6. Cultural safety for First Nations Peoples in the healthcare system

Question 1

What is cultural safety?

Answer 1

• CS is a work towards social justice and better health equality.
• It puts the power for determining whether care is culturally safe in the hands of the care recipients.
• It requires an understanding of the colonising history, and it helps to address racism and provide effective supports to meet ATS People’s needs.

Question 2

What are the principles of cultural safety?

Answer 2

• Prioritise the Council of Australian Governments’ goal of delivering health care that is free of racism and supported by the current close the gap plan 2013 - 2023.
• Improve health service provision supported by the health care guidelines for ATS Peoples.
• Provision of a rights-based health care method supported by the UN declaration on human rights.
• Ongoing commitment to learning, education and training.

Question 3

What does CATSINaM (Congress of Aboriginal and Torres Strait Islander Nurses and Midwives) do?

Answer 3

• advocates for cultural safety
• promotes the achievement of equity, ie equal access to health care, equal chance to achieve an individual’s full health potential
• recognises some barriers to achieving health equity, ie lack of cultural safety, institutional racism …

Question 4

What is cultural respect and its framework?

Answer 4

Cultural respect:

• the core of cultural safety
• recognise, protect and continue the advancement of the inherent rights, cultures and traditions of ATS Peoples

CR frameworks:
- an understanding of ATS culture
- an acknowledgement of cultural differences
responsive to ATS perspectives
- an appreciation of the historical context of colonisation, and practice of racism, and their impacts on ATS Peoples’ wellbeing
address health equity in terms of availability and affordability

Question 5

What are some ways that talking/yarning may be beneficial and important to Aboriginal clients in their interactions with healthcare workers?

Answer 5

Yarning is an important conversational process for ATS Peoples that encourages the sharing of knowledge and connection to self and the communities.
In the health care environment, Yarning is exotic and unfamiliar whereby easily stereotyped and result in negative PT experiences.
However, regardless of the culture, it is fundamental of health care services to make patients comfortable and feel being respected, in which care ensures cultural competent interactions like Yarning to be presented.
Meanwhile, there is merit in acknowledging that Yarning can be an exemplar of clinical conversation to ATS Peoples, which is practised in a culturally safe manner and reduces the influence of western biomedical factors to a minimum.

Question 6

What do you think are some potential barriers to the practice of Yarning in clinical settings?

Answer 6

• time constraints/pressure in the health care system
• lack of cultural competency as some staff may not know how to initiate or conduct a Yarning practice
• lack of cultural understanding as some staff may perceive Yarning as sensitive/culturally inappropriate content or double about the importance of Yarning
• concerns about community health literacy, ie language barriers, poor understanding about individual’s health conditons
• experiences of racism and discrimination