Hlt54115 Nursing : Formulation And Assessment Answers

Q1. Briefly discuss Rheumatic Heart Disease and the cause, including factors that may have led to Shakira contracting the disease. 
Identify and explain two social determinants of health that may have made Shakira more susceptible to the disease.
Explain how one of these determinants may have affected Shakira’s families decision-making around her care.
Include the standard treatment required 
Include relevant Indigenous statistics for RHD compared to the mainstream population.
Q2. Explain how you will provide culturally safe care as an Enrolled Nurse by defining and giving one example of the following terms:
(a) Cultural awareness
(b) Cultural sensitivity
Q3. By acknowledging the impact of events and issues throughout the history of Australian and Torres Strait lslander people it helps the Enrolled Nurse gain insight into the current physical, mental, social, economic and political situations affecting Australian and Torres Strait lslander people and their engagement with community services and health systems.
Considering the health generally of Aboriginal and/or Torres Strait Islander people provide an explanation in your own words of the significance of one the following and briefly explain how they may be affecting the day to day health and wellbeing of these people.
(a) The impact of European settlement/Colonisation
(b) Loss of land and culture
(c) Kinship/skin system 
(d) Mabo case/ Terra Nullius
(e) Forced removal of children
Q4. Successfully working in partnership with Australian and Torres Strait lslander people requires effective communication. Gaining their full participation by consulting with them and involving the individual and at times the community in their health care decisions is essential to providing culturally safe nursing care.
Select one of the following strategies and discuss how this strategy can assist the Enrolled Nurse to improve communication and build a rapport to provide culturally safe care.
Consultation with community representatives
(a) Community participation in decision making
(b) Health clinics built in such a way that male and female areas are separate and have separate entrances. Both male and female health professionals are present.
Q5. Considering Shakira, briefly discuss two ways that an Enrolled Nurse could ensure effective communication when consulting with her and her family.
Q6. A culturally safe organisation consults with Indigenous Australian community leaders and workers. Health services should develop culturally appropriate policies and procedures that provide direction for workers dealing with Indigenous Australian individuals.
Choose one of the strategies below and briefly explain how this would ensure that Shakira and her family would feel comfortable accessing the service.

(a) Employing culturally and linguistically diverse staff throughout the health organisation.
(b) Choose one accessible resource related to a Shakira’s health issues that if available to health employees would assist.
(c) Displaying Aboriginal or Torres Strait Islander art and posters that are clearly visible from the entrance to the building.
Q7. By regularly reflecting on situations you encounter in your work practice you will develop your own cultural safety practices.
How well do you integrate cultural safety into your practice as a student EnrolledNurse? Briefly discuss one of the following questions.
(a) Do you understand how Indigenous Australian culture and history shapes Indigenous Australian people’s interaction with non-Indigenous society?
(b) Do you show you are prepared to re-shape your own values and perceptions to accommodate the needs of Indigenous Australian individuals and co-workers?
Q8. To evaluate the extent to which cultural safety is integrated in your own work and in your workplace it is a good idea to put yourself in the shoes of an Aboriginal or Torres Strait Islander individual.
(a) List two questions an Aboriginal or Torres Strait Islander may ask themselves when considering if they will access the health service.
(b) List two indicators of a culturally unsafe service.

Question 1

Briefly discuss Rheumatic Heart Disease and the cause, including factors that may have led to Shakira contracting the disease

Rheumatic Heart Disease is one of the impediments related to strep throat, which is a comparatively severe illness that can lead to permanent damage to the heart, stroke, and eventually death if left untreated. RHD, as is commonly known, is known to occur after an infection of the throat with a bacteria called group A Streptococcus. If a child experiences one or more episodes of strep throat that are not treated, then it may lead to rheumatic fever. Shakira may have contracted the disease because of her environment and surrounding which was remote. High risk of RHD is associated with poor sanitation, overcrowding, and other conditions that can lead to rapid spread of the strep throat bacteria. The disease may also be hereditary whereby Shakira might have inherited the genes from the mother or father. If the disease is identified early, daily antibiotics may be required until one reaches the age of 25 to 30 to help prevent recurrence of the disease and avoid development of infective bacterial endocarditic and infection of the heart valves.

Question 2

 Explain how you will provide culturally safe care as an Enrolled Nurse by defining and giving one example of the following terms:

• Cultural awareness

According to the Nursing Council of New Zealand (2002), cultural safety in health practice entails putting consideration both terms, which are cultural awareness and cultural sensitivity for all groups of people. According to the Faculty of Health, QUT (2013), an enrolled nurse is required to provide safe care by observing cultural awareness to her healthcare consumers. This is done by not focusing on the cultural dimensions of any culture but rather recognizes as well as respects the cultural identities of others to meet their needs, rights, and expectations, as is the case of the Maori people, who are among the indigenous groups of New Zealand.

• Cultural sensitivity

Cultural sensitivity according to the American Council of Obstetricians and Gynecologists, entails a nursing practitioner having the knowledge, as well as interpersonal skills that enable him or her, appreciate, understand as well as work with individuals from cultures other than their own. an example of a case study is that of an Amish couple who are among the minority groups in America and neither do they believe nor accept enrolling for welfare, therefore, they do not consider taking medical insurances. In this case, the Amish woman underwent a Cesarean delivery and afterward the couple was interviewed by a social worker who had been called in by the nurse to aid them to take up a medical insurance known as Medicaid. By observing a cultural sensitive approach, the social worker should recognize that the Amish couple are not seeking assistance in acquiring health insurance  but rather help them plan for transportation to their home or by helping them reach other members of their Amish community who,  by tradition, provide financial aid and any other assistance to their own people.  

Question 3.1

• Maximize people’s involvement in formulation and implementation of policies affecting them.
• Promote the development of self-adequacy and self-management of the people.
• Enhance the overall development of the people.
• Ensure cooperation in formulation and implementation of policies by the State, Commonwealth, Territory and local governments without diverting responsibilities(Aboriginal and Torres Strait Islander Act 2005)

Question 3.2

The forced removal of children (‘Stolen Generations’) is about how relatives and children removed themselves voluntarily or forcibly from their natural families and this has had intergenerational health effects whereby parents passed on their traumas to their children. Parents had increased substance abuse and mental health complications. The children developed emotional and behavioral challenges and were at a higher risk of hyperactivity, character and emotional disorders and were likely to engage in substance and alcohol abuse. They became depressed, addicted to drugs, and even suicidal. The stolen children had poor parenting and stopped developing intellectually (Bortoli, Coles & Dolan, 2015).

Question 4

Participation in decision-making encompasses input from other family and community members due to kinship structures and family relations. For effective communication, an enrolled nurse should first determine whether the decision-making process needs a consultation with family members. They should then allow for the information presented to be clearly understood by all (O’Sullivan, 2013). The enrolled nurse should be respectful especially if asked to leave the setting they are in for family privacy in discussing the matter. If the matter does not require community participation and may bring shame to the person if private information is shared, the nurse should handle the matter discreetly. Build trust and a rapport for the people to feel comfortable with you and improve communication (Beckett and Keen, 2015). 

Question 5

When consulting with Shakira and her family, an enrolled nurse should use indirect questioning. They could frame a question in the form of a statement and give time for a response. If the question is misunderstood, clarify and use plain words. Secondly, the nurse should be attentive and active while listening to them and avoid selective hearing or constant interruptions because communication may take long due to the narrative explanations and differences in linguistics. For clarity and showing that one has been listening, summarize what they have said while showing empathy (O’Sullivan, 2013).

Question 6

Employing diverse staff who is culturally diverse would help Shakira and her family feels comfortable because a nurse who breaks through the ethnocentric notion that the “Western culture is the only valid way,” is in a better position to respect and appreciate the indigenous culture, behavior, policies and systems. Employing linguistically diverse staff to interpret could also help loosen up the situation. Consider discussing in the first language and avoid jargon to ensure that they are all comfortable with the discussion (McGough, Wynaden & Wright, 2017).

Question 7

I understand that the indigenous people treat the non-indigenous societies with mistrust, which stems from the European settlement and the forceful removal of children from their communities and the effect of the Stolen Generations is felt up to date in the way that they are reluctant to seek medical help. The people feel alienated from the non-indigenous people who lack cultural competence and whose ‘Western culture’ is completely different from theirs (Dudgeon & Hirvonen, 2014). They find this intimidating and perceive that they are being criticized due to their cultural diversity

Question 8 (A)

1. Will I may be criticized, stereotyped, racialized, ignored, discriminated against, or treated with contempt by the healthcare providers?
2. Can I really trust the healthcare provider to be discrete with my personal health information? (Dwyer, Willis & Kelly, 2014).

Question 8. (B)

1. Incompetent, judgmental, and arrogant providers who intimidate the people
2. Discrimination and racism that makes the people fearful, uncomfortable and powerless (Bennett, 2015)

 References

Beckett, J., & Keen, I. (2015). Encounters with indigeneity: writing about Aboriginal and Torres Strait Islander peoples. Aboriginal Studies Press.

Bennett, B. (2015). “Stop deploying your white privilege on me!” Aboriginal and Torres Strait Islander engagement with the Australian Association of Social Workers. Australian Social Work, 68(1), 19-31.

De Bortoli, L., Coles, J., & Dolan, M. (2015). Aboriginal and Torres Strait Islander children in child protection: A sample from the Victorian Children’s Court. Journal of Social Work, 15(2), 186-206.

Dudgeon, P., &Hirvonen, T. (2014). Dark chapters in Australian history: Adopted children from the Stolen Generations. InPsych: The Bulletin of the Australian Psychological Society Ltd, 36(4), 12.

Dwyer, J., Willis, E., & Kelly, J. (2014). Hospitals caring for rural Aboriginal patients: holding response and denial. Australian Health Review, 38(5), 546-551.

McGough, S., Wynaden, D., & Wright, M. (2017). Experience of providing cultural safety in mental health to Aboriginal patients: A grounded theory study. International Journal of Mental Health Nursing.

O’Sullivan, B. (2013). Considering culture in Aboriginal care.

O’Sullivan, B. (2013). Aboriginal and Torres Strait Islander education: An introduction for the nursing profession. Cambridge University Press.

The Aboriginal and Torres Strait Islander Act 2005 https://www.legislation.gov.au/Details/C2012C00258.