Introduction
Indigenous people in Australia are composed of the Aboriginal and Torres Strait people living in the country. Indigenous people in the country are comprised of people with different cultures, languages, and historic cultural values. This group of people existed in their original continents about sixty years ago. Colonization brought about by other countries contributed to the wars, violence, diseases, and famine. The effects of colonization also ruined set cultures and families in different communities. The colonized people could not control their traditions, including their sacred laws, language, and ceremonies, thereby losing their sense of identity. Trauma causes individuals to find it challenging to deal with catastrophic events in their lives. This group of people is known as the stolen generation. The effects that the stolen generation faced in the times were passed down to other generations through sharing sad stories and experiences. The effects of intergenerational trauma continue to affect individuals in the contemporary world. The post discusses the issues indigenous people face in health facilities due to discrimination that still continues to affect the quality of care they receive in health and midwifery facilities and some of the factors that can help alleviate this issue.
What do my practices say about my assumptions, values, beliefs about health care, midwifery, and the people I care for?
Nurses and midwives have the responsibility of providing care to all individuals under them. These professionals must establish a set of values that regulate and provide a framework for making decisions in practice. Nurses should follow a national code of ethics that includes altruism, justice, beneficence, and non-maleficence to all patients (Al Banna, 2017). Nurses and midwives in Australia additionally need to maintain culturally safe practices in their line of work. The code of ethics helps maintain a level of respect for every patient regardless of their cultural background. Beneficence makes sure that nurses perform their services with mercy and generosity, while justice helps maintain fair treatment for all patients.
Where did these ideas come from?
Australia is a country with as many as twenty cultural groups with diverse cultural health beliefs. There have been many disparities in the quality of healthcare provided to Indigenous Australians. The aboriginal people in the country face several disparities in the health facilities, which leads to the low quality of overall health and high mortality rates. The inequalities in healthcare reveal that many Australians, also known as the Torres Strait Islander Australians, have a large percentage of people experiencing more cases of chronic and communicable illnesses, mental illnesses, infant mortalities, and lower life expectancies than the other group (Menzies, 2019). The NMBA ensures nurses and midwives in the region by setting standards to enhance their cultural competence.
What knowledge is being privileged?
Although the country strives to provide equal and fair medical care to all people in Australia, there are still issues to address. The country is based on the foundation that white individuals benefit from better treatments, also known as a white privilege (Hobbs, 2018). White privilege in the country restrains institutions and individuals from giving fair treatment to all citizens. Quality health services are provided to the white members of the county while ignoring the Aboriginal and Torres strait people. The health quality of indigenous people in Australia is very poor due to the unfair treatment they receive from most of the health facilities in the country. This quality is more so demonstrated by the high mortality rates of both adults and infants.
What is the source of the knowledge and its authority?
White privilege in Australia has been a great issue since the time of colonization. The society and foundation of the country were based on a foundation of race. The federation of Australia, established in the year 1900, had several dictations and restrictions to some of the non-white population in the region (Ghezelbash, 2016). Like the Africans and Asians, people living in the country did not have the right to citizenship. These individuals were not included in the national census or voting. The first act of the Federation of Australia was to prohibit immigration from non-European people to protect working conditions for the white population. The ‘White Australia’ policy denied immigrants who failed to pass a test set in the European language. The passing of the Immigration Restriction Act led to many Melanesian workers being deported from the country (Jordan, 2018). According to policy, the non-white immigrants accepted in the country were required to give up their language and culture and assimilate the Australian culture. This policy was the only condition that allowed the settlement of these people into the country. The racism issue in the country received commendations from various policies, politicians, and academics up until 1973. The effects of the white policy are still present in the current time, with many aboriginal people still facing displacement and identity loss. These policies are manifested through acts like drug, alcohol, and child abuse displayed by the aboriginal people.
What views of power do they embody?
The views of white privilege in the country still control some institutions and views in the country currently. White privilege has led to the disrespect of many aboriginal and Torres Strait Islander people in the region (Hobbs, 2018). The healthcare system in the country shows some aspects of discrimination in its operations. The system makes no effort to understand the different cultures in the country, which makes offering care difficult. The government is also reluctant to fund research and healthcare that can benefit the aboriginal people. Research also shows that many Indigenous people do not receive the same medical treatment as their counterparts. Discrimination of aboriginal people leads the white population to believe in the stereotype that people of color can withstand pain (Mayes, 2020). Many of the Aboriginal patients also complain of mistreatment or harmful communication coming from physicians. Benefits such as Medicare do not seem to be equal among the Indigenous residents. Indigenous people were allowed to take on healthcare positions such as nursing and midwifery at the end of the segregation period (Melody et al., 2016). These changes were meant to assist other physicians in knowing how to deal with other people and reduce death rates in the country. Current health workers filling these positions still complain of racism issues in practice. Dealing with these difficulties seems impossible as those who complain are referred to as problematic.
What knowledge is being ignored
Failing to treat people of different cultures with respect is a violation of human rights and expresses racism. Racism is any form of discrimination or despising someone because of their ethnicity, color, or culture. Racism in Australia is not only expressed by individuals. It also occurs in institutions. According to the Racial Discriminatory Act 1975, all acts displaying racism are against the law. Discrimination in health institutions is also a violation of ethics. Ethical knowledge ensures that health workers ensure that each patient receives the best care and maintains the best nursing practices. Australia has a code of ethics that regulates all nursing behavior and acts as a framework for showing respect and providing fair treatment to patients regardless of race, ethnicity, or cultural background (Chaet, 2016). These codes of ethics also govern the Nursing and Midwifery Board of Australia, emphasizing justice, non-maleficence, beneficence, and autonomy. Working against any of the ethics is against the code of conduct and is regarded as unprofessional.
What are cultural, political, or social practices expressed in these ideas?
Although universality insists on maintaining human rights, respecting cultural diversities in any region is essential. Cultural diversity and cultural rights coexist together (Donders, 2016). There are several methods that the individuals and society in the healthcare system can help reduce the discrimination of specific individuals. The first step that the Australian Rights commission should take is to decide the best strategy to address the issue. The next step is to identify all the activities that reflect discrimination, design policies, and engage the community in progressive behavior. Simple social changes can also contribute to the improvement of healthcare for all people in the region. The government should work on raising the social-economic positions of the Indigenous people. Raising the economic standards of the Aboriginal people will help them afford better health care. Indigenous people in the country will also have the opportunity to experience better standards of life and reduce cases of feeling isolated from society.
In Australia, nursing and midwifery care under the Nurses and Midwifery Board of Australia (NMBA) (Bromley, 2018). The NMBA works with the Congress of Aboriginal and Torres Strait Islander people Islanders Nurses and Midwives to develop best practices that maintain cultural safety. This statement means that the organization is in charge of making policies that nurses and midwives follow, including those against cultural discrimination. NMBA should make sure that these professionals follow codes of conduct, especially those about cultural safety. Nursing standards state that physicians should provide safe, appropriate, and good quality healthcare services to all patients. Cultural safety ensures that nurses and midwives provide the best care to the Aboriginal and Torres Strait Islander people according to different historical, social, and structural factors.
Whose interests seem to be served by my practices?
The principle of universality is an ethic that aims to serve all patients regardless of race, ethnicity, or color. Cultural safety is a requirement to serve members of the community. The code of ethics in the country contains eight value statements that members of the NMBA should refer to when exercising their practice. Self refers to nurses and midwives of all practice, including nursing and practicing students (Poorchangizi et al., 2019). A person relates to any individual requiring services like treatment, consultation, or advice. The term colleagues include all members in the health profession according to the law. The term community in Australia refers to all members of society. As a nurse or midwife in the profession, the code of conduct contains seven principles that apply to all nurses and midwives in the county (O’Donohue, 2019). cultural safety entails that nurses and midwives under NMBA provide the best care that meets an individual’s cultural needs.
What is it that causes me to maintain my ideas or theories?
Showing respect and giving fair treatment to people following their cultural backgrounds is ethically correct. Ethics are meant to guide individuals’ morals and help them make the right decisions (Msoroka & Amundsen, 2017). The ethics code nurses and Midwives in the country stresses the need to value diversity in people (Schmidt et al., 2017). The code of ethics for nurses should prioritize respect and kindness to others and themselves and value offering quality services. The code of ethics guides these health workers on ethical practice and decision-making. These values are part of the training given to upcoming nurses in educational centers. Maintaining these values also requires an individual to have morals like respect in their line of work. Showing discrimination is not only unethical but is also unprofessional and unlawful.
What is it that acts to constrain my views of what is possible in nursing and midwifery?
All Nursing and Midwifery workers in Australia are regulated by the Australian Health Practitioner Regulation Agency (Ahpra) (Hunter et al., 2021). Ahpra works together with the National Registration and Accreditation Scheme to perform its function. There are several Boards under Ahpra according to every profession. The Nursing and Midwifery Board of Australia (NMBA) controls the registration of nurses and midwives in the country (Bromley, 2018). NMBA has other functions like creating and approving accreditation of standards, codes, and guidelines for practitioners, assessing all overseas practitioners who desire to work in Australia, and handling all complaints.
The standards from the board also assess and develop nursing curricula in universities and other institutions (Poorchangizi et al., 2019). Several factors influence individual constraints in practice. Nurses’ and midwives’ practices should match their education level, authorization by the law, and the confidence and competency required to perform the tasks. Practicing nursing and midwifery also depends on the needs of the patients, the context of practice, policies, and quality management of the service providers and the organization’s culture. These boards are responsible for assuring that all candidates who qualify for being midwives and nurses aim to provide quality care to all patients. The boards can also help reduce discrimination cases that most of the indigenous people face in the facilities through policies and laws.
What would I do differently?
There are roles that nurses and midwives can play to take control of individual constraints in their line of work and work on expanding their practice. Practitioners should attain appropriate education and training that best suits their line of work and the society they serve. People who serve the Indigenous people should be aware of their constraints to identify the best way to give care. Reflective learning deals with identifying and conducting analysis on different issues in practice to gain understanding and motivate progressive practices (Sherwood et al., 2018). Policy procedures and annual reviews also help determine whether health professionals perform tasks per the practice. Policies also help lower levels of discrimination against a certain type of people by instilling penalties to those who break the rules. Practitioners should also make inquiries to other professionals of ways to retain quality in the level of practice.
What do I consider to be important from a nursing or midwifery perspective?
Education is the foremost important factor considered when offering services to patients. This aspect, however, does not entirely help ascertain that best practices and services will be given to individuals. Nurses and midwives should also improve interactions and enhance learning and teaching practices (Hunter, 2016). As a nurse or midwife, I have to maintain that quality care is provided to the patient with no discrimination. This act also means that I should consider that patients have the right to decide what is best for them; cultural education is an important factor in the healthcare industry to help physicians know how best to provide care to a diverse community. Cultural safety and awareness are important to help create a comfortable and safe environment and ensure that the indigenous people in the country do not face assault. Midwives will benefit from cultural awareness will help them identify the different needs of their patients.
What do I have to work on to effect change?
Establishing change in society starts with changing perspectives as an individual. The main barrier that hinders the level and quality of care that practitioners provide to patients is communication (Afriyie, 2020). Effective communication also includes ethical considerations, paying attention to patient diversity, and choosing the best communication styles. There are usually extended periods of silence in the normal communication between Torres Strait Islander cultures. Physicians should make sure to communicate with the patient and explain why they are touching them and the procedures they will provide to make them comfortable. The interactions between the patients and health practitioners play a significant role in how services are provided. Encouraging feedback also determines how well the patients respond to services and helps physicians get insight into issues requiring improvement.
Conclusion
Discrimination of the Aboriginal and Torres Strait Islander people is an issue that has persisted over the decades. Indigenous people in the country face many disparities in health facilities. These disparities contribute to the poor health that these people face. The law in Australia continues to fight acts of racism, especially in healthcare, by creating laws that are meant to protect these individuals by society and institutions. A review of the health status in the country reveals that there are high rates of chronic illnesses and mortality rates of the Indigenous people compared to the White society. These adverse effects are due to the poor quality of services that these people face in health institutions. The nursing and Midwifery Board of Australia create codes of conduct that ensure cultural safety in the country. Cultural safety is vital in the health industry and in the country to help foster progressive practices.
References
Afriyie, D. (2020). Effective communication between nurses and patients: An evolutionary concept analysis. British Journal of Community Nursing, 25(9), 438-445. https://doi.org/10.12968/bjcn.2020.25.9.438
Al Banna, D. A. (2017). Nurses’ core professional and personal values about nursing in Erbil city hospitals: A profession, not just career. Nursing & Healthcare International Journal, 1(1). https://doi.org/10.23880/nhij-16000106
Bromley, P. (2018). Capability in nursing. Australian Nursing and Midwifery Journal, 26(1), 42-23. https://search.informit.org/doi/10.3316/informit.663401066712415
Chaet, D. H. (2016). AMA code of medical Ethics� opinions related to discrimination and disparities in health care. AMA Journal of Ethics, 18(11), 1095-1097. https://doi.org/10.1001/journalofethics.2016.18.11.coet1-1611
Donders, Y. (2016). Foundations of collective cultural rights in international human rights law. Cultural Rights as Collective Rights, 85-112. https://doi.org/10.1163/9789004312029_006
Ghezelbash, D. (2016). Legal transfers of restrictive immigration laws: A historical perspective. International and Comparative Law Quarterly, 66(1), 235-255. https://doi.org/10.1017/s0020589316000373
Hobbs, J. (2018). White privilege in health care: Following recognition with action. The Annals of Family Medicine, 16(3), 197-198. https://doi.org/10.1370/afm.2243
Hunter, J., Dixon, K., & Dahlen, H. G. (2021). The experiences of privately practicing midwives in Australia reported to the Australian health practitioner regulation agency: A qualitative study. Women and Birth, 34(1), e23-e31. https://doi.org/10.1016/j.wombi.2020.07.008
Hunter, L. (2016). Making time and space: The impact of mindfulness training on nursing and midwifery practice. A critical interpretative synthesis. Journal of Clinical Nursing, 25(7-8), 918-929. https://doi.org/10.1111/jocn.13164
Jordan, F. (2018). Justice for the kanakas: Australia’s ‘invisible’ Melanesians. Green Left Weekly, 1190, 11. https://search.informit.org/doi/abs/10.3316/INFORMIT.791185983135489
Mayes, C. (2020). White medicine, white ethics: On the historical formation of racism in Australian healthcare. Journal of Australian Studies, 44(3), 287-302. https://doi.org/10.1080/14443058.2020.1796754
Melody, S. M., Bennett, E., Clifford, H. D., Johnston, F. H., Shepherd, C. C., Alach, Z., Lester, M., Wood, L. J., Franklin, P., & Zosky, G. R. (2016). A cross-sectional survey of environmental health in remote Aboriginal communities in Western Australia. International Journal of Environmental Health Research, 26(5-6), 525-535. https://doi.org/10.1080/09603123.2016.1194384
Menzies, K. (2019). Understanding the Australian Aboriginal experience of collective, historical, and intergenerational trauma. International Social Work, 62(6), 1522-1534. https://doi.org/10.1177/0020872819870585
Msoroka, M. S., & Amundsen, D. (2017). One size fits not quite all: Universal research ethics with diversity. Research Ethics, 14(3), 1-17. https://doi.org/10.1177/1747016117739939
O’Donohue, W. (2019). Criticisms of the ethical principles for psychologists and code of conduct. Ethics & Behavior, 30(4), 275-293. https://doi.org/10.1080/10508422.2019.1679632
Poorchangizi, B., Borhani, F., Abbaszadeh, A., Mirzaee, M., & Farokhzadian, J. (2019). The importance of professional values from nursing students’ perspective. BMC Nursing, 18(1). https://doi.org/10.1186/s12912-019-0351-1
Schmidt, B. J., MacWilliams, B. R., & Neal-Boylan, L. (2017). Becoming inclusive: A code of conduct for inclusion and diversity. Journal of Professional Nursing, 33(2), 102-107. https://doi.org/10.1016/j.profnurs.2016.08.014
Sherwood, G., Koshy Cherian, U., Horton-Deutsch, S., Kitzmiller, R., & Smith-Miller, C. (2018). Reflective practices: Meaningful recognition for healthy work environments. Nursing Management, 24(10), 30-34. https://doi.org/10.7748/nm.2018.e1684
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