|Description||Marks out of||Wtg (%)||Due Date|
|Assessment 1||20||20||12 August 2019|
Assessment description: Using a modified version of the “What, So What, Now What” model of critical reflection (Rolfe, Freshwater and Jasper, 2001), you are to write a reflection based on the case study below, using the questions provided as a guide with a word count of 800 words (+/- 10%).
AHPRA identifies that Cultural Safety is a model of care of high importance in the delivery of health care. Registered Nurse and Cultural Safety theorist and developer Irihapeti Ramsden stated that to understand Cultural Safety one has to understand what is meant by culture.
Ramsden defined culture as “the accumulated socially acquired result of shared geography, time, ideas and human experience. Culture may or may not involve kinship but meanings and understandings are collectively held by group members. Culture is dynamic and mobile and changes according to time, individuals and groups”. (Ramsden 2002, p 111) It is crucial to note that the model of Cultural Safety does not just anchor itself to ethnicity and that each and every one of us belong to a multiplicity of cultures such as our age, gender, profession, religion, spirituality, sexuality, dis/ability and also our ethnicity.
To achieve culturally safe care, we as nurses and midwives need to undertake self-reflection of our own values, attitudes and beliefs and how they may impact upon our patients care. Self- awareness and self-reflection is vital to ensure that any stereotypical views we hold about any group do not affect the quality of care provided. Self-reflection is an important skill to develop throughout your nursing career, to improve your professional practice and to develop the necessary skills to enable you to provide culturally safe care. As you step into the new world of providing culturally safe healthcare, you need to recognise that self-reflection is a vital component in the provision of culturally safe care.
You are doing a clinical placement on a busy medical ward and you witness the following situation between a Registered Nurse on the ward and a patient who is being admitted:
Alan is being admitted today to the ward where you are on clinical placement. Alan has an existing spinal injury from a motor vehicle accident many years ago and uses a wheelchair to mobilise. He is being admitted to the ward as he has an infected wound on his right leg requiring treatment. He is accompanied by his husband (same sex partner) Mark. The Registered Nurse assumes Mark is Alan’s paid care giver and explains what is going to happen to Alan to Mark whilst ignoring Alan (the patient). The Registered Nurse makes the following comment “Hello there – who do we have here today? Thanks for bringing Alan up - he looks like he might need some antibiotics for that leg. How long has it been sore for – do you know? I will just get his chart out and I’ll get you to answer some questions about Alan’s medical history if that’s OK? Have you worked with him for long?”
Reflect on this situation:
Use the “What, So What, Now What” model of reflection to frame your thinking. The following questions are intended as prompts and are not to be answered individually. Do not use dot points, and write your response in paragraphs under the following headings:
Considering the case study, I would like to reflect by saying that the registered nurse in question might have presumed a patient's spouse to be a paid carer. In order to understand the incidents that led to the conclusion, I would like to reflect and analyse the case study provided. The patient named Alan had been admitted to the hospital with an infected wound on his right leg. Alan was disabled after a spinal injury he suffered from a motor vehicle accident, making him dependent on a wheelchair to mobilise. His husband Mark assisted the patient to the hospital where the attending registered nurse assumed to be a paid carer. The RN also ignored the patient continued to communicate with the patient's husband regarding the medical history of the patient. I would assume that both the patient and his husband would feel discriminated for being a homosexual couple (Jabson, Mitchell & Doty, 2016). In addition to this, I assume, in this case, the patient as well as his husband both felt embarrassed at the RN's disregard for the patient's engagement.
I think that the reaction and behaviour of the RN indicate that her cultural beliefs are against same-sex marriages. I think that cultural beliefs shape the way we react in society and situations. Hofstede's cultural dimensional framework the values, attitudes and behaviour is the impact of the societal beliefs that originate from a common culture (Cuddy et al., 2015). Regardless of the RN's religious belief, I can assume that it common in many religion to have traditional bias of gender roles as well as sexual relationships. I think it is challenging to change the belief system when the impact is observed on a cultural, social and political perspective. The RN's assumption could also be based on the fact that she had not previously encountered a homosexual couple (Jabson, Mitchell & Doty, 2016). Another perspective of the assumption could be due to the fact that the patient Alan is disabled. The RN could have assumed that due to his disabled condition, he would require help or assistance of another care provider.
As an aspiring nurse, I know that I should contain my judgements and biases to myself when treating a patient. It is my duty to ensure that the patient outcome regardless of the cultural, religious and sexual preferences (Snelling, 2016). Regardless of my religious preference, I do not have any disregard or bias towards the sexual preference of people. As an aspiring nurse, I do not assume the sexual preference of my patients and let it affect my beliefs. I believe it is important to accept the differences of people regardless of their sexual orientation. I understand that sexual orientation cannot be chosen or changed and is normal for the majority of the adult population. Therefore, I have no traditional judgements toward same-sex couples. Tolerance and acceptance of humanity is an important belief that I value personally. It is the right of each individual to be provided with equal human rights regardless of their preference in sexuality and culture. Therefore, I personally try not to discriminate among patients or general people in daily lives with respect to their orientation.
Disability can occur at any point in life or exist by birth that may render the person impaired to perform daily activities by themselves. The impairment can be physical, mental, cognitive, intellectual and sensory or in a combination that can affect the lives of people. As an aspiring nurse who is training to provide care for the people, disability to me is also a situation where I assist the individual in progressing to overcome their impairment. There is an associated sympathy and pity for people with a disability that I am conditioned to believe (Howlin, Halligan & O'Toole, 2014). However, I do not let my sense of sympathy disrespect my patient as I need to care and regard for them as per the Code of Conduct in Australia. I do not assume that the person, appearing to be disabled, in reality, disabled to perform his or her activities. I assist them with my services by asking for permission first. I take their consent and then initiate my services. If I would have been in a position of the RN as seen in the case study. I would speak for the patient to describe their problem. I would not assume that they are incapable of speaking themselves, and the person assisting them is their carer.
Empathy is something that I possessed as quality as I grew older without anyone making me understand what it meant. Therefore, I naturally found it easier to understand the feelings, emotions and situation of other people. This is why I chose to nurse as a profession and developed my communication skills to help my patients share their feelings with me. I also read books on sexual orientation, where people described their life experiences and hardships. This helped me understand them on a human level, and I was able to empathise with them in their right to attain equality. I also studied journals regarding sexual orientations to educate myself.