NURSING ASSIGNMENT

Name of the student:

Name of the university:

Author note:

Introduction:
Cultural safety is the environment which helps in providing physically, socially, emotionally and spiritually safe for each and every individual. It is also used in the healthcare setting to provide culturally safe environment to the patient as well as the healthcare staff. This essay mainly focusses on the overview of the cultural safety and its application in the contemporary nursing practice (Parisa et al., 2016). The professional expectation of the nurse or the healthcare staff in order to provide cultural safety are also mentioned in the essay. It is frequently observed that in the contemporary nursing practice, there are certain barrier which can hamper the patient care process. These barriers are Satisfying patient’s expectation, Lack of knowledge in the healthcare staff, Staff crisis in the healthcare setting, and cultural conflict. Cultural conflict is one of the barrier that is most commonly observed in the contemporary nursing practice which requires cultural safety. The task is based on the case study of the healthcare setting, where a patient has been admitted who has been there for the eight factor transfusion, but as the patient was on the home detention for the sexual abuse offence not a single nurse wants to take care of him and is arguing loudly for that. There are instances in the case study which determines that the professional nursing standards are not achieved. Such instances or the incidents are mentioned in the essay. The essay also includes correct professional nursing standards response for the nursing standard barrier. In this the, professional nursing standards such as the code of conduct are explained below. After the response, the changes that should be implemented in the healthcare setting that helps to avoid similar mistakes in the future. Being a graduate nurse, it is my responsibility to implement models that helps an achieving the change with the help of Bridges Transition Model. The essay also involves the factor that will help in the demonstration of the culturally competent practice and also person-centred.

Cultural safety and discuss the application to contemporary practice:
Cultural safety is referred to as the environment which is physically, socially, emotionally and spiritually safe for each and every environment (Pauly et al., 2015). Cultural safety is extremely important in the field of nursing as it helps an individual to get their identity and their needs and the interests (Richardson, Yarwood & Richardson, 2017). Culturally safety environment is considered as the mentally and physically safe environment. In the healthcare setting, patient from different background arrives, hence it is very important for the healthcare staff and the healthcare authorities to implement cultural safety in order to deliver best patient care (Woods, 2017). Apart from the patient, cultural safety should also be staff working at the healthcare setting or any other organization (Braithwaite et al., 2017).

Absence of cultural safety leads to multiple disorder such as depression and other mental health issue (Sue et al., 2019). The vulnerable population such as the individual from different cultural background or the individual who belongs to the poor socio-economic class have the highest death rate (Regidor et al., 2015). In order to reduce such death rate among the vulnerable population, it is important to provide cultural safety to the individual (Henderson et al., 2016).

Contemporary practice helps the students in critically analysing the issue or events which is related to contemporary nursing (Schaltegger & Burritt, 2017). In addition, contemporary nursing also helps in the critical evaluation of the organizational, social, political, professional and the legal practice which helps in the practice of the contemporary nursing (Cherry & Jacob, 2016). Contemporary nursing aids in providing better care to the patient by critically analysing all the factors such as, social, political (Fisher, 2017). By the assistance of the cultural safety, contemporary nursing practice can be used to provide patient care to the individual from different cultural background (Repo et al., 2017). In order to use contemporary nursing in the practice, it is important to overcome the barriers of the contemporary practice.

The common barrier which are observed in the contemporary nursing practice are as follows:

Satisfying patient’s expectation:

Considering the expectation of the patient in order to provide better patient care is very important in the contemporary nursing practice. It is extremely difficult to satisfy the needs and interests of the patient (Geiballa, Abubakr & Ibrahim, 2016)). It is often observed that patient remain unsatisfied with the treatment and the care provided by the nurse in the healthcare setting. Hence, such case can be considered as barrier in providing contemporary nursing practice (Ayalew et al., 2017).

Staff crisis in the healthcare setting:

To provide better care to the patient, it is important to have enough staff who can take care of the patient (Shirley, 2016). Crisis of the healthcare staff poses negative impact on the health recovery of the patient. Healthcare staff crisis occurs due to different reasons which includes, less salary to the healthcare staff, more expenditure in the medical equipment (Vasli & Dehghan‐Nayeri, 2016). Due to the maintenance of the expensive medical equipment the organization compromises in maintaining the healthcare staff. Due to the lack of staff in the healthcare organization, physical and mental wellbeing of the individual is affected (Doetsch et al., 2016).

Lack of knowledge in the healthcare staff

In order to provide enhanced and improved patient care, it is extremely important for the healthcare staff to have enough knowledge regarding the patient (Koch & Breland, 2017). If the health care staff is unqualified or have less knowledge regarding the patient care, it can lead to decreased patient care or patient’s disappointment (Coulter, 2017). It can effects the patient care and hence can be considered as a barrier to the contemporary practice.

Cultural conflict:

Cultural conflict is also commonly observed in an organization among the individual from different cultural background (Lui, 2015). Cultural conflict is also commonly observed in the healthcare organization either among the patient and the healthcare staff or among the healthcare staff (Almost et al., 2017). Due to the cultural difference, patient or the healthcare staff gets less respect as compare to other individual, which lower the self-esteem and confidence of the person (Omura et al., 2018). Such vulnerable population often get discriminated in their workplace which can even lead to mental illness among the individual (Fineman & Grear, 2016).

Cultural conflict is considered as barrier in the cotemporary nursing in order to provide cultural safe care to the individual (Toman, 2017). The vulnerable populations are often discriminated. In healthcare organization, the patient or the healthcare staff are usually assaulted by the patient or the healthcare staff (Linsley, 2016). Such populations were threatened or verbally abused by other individual (Van der Kolk, 2017). However with the help of cultural safety, such vulnerable populations feels safe.

In New Zealand, cultural safety is defines as the effective nursing training of an individual or the family who has been arrived from different culture. An unsafe cultural practice can be considered as demeaning of the cultural identity by illegal action of an individual or the organization (Wepa, 2015).

Critically analyse at least 3 issues that are affecting the delivery of professional nursing care:
Professional nursing care means providing care and treatment to the patient based on eth professional nursing standard (Urden, Stacy & Lough, 2017). Professional nursing practice is the model which describes the communication, collaboration, and the development of the professional traits of a nurse which can be used to provide high quality care to the patient (Slatyer et al, 2017).

Professional practice of a nurse can be applied in the healthcare organization with the help of professional nursing standards. Professional standard is described as the competent level of passion and care provided to the patient in each of the nursing phase (Meretoja, Lindfors & Kotila 2019). It is applied in the nursing practice in order to achieve desired level of the performance of the nurse. The professional standard of the nurses are evaluated by comparing with the professional nursing practice formulated by the higher healthcare authorities (Regan, Laschinger & Wong, 2016).

In the provided scenario, all the registered nurse of an healthcare organization are arguing loudly among themselves regarding the treatment of the patient who has been recently admitted to the hospital. The patient has been admitted to hospital for the eight factor transfusion. The patient has been diagnosed with haemophilia. As the patient has been serving a home detention for a period of time for the offence of sexual abuse.

As, I arrived at the work station, I heard that all the nurses are arguing loudly among themselves and the patient is present directly across the area and has been hearing all the incident. By observing the case study it can be stated that, the professional standards of the nurse that should be followed in not followed in this case. The scenario includes certain events and action that are affecting the professional nursing care are as follows:

The 1st issue which is said to be effecting the professional care of the nursing is the argument of the nurses. It is observed according to the scenario, that all the nurses are argue loudly among themselves at the nursing station. In an organization, especially in the healthcare setting it is extremely important to maintain a quiet and peaceful environment in order to provide better patient care (Salzmann‐Erikson, Lagerqvist & Pousette, 2016). Quite environment is extremely essential in the recovery and healing process of an individual (Hedges, Hunt & Ball, 2019). The argument of the nurses might hamper the sleeping of a patient which is one of the most important part of the recovery process of the patient (Harrington & DeLeskey, 2015). In the presence of excess noise the health of the patient might get further deteriorated. It can have negative impact on the recovery process of the individual. Noise is considered as one of the stressor which can be considered as barrier or hurdle in the healing process of the individual (Pedersen, 2015). Hence, in order to avoid such condition it is important to maintain a quiet and peaceful environment.

2nd issue which is observed in the scenario is the refusal of the nurse to take care of the patient. In the case study it is observed that the not even a single nurse agreed to take care of the patient. As the patient is on the home detention for the offence of sexual abuse. It can hamper the health condition of the patient. Though it is the right of the nurse to refuse for the treatment of the patient if they are not feeling safe, but in such case it can be harmful for the health condition of the patient (Griffith, 2015). In such condition the treatment of the patient get delayed which can lead to further deterioration of the health (Watson et al., 2017).

3rd issue which can be considered to be harm the professional nursing care is that all the incident is visible to the patient. The patient had heard everything that not a single nurse wants to take care of him. It can lead to mistrust among the patient (Dale et al., 2016). Trust is one of the most important tool that can be successfully used to build rapport between the patient and the nurse (Graban, 2016). Lack of trust might hamper the treatment of the patient (Groenewegen, Hansen & de Jong, 2019). In this case the patient knows that no a single nurse wants to take care of him and he might build a perspective. This perspective will not allow him to trust any nurse during his treatment (Drucker, 2017).

Hence, in order to avoid such circumstances it is important for the supervisor to conduct a meeting and the assign a nurse who can take of the patient (Perry, Henderson & Grealish, 2018). It can lead to less argument as well as patient will also get the treatment on the stipulated time and also the feeling of mistrust will not developed among the individual.

Critical analysis of correct professional nursing responses based on knowledge of identified documents:

By observing the above scenario it is important for the nurse to apply the knowledge of legal, ethical, and professional knowledge in order to provide culturally safe care to the patient. Being a registered nurse, it is my responsibility to provide person centred care to the patient (Healthnavigator.org.nz, 2019).

According to Health.govt.nz. (2019), person centred care is defined as providing care to the patient based on their needs, interests, value and culture. It is important for the nurse to provide respect and responsiveness based on patient performance.

According to the principle of the person-centred care, the patient should be provided with physical comfort, emotional support, respect and care-ordination.

I noticed that during the argument, the patient was across the nursing station and had heard everything. It can lower the self-confidence and the self-esteem of the patient and it also provide the patient a feeling of mistrust, which can have negative impact on the health of the individual. In order to reduce the adverse effect on the health of the patient, the culturally safe care is provided to the patient irrespective of the background of the patient.

As a registered nurse, it is my responsibility to provide culturally safe care to the patient. By utilizing my knowledge of the code of conduct of nursing, I will try to educate the nurse and the healthcare staff that each and every patient should be equally treated. The dignity of the patient should be maintained and in order to maintain better health conditions, trust is also important (Nursingcouncil.org.nz, 2019).

As the patient has heard everything, it is important for me as a registered nurse to calm down the patient to regain the trust. Hence, in order to do that, I will communicate with the patient in order to get information about the pain and worries of the patient.

Changes you would want to bring about in relation to this workplace culture and describe one change management model and how this model could be utilised to achieve these changes:
As observed in the case study that the patient is discriminated by the patient for his background (Alpers, 2018). It can have negative impact on the patient and might also hampers the recovery process of the patient (Drewniak et al., 2016). In order to implement person centred care and culturally competent care according to the case study, it is important to bring change in the healthcare organization (Dixon, Holoshitz & Nossel, 2016). The change which should be implemented in the workplace involves:

Conference room for discussion: it is observed in the case study that all the nurses are arguing loudly at the nursing station (Gilmartin et al., 2017). Hence to avoid that all the nurses or the healthcare staff are recommended to discuss in the conference or meeting room (Dimond, Bartlett & Lewis, 2015).

Maintenance of professional nursing standard: in the case study it is observed that the patient has heard everything which hampers the healing process of the patient (Casey et al., 2017). Hence to avoid such, all the health care staff are required to maintain the professional standard (Elliott, 2017).

Enhancing communication between the patient and the providers (Boissy et al.,2017)

To facilitate the change, Bridges Transition Model can be used (Xu et al., 2019). Bridges Transition Model can be used to facilitate change with the help of three stages known as, ending, loosing and letting go, the neutral zone and the new beginning (Paixão et al., 2018). In the 1st stage, the situation or condition which is uncomfortable should be replaced (Walker, 2019). The 2nd stage is the neutral zone (Rosenbaum et al., 2018). It is the zone where the people face difficulty in adapting the new change and needs motivation. The 3rd stage is the last stage where each and every individual has accepted the change (Manson et al., 2016). These model can be used to facilitate change in the healthcare setting.

Critically discuss 3 factors which will demonstrate your practice is culturally competent and person-centred:
Cultural competence is described as the cultural awareness of the cultural diversity (Chiu & Shi, 2019). It requires to function effectively as well as respectfully with the patient as well as the healthcare staff in order to provide better care to the patient irrespective of their cultural background (Degrie et al., 2017). Culture competence in the healthcare staff is defined as the skills, ability and knowledge to provide better patient care (Ang & Van Dyne, 2015). Factors which help in demonstrating that whether the practice in the healthcare is culturally competent and person centred are discussed below:

Minimising cultural conflict: cultural competency is extremely important in the healthcare setting in order to provide best care to each and every patient irrespective of their cultural background (Zein, 2016). To ensure a cultural competent environment, it is important to educate the health care staff and to create awareness regarding the cultural diversity (Sue et al., 2019). It helps in minimising the cultural conflict among the patient and the nurse or among the healthcare staff. It can be achieved only if there is respect for each and every one (Holland, 2017).

Effective communication with the patient: To provide better care to the patient which is person centred as well as culturally competent, it is important for the healthcare staff to involve in effective communication with the patient (Gluyas, 2015). With the help of effective communication, the healthcare staff will be able to form an effective therapeutic relationship with the patient which helps the healthcare professional to provide better care to the patient (King et al., 2015). Hence by the help of applying effective communication, it can be stated that the individual has been provided with person centred (Ruesch et al., 2017).

Understanding the needs and interests of the patient: To provide person-centred care to the patient, it is important for the healthcare staff to acknowledge the needs and interests of the patient (Greysen et al., 2017). In order to do that, gaining the trust of the patient is very important (Bell et al., 2017). For this each and every patient is to be treated equally and respected. Hence, if the patient is treated after understanding the needs and interests of the patient, it can be stated that the treatment is person-centred (Beach, Branyon & Saha, 2017).

Conclusion:
From the above essay, it can be concluded that Cultural safety is the environment which helps in providing physically, socially, emotionally and spiritually safe for each and every individual. In the essay the cultural competency with respect to the contemporary nursing has been provided. The barriers to the contemporary nursing is mentioned in the essay. There are certain issue which are identified in the case study which violates the professional nursing standard are mentioned. The response of the violation are also explained briefly in the essay. By observing the violation, it is recommended to implement change in the workplace to avoid similar situation in future. To facilitate the change, Bridges Transition Model is used in the essay. Apart from these, 3 factors which ensures that the practice is competent and person-centerd are mentioned in the essay.

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