Culture and Cultural Safety, Essay Example

Regarding the pivotal aspects of nursing, we need to mention that it includes the prevention of disease and the treatment of the patients; what is more, it also includes the promotion of healthy lifestyle. It is obvious that caring emerged to be fully interwined with the principles of nursing. Analyzing the philosophy of nursing, one can easily see that this occupation mainly requires the respect towards all the ill, not making emphasis on certain categories of people; the thing is that when you are treating the patients, it means that the key goal that you need to follow must be the one based on your undeniable craving to satisfy the patients with the qualified help. The nature of nursing has much in common with both medicine and scientific expertness. The major task is to heal the sick by preventing the disease. It is necessary to take into account the fact that since the profession of nursing is the one, going through endless process of evolving, nurses are required to be also interested in applying new practices while treating the patients. As a result, one can come to understanding that nursing is an everlasting process of studying and enrichment in new branches of knowledge.

Considering the issue of nursing, one cannot skip with the importance of cultural security as well. It is clear that cultural security emerges to be one of the most significant components within the field of nursing in New Zealand. The construct of the aforementioned issue lies in directing nursing area as ‘safe’ and ‘effective’ for the customer or family/ whanau from dissimilar culture (Richardson & MacGibbon, 2010). Obviously, cultural safety occurs as “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 position; ethnic descent or migrant awareness; religious or spiritual belief; and disability” (Nursing Council of New Zealand [NCNZ], 2011, p.7). Apart from the above-said, cultural safety distinguishes achievement of positive health results via reorganizing the health status of New Zealanders as well as acknowledging the values, beliefs and practices of those having various cultural backgrounds (Wepa, 2004). In accordance with NCNZ (2011), any care offered by nurses that disregards and humiliates the cultural identity of an individual appears to be culturally improper act.

The major goal behind cultural security lies in improving the health status of New Zealanders; moreover, developing the provision of health and disability services by so-called culturally safe nursing workforce. On the basis of cultural safety norms, there has to be trusting negotiations between a nurse and the patient; in addition, a nurse has to demonstrate the power contacts between a nurse and the patients (NCNZ, 2011). It is worth accepting ethnicity based disparities, so that an unfair practice can be minimized. In New Zealand, the policy of Treaty of Waitangi is utilized to negotiations between Mâori and Pakeha, as well to other national minorities. The number of health disparities among the Maori people is mostly related to shortage of availability of culturally adequate health care services (Ren, 2009). To offer culturally secure treatment to people from various cultures, in contemporary nursing field health professionals tend to take into account three pivotal norms of the Treaty of Waitangi, which are relationship, participation and defence (Kingi, 2007).

Relationship occurs as cooperating together with the customer and certain community in order to improve positive health outcomes (MidCentral District Health Board [MDHB], 2008). To be precise, it is worth saying that in partnership the customers are obliged to provide informed decisions and they are also engaged in all the processes which refer to their health, disease, and care. A peculiar thing is that it is not just about engaging patients in making their choices so as to provide an anticipated decision. Being involved in partnership incorporates providing the information to patients, which is vivid and adequate in a way they are likely to understand, so they are able to make an informed choice with regards to their treatment and care as well give some questions. Trusted relationship appears when people’s problems and likes are heard and answered (NCNZ, 2012a).

Participation engages the patients in decision making process, projecting and provision of health and disability services (MDHB, 2008). Active participation of health consumers appears to be important to improve the patient’s insight as well as satisfaction with provided nursing treatment, contributing to advanced care outcomes and improvement of their health state (Sahlsten, Larsson, Sjostrom, Lindencrona and Plos, 2007). For qualified culturally safe nursing treatment and to match patient preferences, it is important for nurses to become aware of the patient’s attitude towards the issue of participation (Larsson, Sahlsten, Sjostrom, Lindencrona & Plos, 2007). Sufficient and obvious information provided by a nurse enhances the active participation of health consumers, whereas the shortage of knowledge results in obstructions to active participation (Florin, 2007).

In protection, it is significant for nurses to provide their services in a manner that appreciates and protects cultural constructs, values and principles of patients from another cultural environment (MDHB, 2008).  It is also extremely vital to defend patients’ privacy, since it is likely to build the trusting relationship between them and health care experts and the patients. Privacy/confidentiality policy is not only about health records; it also applies to all other individually recognisable health data, including genetic information, clinical survey and treatment records, mental health disorder treatment notifications ,suicide notes, terminally diseased notes, patient’ personal data and also the protection of cultural beliefs. This information has to be accessible to nurses who are directly responsible for looking after the health consumers (NCNZ, 2011). To provide culturally safe treatment, health professionals are obliged to protect patients’ rights and privacy. This is the ethical and legal accountability of health care experts (NCNZ, 2011).

Task B

In the given scenario, three items which inhibit the provision of nursing care are breach of privacy and confidentiality, horizontal outrage and discrimination against and disrespect towards the health consumers. These three items are an integral part of culturally unsafe tendency, since they are ignoring the patient’s rights. “Unsafe cultural practice comprises any action which diminishes, demeans or disempowers the cultural identity and well-being of an individual” (NCNZ, 2011, p.7).

The breach of privacy of the patient’s individual details and confidentiality appears to be the most significant dimension that is impacting the delivery of proficient nursing treatment in the given scenario. The nurses are loudly advancing the arguments about their right to reject to look after a patient who, for instance, has history of sexual abuse offence. As the health consumer is directly across from the nurse’s station, there is a definite probability that he heard the communication. Also there is a possibility that other patients, attendants and allied staff participants overheard the conversation, breaching the patient’s confidentiality. In accordance with the Code of Conduct for nurses, principle five (NCNZ, 2012b), it is the duty of health professionals to defend the privacy of health consumers’ personal information. Any information related to a patient should be utilized for professional aims only. Nurses should tell the health consumers if there is need to unravel the information to other health team departments, and obtain informed consent from the patient to uncover that information. However, in case there is any serious risk to the health consumer or public safety, a decision can be made without the patient’s consent. Health consumers’ personal information or health records should be preserved securely and only accessed for the purpose of providing treatment or any legal aspects. Nurses do not have to discuss practice issues in public such as, for example, social media in order to maintain health consumers’ confidentiality and privacy. Despite the fact that the name of a health consumer might be unrevealed, still they could be identified (NCNZ, 2012b).

The nurse-patient negotiations appear to be the most important part of nursing concept. The construct of trust is one of the most significant components in the nurse-patient negotiations. It can be easily figured out as well as easily broken. A trusting nurse-patient partnership apparently depends on communication. Health consumers may like to share their problems with a health professional and may see the nurse as someone who will not judge them and unveil their personal stories with some other people. If the expectations of the patient are not answered by the health professionals, and the health consumer indicates that their information is disclosed to other members of the personnel patient’s trust along with the relationship will be broken once and for all time. On the other hand, the increase of trust partnership between patients and nurses will modify the image of nurses in society as a positive element (Said, 2013). As a result, nurses should not uncover information unless it is mandatory, such as legally or for patient care.

Another issue that is influencing professional nursing treatment in this scenario is discrimination and disregard of a patient. According to the initial principle of the Code of Conduct for nurses, health professionals should respect the dignity and individuality of health consumers (NCNZ, 2012b). This constituent vividly states that nurses should practise in a way that respect and does not discriminate against any patient from any culture, age, gender, sexual orientation and political opinion (NCNZ, 2012b). In this scenario, nurses are discriminating against the patient because he has history of sexual abuse offences. They did not think of the patient’ self-respect and about making a therapeutic relationship with him. They do not support a principle of professionalism, since they are failing to provide culturally safe care by disregarding the health consumers, as they may have overheard the conversation. Health professionals are being judgemental and unwilling to offer nursing care for these patients in the scenario, which may result in the patients’ neglect. It is the accountability of health professionals to look after the patients not showing any signs of discrimination or label (NCNZ, 2012b). Moreover, all nurses are obliged to abide standards of moral relationship and ethics, and have to be non-judgemental (New Zealand Nurses Organisation [NZNO], 2010).

The third aspect that is inhibiting the provision of professional nursing treatment in this scenario is horizontal outrage towards a new graduate nurse by instigating her not to look after the patient. Horizontal outrage originates a negative work atmosphere impairing teamwork and compromising health consumers’ care (Araujo & Sofield, 2011). Horizontal outrage occurs as any unwanted abuse, assaultive and harmful behaviour by a health rofessional or a team of nurses toward a colleague via assaultive viewpoints, actions and sayings within the workplace (Becher & Visovsky, 2012).

In this scenario, senior health professionals are demonstrating a kind of bullying as they pressurised the new graduate nurse to accept the choices of the other nurses. As a new graduate nurse, I may consider senior nurses to limit my rights to voice my attitude towards this issue In view of Kelly and Tazbir, 2013, peer pressure is one of workplace bullying divisions which is likely to compromise health consumers’ care. I am likely to feel fear, and anxiety in this case and I must agree with my senior colleagues’ ideas as I would not want to be an outcast within a new workplace. A feeling of fear, concern and separation can result in emotional disorders, which later lead to poor attentiveness and fallacies. On this phase, I am likely to ruin patient’s security. Workplace bullying results in stress, hazardous culturally nursing actions and improper partnership with health consumers and team members (Yildrim, 2009). In accordance with the Code of Conduct’s sixth principle, health professionals have to work honestly with colleagues and in a co-operative way in order to match health consumers’ requirements (NCNZ, 2012b).

Task C

Health professionals have to be capable of showing their skills and judgement to cope with professional, lawful and ethical accountabilities dimensions and competent enough to recognize an atmosphere that is culturally tolerant in respect of health consumers (NCNZ, 2012c). After what took place in the scenario, being a registered health professional, I figured out that senior nurses maintain improper nursing acts that are not culturally hazardous for health consumers and the nurses. They are breaching the confidentiality and disregarding the health consumers. What is more, there is also horizontal outrage towards a new nurse as senior nurses encourage her to maintain their choices. In such a case, I have accountability as a registered nurse to follow professional principles of nursing practice in order to provide the patients’ safety.

The senior health professionals are violating the confidentiality of the patient’s individual data. They are rejecting to provide health care services for a health consumer who possesses history of sexual abuse offences. The health professionals are obliged to defend and honour the confidentiality of health consumers’ individual information especially about sensitive issues (Privacy commissioner, 2008). In such a case, initially I will shut the door as a health consumer is close to the nursing station. Furthermore, I will tell the health professionals about this, since health consumers are likely to expect that their information will not be shared with the other people. During treatment period, health professionals reassure the health consumer that their information will be protected (NCNZ, 2012b). By loudly communicating about the health consumer’s criminal history, health professionals are breaching the norms of trust. What is more, I will care for this health consumer by obeying professional principles of nursing practice and reassure patient’s security and quality treatment. Evidently, there is high probability that other health consumers, allied personnel and attendant are likely to have overheard the communication. They emerge to be likely to start disrespecting the health consumer that compromises the patient’s safety, respectively. It is the accountability of health professionals to indicate, inform and deal with the cases that impact health consumer and the members of personnel (NCNZ, 2012c) Nurses are responsible for their practice as well as the choices so they have to perform ethically (NCNZ, 2012c).

In the scenario, health professionals are also humiliating and disregarding the health consumer, since they are thought to be involved in sexual abuse offences. It appears to be the right of the health consumer to be treated with respect; the patient also has the right to complain (Health and Disability Commissioner [HDC], 2009). In such a case, as I am aware that health consumer may have heard the communication. I will provide him with an opportunity to fill a complaint form in case he/she wants; I will also fill the incident form and inform to the charge health professional, since it is compulsory to take some measures.  Health professionals have to figure out the legal aspects in the practice and report on this matter to the appropriate people. Health professionals must serve in accordance with relevant legislation/norms/principles and follow health consumers’ rights (NCNZ, 2012c). Disregard/humiliation in respect of the health consumer by health care personnel is very vexing for the health consumer. It is a threat to health consumers’ security and health, since it inhibits patient’s agreement with health care. Usually, people like to commit suicides in case they have low self-esteem; this factor emerges to be extremely depressing for them. It is so destructive for health consumers and their family (Leape, Shore & Dienstag, 2012). Consequently, it is my accountability as a registered health professional to keep health consumers safe by looking after them.

In the given scenario, I have to keep myself safe from horizontal outrage from senior health professionals. Horizontal outrage is likely to result in depression, fear and seriously lowered self-esteem that will lead to poor nursing practice and interpersonal negotiations (Longo, 2010). First of all, I will follow my accountabilities in accordance with lawful and ethical limits by recognizing health consumers’ rights as well providing culturally safe treatment to them. I will also report it as at the earliest convenience after the incident took place. Health professionals have to keep clear and straightforward notes, any entries in health consumers’ notes have to be mentioned, dated and timed. Health consumers are obliged to make certain that all health consumers’ notes are preserved securely for their confidentiality (NCNZ, 2012 b). Being a registered health professional, I should be conscious about my rights, practices and principles of hospital for workplace bullying for my safety, and to master the ability to deal with these cases. Health professionals have to become aware about the workplace protocols in order to manage the issue of outrage acts and keep themselves safe, respectively (Murray, 2009). What is more, I will request help and explanation from the charge health professional and nurse instructor. I will also fill an incidence form on horizontal outrage. It is extremely significant to report incident to charge health professional (Longo, 2010).

Task D

The workplace principles in healthcare system appear to the matter of great importance for individual-centred clinically efficient treatment, whereas, an improper workplace atmosphere results in dramatic impact on the health situation (Manley, Sanders, Cardiff & Webster, 2011). The alterations I would be eager to initiate are preventing horizontal outrage, embodying inter-professional cooperation and advanced performance. To deliver these modifications in workplace environment, I chose Kurt Lewin management approach.

The Kurt Lewin’s management model consists of three phases, which are unfreezing, moving and refreezing (Mclean, 2011). In the first phase of modification (unfreezing), a problem is indicated and measures are prepared in order to accept that alteration. This very phase also encloses breaking the current approaches to working before constructing a new principle of performance (Mcgarry, Cashin & Fowler, 2012). The further phase is the process in which modification is embodied (Huber, 2014). It is important in this process to be sure that new methods of practising can provide more positive results than the existing ways (Chang & Daly, 2012). The final phase (refreezing) is utilized for evaluation of new modifications for its efficacy (Sutherland, 2013).

The first change I am eager to make is how to avoid horizontal outrage. Horizontal outrage, or destructive behaviours between nursing personnel, can result in enormous harm to health consumers and the personnel security as well as wellbeing (Longo, 2010). In the scenario, I think that senior health professionals make me accept their decisions and they are not permitting me to encapsulate my attitude towards particular issues; obviously, it is bullying. In the unfreezing stage, new graduate health professionals have to be aware of zero tolerance principles on bullying (Sayre, 2010). Each individual possesses the right to have a workplace that is fair; each person has the right to be treated with some reverence (NCNZ, 2012c). The clinical manager has a significant role to create a harmonious atmosphere which is based on a high level of proficiency with no signs of no bullying (Cleary, Hunt, Walter & Robertson, 2009). The moving stage is the embodiment of the project, so in this stage, personnel will be taught about strict zero tolerance principles in the workplace environment and the significance of teamwork, which is likely to lead to gradual prevention of horizontal outrage and confusions (Ekici & Beder, 2014). Health professionals have to be educated how to preserve regard and dignity of other members of the personnel taking into consideration culture distinctions (Rocker, 2008). During the refreezing phase, management and health professionals have to estimate the efficacy of rearrangement (Sayre, 2010). It is extremely significant to become aware of whether the modifications have either positive or negative influence (Clarkson, Flores, Johnson & Lonadier, 2012).

The second transformation would be the embodiment of inter-professional cooperation. Efficient inter-professional partnership is an integral element of nursing. It is the cooperation between the members of personnel, health consumers and their families in an honest and accountable way. This facilitates the process of building trust amongst the health consumers (Barwell, Arnold & Berry, 2013). Efficient cooperation between health professionals care personnel is vital for health consumers’ safety and person-centered treatment. As a result, they can express their viewpoints about patient’s health state, care options for necessary health outcomes (Nadzam, 2009). In this scenario, instead of supporting professional cooperation, health professionals are loudly discussing the reluctance to look after the health consumers. To provide quality treatment that is patient-cantered and culturally adequate, health professionals have to take into account the issue of professional negotiations (Arnold & Boggs, 2011).

In the initial stage of Lewin’s change management model, health professionals have to be addressed by responsible nurse or clinical manager concerning their improper cooperation that is worth being improved. Within the moving stage, unprofessional cooperation can be settled on a solution by ongoing teaching policies. The hospital principles also facilitate the process of health professionals’ understanding of the need to cooperate, since one of the reasons behind inappropriate language is the shortage of professional skills (Wachtel, 2011). During the refreezing process, health professionals will assess their learning from teaching projects and keep obeying the guidelines of the nursing practice. Positive cooperation impacts the efficacy of health consumers’ treatment and makes the performance of the teamwork much better (Sully & Dallas, 2010).

The third amendment would be efficient teamwork, since it possesses a critical factor in nursing practice (West, 2012). Effectual teamwork is important for the highly qualified and safe health consumers’ treatment. It makes nursing practice more efficient and improves final outcomes. Moreover, it helps the personnel to become aware of their peers (Ward, 2013). In this scenario, I come to understanding that there is no maintenance and co-operation between health professionals; they cannot come to mutual agreement. In the unfreezing stage, health professionals have to master the significance of understanding, cooperation with each other. Formal education projects are likely to assist in learning the way of collaboration in the workplace. Health professionals are obligated to become aware of the way how the shortage of teamwork between the staff members can lead to a negative influence on health consumers (Barwell et al., 2013). In the moving stage, health professionals will pass ongoing teaching programmed based on effectual teamwork. In the final stage, health professionals will estimate their awareness of the programmer.

Task E

The factors showing my nursing practice are cultural expertise, person-centered clinical supervision, health consumers’ feedback and the utilization of the the principles of the Treaty of Waitangi. Clinical monitoring occurs as very helpful for health professionals in proficient maintenance as well as learning how to become accountable for their individual performance. Clinical inspection is regarded as one of the best methods helping new graduate health professionals in offering culturally risk-free nursing treatment to health consumers (Rassool, 2008). Their performance can be closely inspected by a clinical manager who can recommend the junior personnel whether the treatment offered was culturally harmless or not (Hole, 2009). In other words, to reach culturally secure treatment in nursing practice, any comments, viewpoints, and assumptions from a clinical inspector are very useful (Chang & Daly, 2012).  Being a new graduate health professional, I will request feedback and some comments from a clinical inspector in order to find out whether I provide culturally risk-free practice or not; these feedbacks are likely to help me rearrange my future performance. Clinical inspection emerges to be very important and for the nurses (Dawson, Phillips & Legget, 2012); it is likely to help junior personnel to undergo various problems whilst practicing as well (Lynch, Hancox, Happel, & Parker, 2009).

Feedback from health consumers is really helpful to the health professionals to assess the treatment offered. In accordance with NCNZ (2012c), expertises (1.5 and 2.6), efficacy of nursing care can be evaluated on the basis of health consumers’ feedback, since it is not the health professionals, or team members, it is the customer who receives the treatment (McMurray & Clendon, 2010). Thus, I will request feedback and comments from my clients to make certain that the treatment I offer was actually culturally secure. Once health consumers cannot provide feedback, I will ask another family member to answer my request. I will also provide therapeutic partnership with health consumers. Good collaboration and trust are extremely significant when building an effective therapeutic communication (Richard & Tabatha, 2010).

To assure culturally secure practice and patient-centered treatment, the awareness of the three principles of Treaty of Waitangi, which are partnership, participation and protection cannot be underestimated (NCNZ, 2011). Therefore, I will show these fundamental components during my nursing practice by constructing the cooperation with the health consumers and their family members; I will also demonstrate my striving to instigate them to take part in decision making process as well as care planning for successful health results. By accomplishing these steps, I will get to know their health and disease state in a more detailed way. For instance, I can find out if the clients are allergic to any remedy and. I will also take into consideration their rights of confidentiality, regard, reported consent and informed decisions. Moreover, I will ensure the health consumers that I follow the privacy and confidentiality principles. I will honour their values and beliefs. For instance, in some religions, meat is not permitted to eat; and if I ignore the patients’ traditions, I will demonstrate my disrespect. As a result, I need to be aware of the health consumers’ meals’ choices, pray peculiarities, clothing and other dimensions. I should esteem all cultures, customs, values and beliefs in order to provide highly-qualified nursing practice. All the aforementioned strategies are likely to assist in demonstrating that my practice occurs as culturally secure.

Naturally, the issue of discrimination in nursing is likely to affect both sexes, involving the unfair determination or decision making based on person’s gender as well as racial identity. Some modern scientists report that almost fifteen percent of patients suffer from discrimination while being treated by nurses. There exists the biased practice that different ethnicities are estimated in accordance with their viewpoints; moreover, the nurses tend to take into consideration the appearance of their patients, disregarding the norms ethics and human rights.

In conclusion, although the issue of discrimination in nursing is responded by the implementation of the number of anti-discrimination laws, it still can be faced in many today’s hospitals. This discrimination is typical of both sexes: males and females. The sex discrimination in nursing can be traumatic to human psyche. The person can be psychologically and emotionally destroyed when he or she is discriminated by the nurse. Apart from that, the sex as well as racial discrimination provides the misbalance within the nursing staff and usually results in unhealthy environment. The negative interaction between departments and the increased number of conflicts may contribute badly to the hospital performance. Despite the existence of gender and race discrimination in many hospitals, there should always be given adequate attention by means of regulatory laws. The point is that in case gender or race discrimination act happens, one should never leave it yet use the complete set of laws to support ourselves.

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