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Welcome everybody to my blog! My name is Emma and I'm a CQU student studying my Bachelor of Nursing. This blog is one of my assessment items, which will include six weekly blog entries pertaining to various topics related to Inclusive Practice in nursing. The 'Gibbs Reflective Cycle' will be the framework used to assist me with the construction of my thoughts. I hope you enjoy the content.

Monday, 8 February 2016

Blog 6. Module 11- Disability, Disadvantage, Vulnerability and Stigma

This week’s module discussed difficulties faced when accessing equitable healthcare, from the perspective of families and clients who are either disabled, disadvantaged, vulnerable, and/or stigmatised. Key topics included: government incentives promoting health equity for people with disabilities; historical stories of gross marginalisation of people with physical disabilities; correlation between intellectual disability and poorer health outcomes; caring for hearing and sight impaired; disadvantaged and vulnerable groups; human rights issues and stigmatic views related to ageism, sexual orientation and mental illness. Four interviews relating to person-centred care were also included.
The first interviewee, Leeanne, speaks about her role as carer for her son who has cerebral palsy, and how difficult it is to attend healthcare appointments without availability of mobile transfer resources. The second interviewee, Trudy, discusses how nurses can reduce stigma in mental health. The third interviewee was Kay Stepnay, who speaks of her experiences as a nurse and member of the lesbian community. The fourth interviewee, Kay, talks about how her disability has impacted her life. Overall, each interviewee highlights how nurses must not discriminate or make presumptions in order to reduce stigma; and to treat everybody with kindness, dignity and respect. All four interviewees advised nurses to simply treat clients how you would like to be treated under similar circumstances.
I have learned that historically, people with disabilities were grossly marginalised, institutionalised and generally treated as inferior human beings (Stefánsdóttir & Traustadóttir, 2015). I actually became overwhelmed with emotion when I read about Ann McDonald (Crossley & McDonald, 2010), and how she proved to the misconceived world that when vulnerable people with disabilities are given opportunities to participate and take control over their care, they can achieve remarkable feats. I have also learned that the government has since developed the Disability Discrimination Act ([1992] Australian Human Rights Commission, 2016) and subsequent advocacy groups, in order to provide equal opportunity to people with disabilities - via a person-centred approach, underpinned by community engagement. The National Disability Insurance Scheme (NDIS) Act (2013), and its recent implementation, is one such health equity initiative that seeks to connect existing services to people with disabilities (NDIS, 2013).
Overall, I understand that in order to reduce stigma, it is essential to treat all people as individuals, and to never stereotype or discriminate. As a nurse, I will endeavour to provide person-centred care, and always consider the client as the expert, despite their condition or disability. I will not make presumptions and will instead seek to provide individualised care based on my clients’ specific needs; through non-judgement, established trust, open communication and mutual respect.


REFERENCES
Australian Human Rights Commission. (2016). Disability Discrimination Act action plans: A guide for business. Retrieved from https://www.humanrights.gov.au/disability-discrimination-act-action-plans-guide-business
Crossley, R., & McDonald, A. (2010). Annie’s coming out [electronic resource]. Retrieved from http://www.annemcdonaldcentre.org.au/annies-coming-out (original work published 1984)
National Disability Insurance Scheme (NDIS). (2013). About NDIS. Retrieved from http://www.everyaustraliancounts.com.au/about-ndis/  
National Disability Insurance Scheme (NDIS) Act (2013). Retrieved from http://www5.austlii.edu.au/au/legis/cth/num_act/ndisa2013341/
Stefánsdóttir, G., & Traustadóttir, R. (2015). Life histories as counter-narratives against dominant and negative stereotypes about people with intellectual disabilities. Disability & Society30(3), 368-380. doi:10.1080/09687599.2015.1024827
User757. (2007, Apr 3). Anti-Discrimination Advert [Video file]. Retrieved from https://www.youtube.com/watch?v=7wr3ujTt89A
REFERENCES
Australian Commission on Safety and Quality in Health Care (ACSQHC). (2013). Consumers, the health system and health literacy: Taking action to improve safety and quality. Consultation paper. Sydney: ACSQHC.
Australian Human Rights Commission. (2016). Disability Discrimination Act action plans: A guide for business. Retrieved from https://www.humanrights.gov.au/disability-discrimination-act-action-plans-guide-business
Australian Association of Social Workers (AASW). (2015). Preparing for culturally responsive and inclusive social work practice in Australia: Working with Aboriginal and Torres Strait Islander peoples. Retrieved from http://www.aasw.asn.au/document/item/7006
Balhara, Y. (2011). Culture-bound Syndrome: Has it found its right niche?. Indian Journal of Psychological Medicine33(2), 210-215. doi:10.4103/0253-7176.92055
Background Picture: Stethoscope Lovehearts [Photograph]. (n.d.). Retrieved from https://encrypted-tbn3.gstatic.com/images?q=tbn:ANd9GcTutsGjrN0ZwSwW1OW15Sga8b5ClZmM-WXRS7ksl7M_sKsqhyF0
Blog Title Picture: People Holding Hands Silhouette [Photograph]. (n.d.). Retrieved from http://www.jerseygirltalk.com/wp-content/uploads/2013/06/recovery.bmp
Braveman, P. (2014). What is health equity: And how does a life-course approach take us further toward it?. Maternal and Child Health Journal18(2), 366-372. doi:10.1007/s10995-013-1226-9
Community Services and Health. (2011, Nov 20). Jenni Langgrel - Primary Health Care Manager [Video file]. Retrieved from https://www.youtube.com/watch?v=4lBNue0SqK8
Costa dos Reis, A., & Mendes Costa, M. (2014). Caring for immigrants: From interacting in practice to building nurses’ cultural competencies. Revista De Enfermagem Referência4(2), 61-68. doi:10.12707/RIII13118
Crossley, R., & McDonald, A. (2010). Annie’s coming out [electronic resource]. Retrieved from http://www.annemcdonaldcentre.org.au/annies-coming-out (original work published 1984)
Department of Health. (2011). Health Literacy. Retrieved from http://www.health.gov.au/internet/publications/publishing.nsf/Content/womens-health-policy-toc~womens-health-policy-key~womens-health-policy-key-literacy
Department of Health. (2015). Immunise Australia program: Myths and realities. Retrieved from http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/myths-about-immunisation
Department of Health and Ageing (DHA). (2010). Diversity and inclusive practice. Retrieved from http://www.responseability.org/__data/assets/pdf_file/0004/4864/Diversity-and-Inclusive-Practice.pdf
Dienger, J. (2013). The impact of workplace relationships on engagement, well-being, commitment and turnover for nurses in Australia and the USA. Journal of Advanced Nursing69(12), 2786-2799. doi:10.1111/jan.12165
Downing, R., & Kowal, E. (2011). Putting Indigenous cultural training into nursing practice. Contemporary Nurse: A Journal for the Australian Nursing Profession, 37(1), 10-20. doi:10.5172/conu.2011.37.1.010
Duncan, D. (2015). Medication adherence in chronic obstructive pulmonary disease. Nurse Prescribing13(4), 172-177. Retrieved from http://www.nurseprescribing.com/
Ewing, G., Austin, L., Diffin, J., & Grande, G. (2015). Developing a person-centred approach to carer assessment and support. British Journal of Community Nursing20(12), 580-584 doi:10.12968/bjcn.2015.20.12.580
Gill, G., & Babacan, H. (2012). Developing a cultural responsiveness framework in healthcare systems: an Australian example. Diversity & Equality in Health & Care9(1), 45-55. Retrieved from http://diversityhealthcare.imedpub.com/volume-issue.php?volume=Volume%209,%20Issue%201&&year=2012
Grant, J., & Luxford, Y. (2011). 'Culture it's a big term isn't it'? An analysis of child and family health nurses' understandings of culture and intercultural communication. Health Sociology Review20(1), 16-27. doi:10.5172/hesr.2011.20.1.16
Grant, J., Parry, Y., & Guerin, P. (2013). An investigation of culturally competent terminology in healthcare policy finds ambiguity and lack of definition. Australian & New Zealand Journal of Public Health37(3), 250-256. doi:10.1111/1753-6405.12067 
Guzys, D., & Petrie, E. (2014). An introduction to community and primary health care. Port Melbourne, VIC: Cambridge University Press.
Haghshenas, A., & Davidson, P. (2011). Quality service delivery in cardiac rehabilitation: cross-cultural challenges in an Australian setting. Quality in Primary Care19(4), 215-221. Retrieved from http://www.ingentaconnect.com/content/imedpub/qpc 
Hendricks, J. & Cope, V. (2013). Generational diversity: What nurse managers need to know. Journal of Advanced Nursing69(3), 717-725. doi:10.1111/j.1365-2648.2012.06079.x
Holland, C. (2014). Close the gap: Progress and priorities report 2014. Retrieved from https://www.humanrights.gov.au/our-work/aboriginal-and-torres-strait-islander-social-justice/publications/close-gap-progress-and
Hughes, C., & Goldie, R. (2011). 'I just take what I am given': adherence and resident involvement in decision making on medicines in nursing homes for older people: a qualitative survey. Drugs & Aging26(6), 505-517. doi:10.2165/00002512-200926060-00007
Hugo, G. (2014). Change and continuity in Australian international migration policy. International Migration Review48(3), 868-890. doi:10.1111/imre.12120
Jaklina, M., Tracy, A., & Rajna, O. (2013). Development of a translation standard to support the improvement of health literacy and provide consistent high-quality information. Australian Health Review37(4), 547-551. doi:10.1071/AH13082
Leach, M., McIntyre, E., & Frawley, J. (2014). Characteristics of the Australian complementary and alternative medicine (CAM) workforce. Australian Journal of Herbal Medicine26(2), 58. Retrieved from http://www.nhaa.org.au/publications/australian-journal-of-herbal-medicine
Low Aromatic Unleaded. (2014, Dec 1). Alice Springs bush nurse, Vicki Gordon- helping young people [Video file]. Retrieved from https://www.youtube.com/watch?v=slEalWQ7GL4
Mendes, A. (2015). Culture and religion in nursing: Providing culturally sensitive care. British Journal of Nursing24(8), 459-459. doi:10.12968/bjon.2015.24.8.459
Moore, G., Manias, E., & Gerdtz, M. (2011). Complex health service needs for people who are homeless. Australian Health Review35(4), 480-485. doi:10.1071/AH10967
National Disability Insurance Scheme (NDIS). (2013). About NDIS. Retrieved from http://www.everyaustraliancounts.com.au/about-ndis/ 
National Disability Insurance Scheme (NDIS) Act (2013). Retrieved from https://www.google.com.au/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=national%20disability%20insurance%20scheme%20act%202013 
Our Health Australia. (2012, Oct 10). Our Health - Australian consumers share their views and experiences [Video file]. Retrieved from https://www.youtube.com/watch?v=RmXUbupZctM   
Patel, N., Stone, M., Hadjiconstantinou, M., Hiles, S., Troughton, J., Martin-Stacey, L., & ... Khunti, K. (2015). Patient education: Using an interactive DVD about type 2 diabetes and insulin therapy in a UK South Asian community and in patient education and healthcare provider training. Patient Education and Counseling98, 1123-1130. doi:10.1016/j.pec.2015.04.018
Plaza del Pino, F., Soriano, E., & Higginbottom, G. (2013). Sociocultural and linguistic boundaries influencing intercultural communication between nurses and Moroccan patients in southern Spain: A focused ethnography. BMC Nursing, 12(1), 14. doi:10.1186/1472-6955-12-14
Poroch, N. (2012). Kurunpa: Keeping spirit on country. Health Sociology Review21(4), 383-396. doi:10.5172/hesr.2012.21.4.383
Proculled. (2007, Jan 6). The Seekers- I am Australian [Video file]. Retrieved from https://www.youtube.com/watch?v=aSoGJQkKDYk
Shahriari, M., Mohammadi, E., Abbaszadeh, A., & Bahrami, M. (2013). Nursing ethical values and definitions: A literature review. Iranian Journal of Nursing & Midwifery Research18(1), 1-8. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748548/
Side Picture 1.: Variance of Australian Culture [Photograph]. (n.d.). Retrieved from http://resources0.news.com.au/images/2011/02/07/1226001/683792-multicultural-experiment.jpg
Side Picture 2.: Equity [Photograph]. (n.d.) Retrieved from http://www.abc.net.au/reslib/201504/r1412977_20253078.JPG
Side Picture 3.: Nursing Midwifery Board of Australia [Photograph]. (n.d.) Retrieved from https://www.ahpra.gov.au/documents/default.aspx?record=WD15%2F17440%5Bv2%5D&dbid=AP&chksum=Rr0%2BSgmn%2FVJsMqL9E6n%2FNJuXjWyVbr%2B1z4TtGWAKxvc%3D   
Side Picture 4.: World Health Organisation [Photograph]. (n.d.) Retrieved from https://www.google.com.au/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwj744SDn9vKAhWGj5QKHcJIDd0QjB0IBg&url=http%3A%2F%2Fbobdillon33blog.com%2F2015%2F10%2F22%2Fthe-beady-eye-looks-at-world-organisations-part-seven-world-health-organisation-who%2F&psig=AFQjCNGVrRG9TttyDPHdxaPZmh_kcs6zxQ&ust=1454576808167739
Side Picture 5.: NDIS [Photograph]. (n.d.) Retrieved from https://www.google.com.au/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiRp4DrntvKAhVFk5QKHYVIA9wQjB0IBg&url=http%3A%2F%2Fcharterstowersplusmore.com.au%2Fcharters-towers-among-first-to-access-ndis%2F&psig=AFQjCNF7YEkmQLYbBGQU24hxYwNQu-FgWA&ust=1454576760806080
Stefánsdóttir, G., & Traustadóttir, R. (2015). Life histories as counter-narratives against dominant and negative stereotypes about people with intellectual disabilities. Disability & Society30(3), 368-380. doi:10.1080/09687599.2015.1024827
Stuart, L., & Nielsen, A. (2011). Two Aboriginal registered nurses show us why black nurses caring for black patients is good medicine. Contemporary Nurse: A Journal for the Australian Nursing Profession37(1), 96-101. doi:10.5172/conu.2011.37.1.096
Truskett, P. (2014). How informed is informed consent?. ANZ Journal of Surgery84(4), 199-200. doi:10.1111/ans.12553
User757. (2007, Apr 3). Anti-Discrimination Advert [Video file]. Retrieved from https://www.youtube.com/watch?v=7wr3ujTt89A
VCH Primary Care. (2014, June 19). Health Literacy Basics for Health Professionals [Video file]. Retrieved from https://www.youtube.com/watch?v=_8w9kdcRgsI
Vessey, J., Demarco, R., & DiFazio, R. (2011). Bullying, harassment, and horizontal violence in the nursing workforce: The state of the science. Annual Review of Nursing Research28, 133-157. doi:10.1891/0739-6686.28.133
Waite, R., Nardi, D., & Killian, P. (2014). Examination of cultural knowledge and provider sensitivity in nurse managed health centers. Journal of Cultural Diversity21(2), 74-79. Retrieved from https://www.questia.com/library/p587/journal-of-cultural-diversity
Ward, B., Humphreys, J., McGrail, M., Wakerman, J., & Chisholm, M. (2015). Which dimensions of access are most important when rural residents decide to visit a general practitioner for non-emergency care?. Australian Health Review39(2), 121-126. doi:10.1071/AH14030
Willis, C., Saul, J., Bitz, J., Pompu, K., Best, A., & Jackson, B. (2014). Review paper: Improving organizational capacity to address health literacy in public health: A rapid realist review. Public Health, 128, 515-524. doi:10.1016/j.puhe.2014.01.014
World Health Organisation (WHO). (2014). Quick Guide to Health Literacy: fact sheets, strategies, resources. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved from http://www.health.gov/communication/literacy/quickguide/Quickguide.pdf






Monday, 1 February 2016

Blog 5. Week 10- Health Literacy

This week’s module explained the concept of health literacy (HL). Key concepts included: exploration of HL from a global, community and individual perspective; the social determinants influential to HL levels; risk groups of low HL; and how HL promotion requires governments, healthcare providers and consumers to work collaboratively, in order to effectively action sustainable change (Australian Commission on Safety and Quality in Health Care [ACSQHC], 2013; Willis et al., 2014). An interview was also included in this module. Peter is vision impaired and talks about how his disability has limited his employment opportunities; how transport issues and social exclusion has made his life difficult; and how nurses should reserve time to listen attentively and treat all clientele equally.
From this module, I was surprised to discover that 60 percent of Australians have lower than average HL- meaning that these people leave healthcare appointments without understanding what they’ve been told (ACSQHC, 2013, p.5). This is a costly problem, which will grow as the population ages and chronic conditions increase (Department of Health, 2011). I have, therefore, recognised that health education is central to promoting HL, and requires successful provision of client health information. If clients can easily access and understand the information provided, then they can subsequently make their own informed healthcare decisions, and be pro-active with their healthcare (ACSQHC, 2013; Guzys & Petrie, 2014).
As a nurse, I must form therapeutic relationships with clients and deliver healthcare information which can be easily understood (Guzys & Petrie, 2014). However, I may not recognise health illiteracy. Therefore, I will adopt the following strategies with all clientele: convey key points first; speak slowly, without medical jargon; and use translated resources and visual information to overcome language barriers and improve client understanding (ACSQHC, 2013; Jaklina, Tracy, & Rajna, 2013). Seeking clarification of understanding is important to me, therefore, clients will be asked to relay health information in their own words. Upon discharge, I also intend to assess my clients’ knowledge and proficiency regarding their prescribed medications- particularly nebuliser, blood glucose monitoring and insulin therapy techniques. Studies show that these practices can assure patient safety; further improving HL, because medication adherence contributes to client autonomy and empowerment (Duncan, 2015; Hughes & Goldie, 2011; Patel et al., 2015).
Please watch this video to gain further understanding:

REFERENCES
Australian Commission on Safety and Quality in Health Care (ACSQHC). (2013). Consumers, the health system and health literacy: Taking action to improve safety and quality. Consultation paper. Retrieved from http://www.safetyandquality.gov.au/wp-content/uploads/2012/01/Consumers-the-health-system-and-health-literacy-Taking-action-to-improve-safety-and-quality3.pdf
Department of Health. (2011). Health Literacy. Retrieved from http://www.health.gov.au/internet/publications/publishing.nsf/Content/womens-health-policy-toc~womens-health-policy-key~womens-health-policy-key-literacy
Duncan, D. (2015). Medication adherence in chronic obstructive pulmonary disease. Nurse Prescribing13(4), 172-177. Retrieved from http://www.nurseprescribing.com/
Guzys, D., & Petrie, E. (2014). An introduction to community and primary health care. Port Melbourne, VIC: Cambridge University Press.
Hughes, C., & Goldie, R. (2011). 'I just take what I am given': adherence and resident involvement in decision making on medicines in nursing homes for older people: a qualitative survey. Drugs & Aging26(6), 505-517. doi:10.2165/00002512-200926060-00007
Jaklina, M., Tracy, A., & Rajna, O. (2013). Development of a translation standard to support the improvement of health literacy and provide consistent high-quality information. Australian Health Review37(4), 547-551. doi:10.1071/AH13082
Patel, N., Stone, M., Hadjiconstantinou, M., Hiles, S., Troughton, J., Martin-Stacey, L., & ... Khunti, K. (2015). Patient education: Using an interactive DVD about type 2 diabetes and insulin therapy in a UK South Asian community and in patient education and healthcare provider training. Patient Education and Counseling98, 1123-1130. doi:10.1016/j.pec.2015.04.018
VCH Primary Care. (2014, June 19). Health Literacy Basics for Health Professionals [Video file]. Retrieved from https://www.youtube.com/watch?v=_8w9kdcRgsI
Willis, C., Saul, J., Bitz, J., Pompu, K., Best, A., & Jackson, B. (2014). Review paper: Improving organizational capacity to address health literacy in public health: A rapid realist review. Public Health128, 515-524. doi:10.1016/j.puhe.2014.01.014








Monday, 25 January 2016

Blog 4. Week 9- Equity and Diversity in the Workplace

This module explored the importance of a multicultural healthcare team, and how equity and diversity positively contributes to the entire workplace. The following areas were explored: equity and diversity defined; multicultural workforce in healthcare; cultural shock; faith, Indigenous Australians, gender differences and generational diversity in the workplace; and how leadership can help to promote a healthy and inclusive workplace.
After reading about different cultural backgrounds related to age, gender, ethnicity, and leadership; I now appreciate the need to support, respect and value the differences of all individuals who work within the multidisciplinary healthcare team. I have learned that generic skills, rather than stereotypes and cultural labelling, must be promoted; because although our choices are influenced by our cultural background and circumstances, it does not define who we are (Downing & Kowal, 2011). We all chose employment in healthcare, because we all share the same values and ethics which underpin the many codes, guidelines and health policies in which we are legally bound to follow (Shahriari, Mohammadi, Abbaszadeh, & Bahrami, 2013). Furthermore, as a provisional healthcare team, our primary focus should be our patients, which requires open collaboration and mutual respect amongst staff. This is because studies have shown that lack of co-operation between work colleagues can prevent open exchange of patient information- of which, subsequently impacts negatively on patient health outcomes (Dienger, 2013; Vessey, Demarco, & DiFazio, 2011).
Therefore, as a nurse, I will be culturally aware and supportive of my colleagues’ diverse backgrounds, because I fully recognise that a healthy nursing culture will ultimately benefit our patients (Hendricks & Cope, 2013). New nurses can offer contemporary medical knowledge; older nurses can mentor inexperienced staff members; and culturally and linguistically diverse (CALD) employees can overcome language barriers, by acting as interpreters if the same dialect is shared (Waite, Nardi, & Killian, 2014). I will also encourage Indigenous Australians to pursue a career in nursing, because many Indigenous patients feel more comfortable, if healthcare treatment is received from people with similar cultural backgrounds (Stuart & Nielsen, 2011).

REFERENCES
Community Services and Health. (2011, Nov 20). Jenni Langgrel - Primary Health Care Manager [Video file]. Retrieved from https://www.youtube.com/watch?v=4lBNue0SqK8
Dienger, J. (2013). The impact of workplace relationships on engagement, well-being, commitment and turnover for nurses in Australia and the USA. Journal of Advanced Nursing69(12), 2786-2799. doi:10.1111/jan.12165
Downing, R., & Kowal, E. (2011). Putting Indigenous cultural training into nursing practice. Contemporary Nurse: A Journal for the Australian Nursing Profession, 37(1), 10-20. doi:10.5172/conu.2011.37.1.010
Hendricks, J. & Cope, V. (2013). Generational diversity: What nurse managers need to know. Journal of Advanced Nursing69(3), 717-725. doi:10.1111/j.1365-2648.2012.06079.x
Shahriari, M., Mohammadi, E., Abbaszadeh, A., & Bahrami, M. (2013). Nursing ethical values and definitions: A literature review. Iranian Journal of Nursing & Midwifery Research18(1), 1-8. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748548/
Stuart, L., & Nielsen, A. (2011). Two Aboriginal registered nurses show us why black nurses caring for black patients is good medicine. Contemporary Nurse: A Journal for the Australian Nursing Profession37(1), 96-101. doi:10.5172/conu.2011.37.1.096
Vessey, J., Demarco, R., & DiFazio, R. (2011). Bullying, harassment, and horizontal violence in the nursing workforce: The state of the science. Annual Review of Nursing Research28, 133-157. doi:10.1891/0739-6686.28.133
Waite, R., Nardi, D., & Killian, P. (2014). Examination of cultural knowledge and provider sensitivity in nurse managed health centers. Journal of Cultural Diversity21(2), 74-79. Retrieved from https://www.questia.com/library/p587/journal-of-cultural-diversity









Monday, 18 January 2016

Blog 3. Module 8- Cultural Competence and Care in Communities

This module explored various cultural challenges nurses experience when providing healthcare within the community. Various sub-cultures were identified, including: illicit drug users; homeless people; and conscientious objectors to immunisation. Key topics were included: immunisation and ear infections amongst Indigenous communities; rural and remote healthcare barriers; chronic health conditions; and government programs committed to addressing community health issues. There was also an interview with Rosalie, who discusses how her disabled daughter, Rikki, should be cared for in respite. To prevent breakdown of care situations, the interview highlighted the importance of assessing, acknowledging and addressing the needs of carers; and recognising that vulnerable patients must be treated with dignity, compassion, and respect (Ewing, Austin, Diffin, & Grande, 2015).
Overall, this module taught me that open communication is integral to effective community nursing, in order to gain mutual trust, respect and acceptance; because cultural understanding can support and empower all community members (Grant & Luxford, 2011). I also discovered that one’s own inherent health beliefs can affect patient advocacy regarding certain treatment choices (Costa dos Reis & Mendes Costa, 2014). Furthermore, I discovered accessibility to primary health services is arduous within rural communities; and that prevalent stigmatic views prevent homeless people and substance misusers from utilising urban healthcare services (Moore, Manias, & Gerdtz, 2011; Ward, Humphreys, McGrail, Wakerman, & Chisholm, 2015).
 As a nurse, I hope to overcome these barriers, by formulating realistic healthcare plans that utilises multi-services within the community, in order to achieve optimal patient outcomes. I also pledge to be non-judgemental and respectful of patients’ healthcare choices- regardless of my personal beliefs. However, I will still explore the reasoning behind their choices, because research shows that health professionals are the most influential in helping consumers make informed decisions about their treatment options- particularly regarding children’s vaccination (Department of Health, 2015). Therefore, active listening will not only help me to build a therapeutic nurse-client relationship; it will also afford me opportunities to offer scientifically valid healthcare advice- if clientele knowledge appears misguided or incorrect. This includes honest disclosure of all risks and benefits associated with treatment options, in order to obtain informed consent (Truskett, 2014).

REFERENCES
Costa dos Reis, A., & Mendes Costa, M. (2014). Caring for immigrants: From interacting in practice to building nurses’ cultural competencies. Revista De Enfermagem Referência4(2), 61-68. doi:10.12707/RIII13118
Department of Health. (2015). Immunise Australia program: Myths and realities. Retrieved from http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/myths-about-immunisation
Ewing, G., Austin, L., Diffin, J., & Grande, G. (2015). Developing a person-centred approach to carer assessment and support. British Journal of Community Nursing20(12), 580-584 doi:10.12968/bjcn.2015.20.12.580
Grant, J., & Luxford, Y. (2011). 'Culture it's a big term isn't it'? An analysis of child and family health nurses' understandings of culture and intercultural communication. Health Sociology Review20(1), 16-27. doi:10.5172/hesr.2011.20.1.16
Low Aromatic Unleaded. (2014, Dec 1). Alice Springs bush nurse, Vicki Gordon- helping young people [Video file]. Retrieved from https://www.youtube.com/watch?v=slEalWQ7GL4
Moore, G., Manias, E., & Gerdtz, M. (2011). Complex health service needs for people who are homeless. Australian Health Review35(4), 480-485. doi:10.1071/AH10967
Truskett, P. (2014). How informed is informed consent?. ANZ Journal of Surgery84(4), 199-200. doi:10.1111/ans.12553
Ward, B., Humphreys, J., McGrail, M., Wakerman, J., & Chisholm, M. (2015). Which dimensions of access are most important when rural residents decide to visit a general practitioner for non-emergency care?. Australian Health Review39(2), 121-126. doi:10.1071/AH14030




Monday, 11 January 2016

Blog 2. Module 7- Multiculturalism and Health

This module focused on Australian migrant populations and accessibility to healthcare services. Key topics included: an Australian immigration history overview and how government policy shaped post-war migration (Hugo, 2014); identification of social and health-related issues of the migrant population; and how language barriers and low health literacy can limit accessibility to healthcare services. Three interviews involving migrants of different backgrounds were also included.
The first interviewee was Mark, an English-speaking, planned migrant from South Africa. Mark spoke of having no problems with accessing Medicare services and finding employment. Conversely, Asif, a Pakistan refugee was interviewed. He spoke of his reliance on friends to support him entirely for two years; and how he had no access to employment or Medicare during that time, instead relying on Red Cross to pay his medical fees. English is Asif’s second language, which I admittedly found difficult to understand. I cannot imagine how hard and foreign Australia must be for him. I have since discovered that refugees face greater challenges than planned migrants in having their healthcare needs met- due to language barriers and lack of resources (Grant, Parry, & Guerin, 2013). Mercy was the last interviewee- a planned migrant from Ghana, who works as a nurse and midwife. Mercy outlined the importance of never stereotyping patients when providing healthcare, and to instead ask what their individual needs are.
Twenty percent of Australians are overseas-born- of which, more than half originated from non-English speaking countries (Gill & Babacan, 2012, p. 46). Therefore, as a nurse, I will independently research various cultures in order to gain a broader understanding. However, I will never make presumptions, because I also recognise and respect that people from different nationalities can sometimes have definite cultural boundaries (Plaza del Pino, Soriano, & Higginbottom, 2013). Instead, I will customise individual healthcare plans based upon open communication, and utilise interpreter services to help overcome language barriers. If an interpreter is unavailable, then I will use visual aids and other pictorial information to address health literacy and language problems (Gill & Babacan, 2012).

                                                              REFERENCES
Gill, G., & Babacan, H. (2012). Developing a cultural responsiveness framework in healthcare systems: an Australian example. Diversity & Equality in Health & Care9(1), 45-55. Retrieved from http://diversityhealthcare.imedpub.com/volume-issue.php?volume=Volume%209,%20Issue%201&&year=2012
Grant, J., Parry, Y., & Guerin, P. (2013). An investigation of culturally competent terminology in healthcare policy finds ambiguity and lack of definition. Australian & New Zealand Journal of Public Health37(3), 250-256. doi:10.1111/1753-6405.12067 
Hugo, G. (2014). Change and continuity in Australian international migration policy. International Migration Review48(3), 868-890. doi:10.1111/imre.12120
Our Health Australia. (2012, Oct 10). Our Health - Australian consumers share their views and experiences [Video file]. Retrieved from https://www.youtube.com/watch?v=RmXUbupZctM
Plaza del Pino, F., Soriano, E., & Higginbottom, G. (2013). Sociocultural and linguistic boundaries influencing intercultural communication between nurses and Moroccan patients in southern Spain: A focused ethnography. BMC Nursing, 12(1), 14. doi:10.1186/1472-6955-12-14


                                                               



Monday, 4 January 2016

Blog 1. Module 6- Cultural Health Practices and Beliefs

This module explored how spirituality, faith and cultural beliefs can influence consumer healthcare needs. Key topics included: various cultural dietary requirements; gender preferences; death and dying; medical procedure preferences; culture-bound syndromes (a term used to describe unique conditions specific to a culture); faith and the healthcare professional; and a lecture on complementary alternate medicines (CAM)-also known as alternative therapies, such as naturopathy and massage therapy (Balhara, 2011; Leach, McIntyre, & Frawley, 2014).
A lesson plan was also included and involved two important aspects. Firstly, there was a roleplay between a nurse and palliative patient, Diane- an Indigenous Australian. Diane discusses her cultural wishes concerning her body following her death. This involves following the tradition of not naming the dead, and for her Elders to perform a smoking ceremony with her body. I was unaware of these practices, however, further research has revealed that (due to post-settler experiences of marginalisation and disconnection from their culture) Indigenous Australians often experience immense feelings of loss close to dying; and hope to reconnect their spirits to their native land via traditional death ceremonies and rituals (Poroch, 2012, p. 384). The second aspect of the lesson plan involved Kim- clinical nurse educator and breast care nurse from the McGrath Foundation. Kim speaks about her role in supporting clients and their families, following breast cancer diagnosis. Kim emphasises that nurses must provide holistic care which centres on the emotional and physical needs of patients.  
Overall, I have learned that in order to implement person-centred care, I must firstly ask my patients about their own unique belief systems, and avoid making assumptions based on stereotype or appearance. Care plans tailored in accordance to their expressed cultural needs can then be formed. This is important, when it is considered that Australia is a multicultural society, with people from over 200 nationalities now calling Australia home (Haghshenas & Davidson, 2011, p. 216). Additionally, maintaining non-judgement and open-mindedness when seeking value in other people’s differing belief systems will further improve my cultural sensitivity; and also impact positively on my patients’ care experiences (Mendes, 2015). I hope to preserve the dignity of my patients, and form strong therapeutic relationships, by respecting their alternative health choices and treatment options- regardless of my own personal beliefs.

REFERENCES
Balhara, Y. (2011). Culture-bound Syndrome: Has it found its right niche?. Indian Journal of Psychological Medicine33(2), 210-215. doi:10.4103/0253-7176.92055
Haghshenas, A., & Davidson, P. (2011). Quality service delivery in cardiac rehabilitation: cross-cultural challenges in an Australian setting. Quality in Primary Care19(4), 215-221. Retrieved from http://www.ingentaconnect.com/content/imedpub/qpc 
Leach, M., McIntyre, E., & Frawley, J. (2014). Characteristics of the Australian complementary and alternative medicine (CAM) workforce. Australian Journal of Herbal Medicine26(2), 58. Retrieved from http://www.nhaa.org.au/publications/australian-journal-of-herbal-medicine
Mendes, A. (2015). Culture and religion in nursing: Providing culturally sensitive care. British Journal of Nursing24(8), 459-459. doi:10.12968/bjon.2015.24.8.459
Poroch, N. (2012). Kurunpa: Keeping spirit on country. Health Sociology Review21(4), 383-396. doi:10.5172/hesr.2012.21.4.383
Proculled. (2007, Jan 6). The Seekers- I am Australian [Video file]. Retrieved from https://www.youtube.com/watch?v=aSoGJQkKDYk