Aboriginal and Torres Strait Islander Man from Palm Island
You are a registered nurse working at a hospital in
Brisbane. Matt is a 24 year old Aboriginal and Torres Strait Islander man from
Palm Island, he is currently an inpatient, but is awaiting transfer to the
discharge lounge. He will be traveling back to Townsville today where he will
continue his care from his mother’s home in Kirwan, Townsville.
He experienced some challenges
while admitted to your ward, however thanks to your confident and informed
patient advocacy and culturally safe care, he was able to be empowered to
complete his care.
Following is the discussion
You have been asked to review the discharge plan for Matt. The discharge plan currently identifies the Townsville Hospital as the facility that has been in correspondence. However, you know from recent discussions with Matt that he plans to have his care handed-over to the Townsville Aboriginal and Islander Health Service (TAIHS), the local Aboriginal Community Controlled Health Service (ACCHS). When you approach the Community Hospital Interface Program (CHIP) nurse about this error, she asserts that ACCHSs are just like a General Practice (GP), and may not have the resources to support Matt’s rehabilitation.
The Australian Human Rights Commission’s Close the
Gap 2018 report highlights the need for greater investment ACCHSs as a
preferred service for closing the gap. Address the following tasks in your
- define what an ACCHS is, and discuss how ACCHSs respond to holistic health needs, as per the Aboriginal and Torres Strait Islander definition of health (as included in the NACCHO Constitution) (325 words)
- what is ACCHS
- what is holistic health and its needs
- how ACCHSs respond to holistic health needs.
- compare and contrast ACCHSs and GPs regarding their ability to provide holistic and culturally safe care (325 words)
- what is ACCHSs ability to provide holistic and culturally safe care
- what is GPs ability to provide holistic and culturally safe care
- what are their similarities and differences in providing holistic and culturally safe care
- describe the role of the Aboriginal and Torres Strait Islander Health Worker (ATSIHW). Discuss what nurses need to consider when working with ATSIHW in an interdisciplinary team (325 words)
- describe the role of ATSIHW
- Discuss what nurses need to consider when working with ATSIHW in an interdisciplinary team
- define self-determination and explain how it relates to ACCHOs, ATSIHWs and cultural safety (325 words)
- define self-determination
- explain how it relates to ACCHOs
- explain how it relates to ATSIHWs
- explain how it relates to cultural safety
Aboriginal Community Controlled health Services (ACCHS) – Sample Paper
Indigenous Australians have been experiencing poor
healthcare services that pay little or no attention to their cultural needs.
This resulted to poor access to primary care, causing huge health disparity
between indigenous people of Australia and the rest of the population (NACCHO,
2014). To improve the situation, the indigenous family focused on developing
their own healthcare system that is managed and controlled by indigenous people,
for indigenous people of Australia. The established ACCHS focused on provision
of culturally based and holistic care to indigenous people of Australia (Ward, Fredericks & Best, 2017). This paper focuses on analysing ACCHS and its role
in ensuring effective provision of healthcare for indigenous people of
ACCHS and its Response to Holistic Health Needs as per
the Aboriginal and Torres Strait Islander Definition of Health
ACCHS refers to an incorporated Aboriginal organization based in and initiated by a local Aboriginal community. ACCHS was established across Australia to offer culturally accessible and appropriate primary care for Aboriginal and Torres Strait Islander people (Panaretto, Wenitong, Button & Ring, 2014). It offers culturally appropriate, comprehensive and holistic health care services to indigenous Australians community, who also controls it via Board of Management which is locally elected (Panaretto et al., 2014). ACCHS offers an extensive range of community, preventive, cultural and population wellbeing and health services (NACCHO, 2014).
Read also Application of Culturally Safety to the Aboriginal and Torres Strait Islander Peoples’ Health and Well-being Context
Holistic health characteristically regards the whole
person; spirit, mind and body. A holistic healing approach goes past symptoms
elimination. Its condition defines the momentary condition of mental-psychical-social
and physical relationships. Holistic health needs to consider the overall
wellbeing of a person and aspects that influence people’s wellbeing which
include economic needs (Mato-Juhasz, Kiss-Toth & Szegedi, 2016). According
to Mato-Juhasz et all., (2016), the general health state of a person is
determined by several factors which include personal behaviour factors,
external environment factors and the host factors. Holist health needs to
consider individual spiritual, economic social, emotional and physical needs,
their response to illness, and the illness effect on individual ability to meet
self-care requirements. Nurses offering holistic health care ensure that
patients receive the prescribed medication, social and psychological support by
talking to them and building friendship and trust with patients, give training
about self-care, and ensure spiritual support (Mato-Juhasz et al., 2016).
holistic health involves considering the cultural aspects of indigenous people
and how they influence their health, accessibility aspects, individual behaviours,
lifestyle and individual perception of health (Ware, 2013). It also focuses on
eliminating barriers that have been preventing effective access to primary care
in the past, which include different social determinant of health among
aboriginal people. The ACCHS responds to holistic health needs by integrating
Aboriginal and Torres Islander people culture into the primary care services.
They also consider their economic status and how it influences the
accessibility to primary health care (Ware, 2013).
ACCHSs vs GPs Regarding the Ability to Provide
Holistic and Culturally Safe Care
ACCHS was specifically designed to address the health
needs of indigenous Australians. Its main purpose was to bridge the health gap
by ensuring equity to access to healthcare services. ACCHS was incorporated by Aboriginal
organizations and initiated in a local Aboriginal community, employing
Aboriginal workers, and ensuring culturally competent health care services. ACCHS
has been found to offer the more effectual and equitable primary health care
services to indigenous people (Ong, Carter, Kelaher & Anderson, 2012). This
means that ACCHS is one of the most cultural safe healthcare environments for
indigenous people in Australia. ACCHS was also designed with holistic healthcare
in mind. Its implementation thus plays a great role in ensuring the
accomplishment of holistic care (Baba, Brola & Hill, 2014).
The Australian General Practice Services (GPS) have severally failed in providing effective healthcare services to Australian indigenous community. According to Kilian and Williason (2018), aboriginal adolescents and children in need of mental care services experienced difficulties navigating the Australian health care system, due to complex socio-cultural factors. This situation has also been experienced in other healthcare units in the GPS. Holistic health normally involves considering all factors that can influence people’s health. The GPS inability to consider indigenous people cultural aspect and how it influences their health and wellbeing makes it fail in provision of holistic care (Thomas, Mitchell, Rich & Best, 2018).
Read also Political Discrimination Faced by Indigenous People in Contemporary Australia
ACCHS was basically created with indigenous people cultural
and holistic care needs in mind. It thus demonstrates high ability to ensure
culturally safe healthcare environment and total consideration of holistic
health needs of patients. On the contrary, GPS has failed in creating a culturally
safe health care environment for indigenous Australians. GPS was design to
address healthcare needs of Australia people. Its designer had little or no
knowledge or concern on special cultural needs of indigenous people that would
influence their health. Although GPS is designed for holistic care its
inability to consider cultural influences in indigenous people’s health makes
it perform poorly in provision of holistic health care.
The Role of the Aboriginal and Torres Strait Islander
Health Worker (ATSIHW)
ATSIHW refers to persons with initial qualification in the clinical practice and primary health care field. They play an essential role in the provision of primary and clinical health care for community groups, families and individuals, including specialty areas of mental health, alcohol and drug, eye and diabetes and ear health (Health.NSW, 2018). The ATSIHWs common goal is to help the Aboriginal and Torres Strait Islander people to assume a strong role in managing and controlling their own lifestyles and health. Their main role in healthcare include offering cultural and health education to the community, acting as interpreters and communicators, treating injuries and diseases, and keeping medical records. They also offer life skills education, crisis intervention referral and counselling, and offer input in the evaluation, planning, monitoring, development and implementation of all health programs in the community (Health.NSW, 2018).
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According to Nancarrow et al. (2013), interdisciplinary team work refers to a complex process where in, different kinds of staff operate together to share skills, knowledge and expertise to influences patient care. The complexity is compounded by the team work multifactorial nature, comprising of the mix of skills, service organization, care setting, management structures and individual relationships (Nancarrow et al., 2013). While working together with ATSIHWs nurses need to ensure effective communication between the two team members. Effective communication ensures enhancement of care safety by avoid errors due to miscommunication, especially in a situation where (Ramsamy, 2018).
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ATSIHWs performs role that are quite similar to those of nurses, despite being less qualified. It is therefore important for the two groups define their roles and boundaries in an interdisciplinary operation, considering what ATSIHWs can or cannot do based on their level of qualification. Nurses should demonstrate respect for ATSIHWs and respect their contribution to the interdisciplinary operation (Ramsamy 2014). Effective care plan should also be enhanced to ensure total participation of all, without feeling undermined. The two groups can also have shared roles and work as a team to enhance effective care for all especially in the nursing aspects that ATSIHWs are good at (Gausvik et al., 2015).
Self-Determination and how it Associates to ACCHOS,
ATSIHWs and Cultural Safety
Self-determination refers to the equal entitlement to
be in ones destinies control, while living with the governing institutions.
Self-determination is important to enhancing indigenous wellbeing and health (O’Mara,
2012). Self-determination involves engaging the aboriginal and Torres Strait
Islander population in each decision making layer, to be able to meet their
health needs. Active involvement is required in the control, delivery and
design of health services to those who will be using the services (O’Mara,
ACCHOs are health care organizations created by
indigenous Australian people for their own health care services. The ACCHOs
played a great role in the development of ACCHs that is total a
self-determination healthcare system for indigenous people (Mazel,
2016). The system is
created with intention of eliminating things that indigenous people did not
like in the GPS, and integrating things they wished could have been prioritized
in GPS. ACCHS is a system in which indigenous people took the main control in
the health research, completion and assessment, obtaining the actual picture of
the indigenous people health needs and considered them in developing indigenous
people health care system (Armstrong & Hayman, 2012). ATSIHWs ensure
self-determination by running the indigenous people health care services in a
manner that considers their cultural needs. This ensures that the health care
services are provided as people would want them to be. ATSIHWs belong to
Aboriginal and Torres communities and thus, they clearly understand their
health needs and how they can be addressed to gain better outcome. The
involvement of indigenous people in the development of the ACCHS ensured that
they integrated their cultural aspects in the provision of health care system (Ward, Fredericks & Best, 2017). The engagement of Aboriginal and Torres in the
health care services provision through ATSIHWs ensured effective implementation
of indigenous cultural aspects in care. This resulted to creation of a
culturally safe health care environment through self-determination (Ward, Fredericks & Best, 2017).
Conclusion Indigenous people of
Australia have been experiencing cultural challenges in the main Australian
health care system. This resulted to a huge health gap between them and the
rest of the Australian population. The need for culturally safe healthcare
system pushed the indigenous people into fighting for self-determination health
care system, where indigenous people were fully involved in developing a health
care system that suits their health care needs and that ensure a cultural safe
health care environment. This resulted to the development of ACCHS which is
commended for serving aboriginal and Torres people in a more satisfactory
manner by considering their holistic health and cultural aspects.