¶ … Australia, indigenous people recognize themselves as belonging to Aboriginal or Torres Strait Islander or by descent, and also identified as the same by the society. A resistance has been observed in them to access hospitals for healthcare. Therefore, healthcare professionals need to plan, implement and maintain appropriate policies for their treatment. Also, cross-cultural awareness training should be given to paediatric hospital staff. (Munns & Shields, 2013, p. 22)
How would you support Rianna and her family in this situation?
The poor health status of Aboriginal and Torres Strait Islander Australians is well documented, and has been the subject of official policy and program attention for many years. The mainstream health system has responded to increased funding and clear portfolio responsibility, with increasing attention to the burden of illness that Aboriginal people experience and the need for effective health care (Dwyer et al., 2014). I would thus make arrangement for proper treatment of Rianna and for her aunt's stay with her. I would utilise four elements of PDSA (Plan-Do-Study-Act) cycle, generated by Edward Shewhart, for the treatment, i.e. (i) P -- plan the change to be tried; (ii) D -- implementing the planned changes; (iii) S -- study or critically analyse the result of the change applied, briefing the result found; and (iv) A -- adjust the plan accordingly, scheduling the next phase and implanting and observing the fluctuations. I would also instruct the liaison officer to make sure they continue the treatment and does not think about DAMA (Discharge against medical advice) (Durey et al., 2012, p. 147).
2- Discuss the challenges that you see within this scenario and how would you deal with them in your clinical context?
As mentioned earlier, the building rapport process prior to medical examinations is the most critical task. Thus, a culturally respectful conversation is most apt for understanding the patient's medical history and present health condition. I would be respectful when discussing the prior treatment of Rianna otherwise it might hurt her beliefs. Before physical examination, I would explain the need to touch her, and why and where and would allow her aunty Kalinda to be by her side so that she is comfortable while undergoing treatment. Language proves to be another barrier, thus, as Rianna is not old enough, I would explain the diagnosis and cause of her illness to her aunty in a simple language with the help of visual aids. I would also ask Rianna about certain choices, if available, of oral...
Adhering to
medication is another critical issue so I will make sure that her aunty Kalinda understood all the prescribed medicines clearly by keeping my language simple and using hand gestures and visual aids on
prescription regarding doses and asking her twice about the medication. I would also inform her aunt about the
pain management in a culturally respectful way (Queensland Health, 2014, pp. 11-14).
3-Consider Family-centred Care.
Paediatric health facilities often come across a universal term i.e. family-centred care (FCC), which means that the child admitted is not just an individual patient but the central part of a family and their
welfare depends on their child's well-being, specifically in traumatic events. As defined by Mikkleson, "family-centred care is characterized by a relationship between healthcare professionals and the family, in which both parts engage in sharing the responsibility for the child's healthcare" (cited in Shields, 2015, p. 140). I would therefore try to
place Rianna's bed in a children's ward, as it would facilitate her healing process. I would also try to make arrangements for her aunt's stay and
food with her to make both of them more comfortable in each other's company. I would try to educate aunty Kalinda and cleaning and domestic staff about the basic concept of family-centred care, so that they incorporate their share in making the process smooth. Thus, FCC does not just mean making her aunt stay with her; rather it means to make a pleasant rapport with the family and patient. Being a healthcare professional, to make sure that family-centred care works effectively, I must explain the medication and create a good communication and partnership with Rianna's aunt, making the FCC effective (Shields, 2015, pp. 139-142).
4- Consider Australian Aboriginal cultural, social, geographical factors influencing access to health.
In Australia, it has been reported that the health of the Aboriginal people has been influenced by various cultural,
socioeconomic and geographical factors. Many Aboriginal people and healthcare practitioners raised their concern regarding the health and welfare of the Aboriginal population and many point these problems to lack of
money,
transportation, language and cultural barriers. The issues regarding access to health included distance and conveyance issues in the first place; then economic and social cost of travelling the distance for care; availability of services and affordability of these services. Most Aboriginal people experienced these issues in some way or the other. Interviews of Aboriginal people identified…
