Communication and diversity in organizational settings

Communication, Diversity

This is the first time that Billy has come down to the big smoke, describe Billy's cultural shock and its impact on his health and well being.

For anyone migrating to an urban center from a rural area or even a small tow, entering the big city can be a shock. The big smoke offers an intensity of sensory input such as noise from cars, exhaust fumes and industrial smells; and a bombardment of visual stimuli from buildings, moving objects, and people. People who are used to peace, wide open spaces, solitude, and fresh air will instantly feel culture shock. Moreover, the world moves faster in the big city. People walk faster, people ride in cars, buses, and taxis. Any exchange between two human beings is sped up. As a result, human exchanges and communications can seem less personal. The impact of these shocking cultural differences on Billy's health and well-being may be palpable. His system might react by producing an increased level of adrenaline; his immune system response might diminish not only because of the exposure to foreign stimuli but also due to the heightened levels of stress he feels in the foreign environment. Not being able to communicate because of language and cultural barriers will aggravate stress and could hinder Billy's healing.

2. What are the basic differences between cultures, particularly the cultures of Aboriginal and Torres Strait Islander people and others?

Aboriginal and Torres Strait Islander people have different family and social structures and different ways of communicating than people from other cultures. Use of body language, perceptions of social power, and other nonverbal means of communication can be lost in translation. Values are also different, which significantly impacts health care. Moreover, the entire concept of health and well-being is different for someone from an aboriginal background and someone who is not.

3. What are some of the cultural factors that you would need to consider when you are delivering care to Billy?

Culture, language, sociology, and core values are the key factors I would consider when delivering care to Billy. Cultural factors including daily customs and rituals are important to take into account when delivering care. We health care workers need to respect the desire to practice whatever traditional rituals that keep the individual connected to his or her home and community. Food and eating rituals would be included under the general rubric of culture. Similarly, language barriers must be the most difficult obstacle to providing optimal health care. Not only verbal or spoken language but nonverbal communication will be different between mine and another's culture. It is up to me to be sensitive and patient when working with people from other backgrounds, like Billy. I would not leap to any conclusions about a person's attitude toward health care or towards me as a health care worker because each culture uses different signs to denote emotional or psychological states. Sociological issues such as the value of having family in the room, which family members to address and how, and gender roles are also cultural factors that may impact health care. For example, Billy might not want his wife to know his course of treatment or he might need her in the room with him at all times. I need to find out for sure what Billy's needs are. Finally, I need to respect Billy's choices with regards to health care. His choices will reflect his culture's values regarding ideals of health and well-being. For some people, health is not merely the absence of quantifiable disease; health is a spiritual issue.

4. List five factors that have contributed to the health status of Aboriginal people today?

Five factors that have contributed to the health status of Aboriginal people today include population migration; poverty; alienation; dietary and lifestyle changes; and genetics.

5. Why is it important for you as a health professional to be aware of these factors and what can you do to reflect cultural safety in your workplace and professional relationships?

The factors that have shaped Aboriginal health continue to impact the lives of patients like Billy. It is important for me as a health care professional to be aware of these factors so that I do not operate out of prejudice or bias. Rather, I need to be sensitive to the different issues affecting different people and apply appropriate treatment methodology based on those issues. Moreover, being educated about the issues affecting different cultures means that I am better prepared to discover the cause for and appropriate solution to an illness.

6. English for Billy is a second language. There is another Aboriginal patient on the ward from Albany. The nurse you are working with suggests to see if the other patient can act as a translator for Billy. Would this be appropriate, give reasons for your answer?

The Aboriginal patient from Albany might not speak Billy's Torres Strait language. Only if that other patient were familiar with Billy's tongue or a variation thereof would be appropriate to ask for translation.

7. What are some strategies that you could utilise to make Billy feel more secure in the hospital environment?

Inviting friends and family members into the room is one way to help Billy feel more secure. Asking Billy what he needs in terms of basic comforts such as appropriate sleeping arrangements or food would also help. Billy should be permitted to carry with him any special objects that help him feel safe and secure, as long as the objects do not interfere with his healing or with the hospital environment.

8. You have difficulty locating the pedal pulses, what is the name of the machine that you could use to assist?

Some portable ultrasound devices may be used to locate the pedal pulses.

9. Review Billy's history - what condition has contributed to the difficulty in finding his pedal pulses?

Diabetes has mostly likely contributed to the difficulty.

10. You walk into the room not long after Billy has had his first dose of antibiotic commenced via the drip. He is experiencing difficulty in breathing and appears very unwell. How will you tell him what you suspect is wrong?

I would explain that his system is out of balance and that we are doing everything we can to assist him; explaining his conditions using Western medical terminology would only serve to alienate him more from the whole health care process.

11. The doctor has ordered Billy strict RIB. Billy wants to go outside for a smoke. He is becoming quite anxious and is trying to get out of bed to go outside. He tells you that if he can't he's going back home. How would you deal with this situation and advocate for Billy?

I would advocate for Billy's right to smoke outside on his behalf, because not smoking is appearing to make him anxious and therefore counterproductive.

12.When you are doing Billy's dressing you notice he appears very uncomfortable and appears to be in a lot of pain. How would you assess Billy's pain?

I would assess exactly where Billy was experiencing the pain and make sure he did not mind being touched while I made the assessment.

13. What strategies could be implemented to ensure Billy's comfort and modesty whilst doing his dressing?

Several strategies can be used including assistants holding sheets; curtains; and also appropriate body language that signal respect for Billy's privacy.

14. You are aware of the cultural diversity in Australian society with many individuals living in many cultures. Briefly outline how many cultures occupy the Australian society.

Australia is one of the more diverse nations on the planet with as many as 200 different national groups represented on the Continent (Department of Education and Training). About the same number of different languages are spoken in Australia, which also boasts considerable religious diversity too.

15. How do we as a nation, accept the cultural influences and changing cultural practices in Australia and its impact on diverse communities that make up Australian society?

Australia has traditionally adopted multiculturalism as the foremost model used to address cultural diversity. Multiculturalism allows for the unfettered expression of language and culture in our towns and communities. Eliminating discrimination and racism are the core concerns of addressing the changing population in Australia.

16. Recognising the impact of cultural practices and experiences on personal behaviour, interpersonal relationships, perception and social expectations of others, describe what that impact is. For example, and Italian Roman Catholic may get distressed seeing so many mosques around Northbridge, and may think that every gentleman with a beard is a terrorist and hence this may impact on the above opening statement. Give three more examples and their impact.

We are all affected by stereotypes and prejudices surrounding various cultures. For example, the same Roman Catholic might react with similar derision around Jews and Aboriginal persons as around Muslim communities. A person might walk on the other side of the street, avoid certain neighborhoods, or talk rudely to a person from a different background from their own.

17. Johann calls you and says that Billy smells and he needs a shower. If you don't move Billy to another ward, Johann will sign himself out. Explain in details what you would do to resolve this cross cultural situation.