered Nurse in charge of the shift also arrived and apologised for the error.

• The patient then asked not to be looked after by the original Registered Nurse for the rest of the shift.

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Presentation Title

Reflect on the five principles of cultural safety

Questions for reflection

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Presentation Title

• What areas of his practice should the Registered Nurse reflect upon and why?

• What beliefs, values and attitudes may have influenced his culturally unsafe practice?

Reflect on your own practice

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Presentation Title

• Describe one example of how the nurse used power in his care giving

• Describe one example on how he could have minimised the power difference

Minimise power differences

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• Describe the conversation that the nurse should have had

Engage in conversation with clients

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• Describe the lack of understanding demonstrated by the nurse

Allow self-determination

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• Name the actions of the nurse that were diminishing, demeaning or disempowering

Do not diminish, demean or disempower

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Presentation Title

Yatdjuligin: Aboriginal and Torres Strait Islander Nursing and Midwifery Care

Editors: Odette Best & Bronwyn Fredericks. 2014

Health care and Indigenous Australians: cultural safety in practice.

Kerry Taylor & Pauline Guerin. 2010

Reference