My report on cultural awareness in tennant creek

The town of Tennant Creek, has a population of 6307 people,  84.6% were born in

Australia, 51% identify as Aboriginal, 35.2 % speak a language other than English at home

(www.nt.gov.au/ntt/financial/budget). Tennant Creek is a multilingual community (Aboriginal

child language acquisition project, 2008).  There are other minority groups residing in


Tennant Creek and often overseas tourists pass through during the summer months.  It is the

only town of any size in the Barkly Tablelands. It lies on the Stuart Highway 510 kilometres

North of Alice Springs and 670 kilometres South of Katherine. The Barkly tablelands covers

an area of 240,000 square kilometres between the tropical 'Top End' and the arid 'Red Centre’,

approximately the size of New Zealand (www.ntgov.com.au).

The health status and health services needs of Aboriginal people, and Aboriginal concepts of health and illness, differ from those of the general population in many ways. Therefore the development of policies, programs, and resources that affect Aboriginal people must take these differences into account.  Cultural Security is about ensuring that the delivery of health services is such that no one person is afforded a less favourable outcome simply because she or he holds a different cultural outlook (reference).  The aboriginal definition of health is “Health does not mean the physical well-being of the individual but refers to the social, emotional, spiritual and cultural well-being of the community.  This is a whole of life view and includes the cyclical concept of life death-life” (Stout & Downy, 2009).   

Cultural safety was a concept developed in New Zealand; the following is the definition of cultural safety

“The effective nursing practice of a person or family from another culture,

and is determined by that person or family. Culture includes, but is not

restricted to, age or generation; gender; sexual orientation; occupation

and socioeconomic status; ethnic origin or migrant experience; religious

or spiritual belief; and disability.

The nurse delivering the nursing service will have undertaken a process

of reflection on his or her own cultural identity and will recognise the

impact that his or her personal culture has on his or her professional

practice. Unsafe cultural practice comprises any action which

diminishes, demeans or disempowers the cultural identity and wellbeing”

(Guidelines for cultural safety, the treaty of Waitangi and Maori Health in nursing education and practice, march 2005).

Cultural Awareness Is a beginning step toward understanding that there is difference. Many people undergo courses designed to sensitise them to formal ritual and practice rather than the emotional, social, economic and political context in which people exist as an individual (guidelines for cultural safety the treaty of Waitangi and Maori Health in Nursing education and practice, 2005).

Cultural Sensitivity can alert health professionals to the legitimacy of difference between their culture and their client’s culture, and begins a process of self-exploration as the powerful bearers of their own realities and the impact this may have on others. (Guidelines for cultural safety the treaty of Waitangi and Maori Health in Nursing education and practice, 2005).  Cultural Safety is an outcome of nursing education that enables safe service to be defined by those who receive the service (guidelines for cultural safety the treaty of Waitangi and Maori Health in Nursing education and practice, 2005). Unsafe cultural practices are any action that diminishes, demeans or disempowers the cultural identity and wellbeing of an individual (The Royal Australasian college of Physicians, 2004).

Policies

The Northern Territory government has recently developed a policy for Aboriginal Cultural Security, the policy states that by providing culturally secure services all Territorians can have access to safe and effective services (Aboriginal Cultural Security, 2009 pg3). The Northern Territory’s population is 215000, 30% identify as being Aboriginal and Torres Strait Islanders, the Department of  health and Families employs over 5,000 people with only 10% being Aboriginal and Torres Strait Islanders (Aboriginal Cultural Security, 2009) The policy requires health services to identify the elements of Aboriginal culture that affect the delivery of health and community services in the Northern Territory, to review service delivery practices to ensure they do not unnecessarily offend Aboriginal peoples culture and values, change service delivery practices where necessary and to monitor service activity to ensure that the services continue to meet culturally safe standards (Aboriginal Cultural Security, 2009 pg2).  It is a strategy to improve services to Aboriginal people by making sure the way health services are delivered takes important cultural matters that may have a bearing on health and community outcomes into account (Aboriginal Cultural Security, 2009 pg2).  The Department of health and community services will work closely with Aboriginal communities, some changes to services provided; include the number of Aboriginal people employed and the way quality is assessed in the workplace (Aboriginal Cultural Security, 2009).This policy of cultural security is a commitment to further strengthen Aboriginal people’s access to health and community services.  Ideally this policy would see health services develop partnerships with aboriginal peoples to better improve the way they view and access health services (Aboriginal Cultural Security, 2009).  Fostering cultural security by engaging the community in service planning develop and monitor standards of practice relating to cultural competence for the organisation, system and individual staff, develop training programs going beyond awareness to develop skills and knowledge, effective implementation and assessment strategies (Aboriginal Cultural Security, 2009).   The implementation of the cultural safety policy will include workforce development by improving the knowledge base of all staff employed by the hospital workforce reform, changing the public health, clinical and administrative practices, monitoring and accountability developing measures and indicators of success.  Community engagement involving the wider community in developing and monitoring policy and its functioning (Aboriginal Cultural Security, 2009).

 

The Northern Territories Department of health and families corporate plan 2009-2012 recognises that developing and delivering a system of services that is underpinned by cultural security, safety and quality is essential for the effective delivery of health services.  The department of health and families Aboriginal and Torres Strait Islander Strategic workforce plan 2008-2011 recognises strengthen the Aboriginal and Torres Strait Islander workforce is a priority to help and improve the economic and social health and well being of  Aboriginal and Torres Strait Islander people, building a sustainable Aboriginal and Torres Strait Islander workforce, strengthening a capable Aboriginal and Torres Strait Islander workforce, attraction and retention of Aboriginal and Torres Strait Islander talent and optimizing the Aboriginal and Torres Strait Islander workforce (pg 1). Interestingly gainful employment is one of the key social determinants of health, strengthen employment could potentially influence the health and well being of the entire community (Aboriginal and Torres Strait Islander Workforce, 2009).

The Australian nursing and Midwifery council was established in 1992 to facilitate a national approach to nursing and midwifery regulation.  The code of Professional Conduct for Nurses in Australia, the Code of Ethics for Nurses in Australia and the Australian Nursing and Midwifery Council National Competency Standards for the Registered Nurse, The National Competency Standards for the Enrolled Nurse and the National Competency Standards for the Nurse Practitioner, “provide a framework for accountable and responsible nursing practice in all clinical management, education and research areas” (Code of Ethics, 2008).  The Australian and Midwifery Council sets out national standards to assist nurses and midwifes to deliver safe and competent care these standards are the core competency standards on which nurses and midwifes are assessed on in order to obtain a practicing certificate (National Competency Standards for Registered Nurses, 2008).

Australian Nursing and Midwifery Council Code of Professional Conduct for Nurses in Australia (2008 pg 1) “sets the minimum standards for practice a professional person is expected to up hold both within and outside of professional domains in order to ensure the ‘good standing’ of the nursing profession” .  Standard 4 of the code states “Nurses respect the dignity, culture, ethnicity, values and beliefs of people receiving care and treatment and of their colleagues” (pg 1).  Nurses should uphold the standards of culturally informed and competent care, ensure the safety and quality of care is not compromised because of harmful prejudicial attitudes about race, culture, ethnicity, gender, sexuality, age, religion, spiritually, political, social or health status (Code of Conduct, 2008, pg4).  The Code of Ethics for nurses in Australia outlines the nursing professions commitment to respect, promote, protect and uphold the fundamental rights of people who are both recipients and providers of nursing and health care. Value statement 3 of the code states “Nurses value the diversity of people” (pg6).  In other words the nurse must acknowledge the similarities and differences between their culture and others and appreciate how different cultural backgrounds may influence the provision of health care and how it is received (code of ethics, 2008).