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Culture and ethnicity: The delivery of health care

Maori people includes a large percentage of users of health services and the health position of Maori is recognized as a health priority area (Nursing Council of New Zealand (NCNZ), 2009). To work effectively and providing Maori health centered nursing attention, it is prerequisite for nurses to learn record of New Zealand, understand Maori health insurance and incorporate ideas of Treaty of Waitangi in their medical practice (Scryymgeour, 2009).

Treaty of Waitangi was agreed upon on Feb 6, 1840. It is a formal agreement signed between British Crown and Maori (indigenous people of New Zealand). It is founding file of New Zealand and has great relevance for health care professionals while working with Maori clients. You will discover three main ideas of the Treaty commonly referenced as 3P`s. They are Partnership, Safeguard and Contribution (Ministry of health, 2002). Nurses being agencies of the federal government (Crown) are committed to recognizing the rights of Maori and honoring the Treaty of Waitangi through the use of its guidelines.

Nurses apply the rule of Relationship by keeping a therapeutic marriage with their consumer. Nurses work in collaboration with clients towards the normal purpose of attaining better health final results. Nurses respect the initial cultural personal information of your client by concerning clients in decision making. This strengthens clients` consciousness regarding their treatment and point out the options of positive health effects. In addition, it preserves the integrity of clients. (NCNZ, 2009).

The second basic principle of the Treaty is Cover. As per this principle, the Crown has obligation to safeguard Maori health (Wepa, 2004). When looking after Maori clients, nurses are committed to the protection and improvement of Maori health by giving best quality health care which is culturally safe and appropriate to Maori clients. Its target is to lessen inequalities in healthcare delivery among Maori and Non-Maori.

Third process of the Treaty is Contribution. In healthcare setting, it is expected from the nurses to enable clients and encourage a dynamic contribution from them. It is vital for nurses to activate clients in all decisions related to their care. Nurses identify they can involve client`s family in planning individualized healthcare for the client. However, it can be possible only when the client wish to do so. (Scryymgeour, 2009).

Government ensures that treaty of Waitangi is accepted and honored in health care system. Waitangi Tribunal was set up under Treaty of Waitangi Action 1975. If Maori clients do not acknowledge the given health care as culturally safe or when there is a breach of Treaty, it could be resolved to the Tribunal to get a solution for such problem. Then, Community Health and Impairment Act 2000 came into action to ensure that health practitioners value the Treaty. Besides this, the federal government developed the brand new Zealand Health Strategy (200) for promoting adequate delivery of healthcare and combating inequalities in health. Among its ideas is Acknowledging the Treaty of Waitangi.

Nurses can integrate concepts of the Treaty effectively to bring positive health benefits once they understand concept of Maori Health. Maori Health Strategy (2002) recognized various risk factors such as record of colonization, poverty, poor housing, overcrowding and unemployment; add toward poor Maori health final results. Nurses must understand Maori health. This may permit nurses to serve unique needs of Maori clients by giving nursing care and attention which is pertinent and appropriate to Maori cultural and personal needs of clients.

There will vary health models, which can be used to gain better understanding of Maori health. For instance, Te Whare Tapa Wha and Te Wheke. Relating to Durie (2001), Te Whare Tapa Wha model represents four proportions of health in form of four wall surfaces of whare (house). These are taha wairua(spiritual health), taha hinengaro (mental health), taha tinana (physical health) and taha whanau (family health). If any wall structure is weakened, it hampers the positive health outcomes. It is vital for nurses to recognize Maori beliefs and values to make constructive relationship with clients to accomplish positive health final results.

Treaty of Waitangi functions as program for culture safety. Nurses employed in the New Zealand must be skilled to apply culturally safe good care and incorporate guidelines of the Treaty of Waitangi in their nursing practice (Scryymgeour, 2009). The term kawa whakaruruhau or ethnic safe practices developed after dissatisfaction of Maori pupil nurses about sufficient delivery of health care and its usage of Maori human population. Ramsden firstly launched cultural safety in medical in 1980, that was later included in nursing curriculum by the Medical Council of New Zealand (NCNZ) in 1990. It really is expected from nurses to provide culturally safe care by keeping in consideration all that makes every specific unique. Cultural safe practices is an end result of medical practice that empowers the receiver of good care to establish culturally safe practice

The key aspect in cultural basic safety is biculturalism. Ramsden (2002) identified that every relationship between people is bicultural, because every person has a distinctive cultural identity. As per NCNZ (2009) recommendations for cultural safe practices in nursing education, in order to understand and become culturally safe, firstly, nurses must discover their own social values, beliefs and attitude, which may affect the way they provide health care with their clients. Subsequently, nurses will need to have gained sufficient knowledge and skills necessary to practice culturally safe. Nurses must respect the social diversity of client by recognizing the similarities and variations between diverse civilizations. It insists on changing the energy in health care setting up from nurses to recipients of good care. Once this turnover occurs, the clients are empowered to define the culturally safe practice (Papps, 2007).

Culturally safe practice is absolutely worth it when nurses work with patients from a culture dissimilar to their own. Nurses work to provide culturally sensitive care. The clients` view about the given nursing care allows nurses to indicate back and examine their own nursing practice. Nurses are recognized as bearer of their own cultures, values and behaviour (Natinonal Abroginal Health Organisation, 2006). Nurses use electric power during their nursing practice and also enable clients. However, there could be power imbalances in which the client seems powerless. These issues require to discuss and ensure that client get culturally safe health care. Nurses have responsibility to keep up balance between ability relationships. It can only be possible when nurse creates a therapeutic romance with your client by allowing lively participation from the client (Meyst, 2005).

Nurses confront many situations where cultural beliefs and beliefs of clients may influence the delivery of health services. For example, blood transfusion is performed in a good faith to increase the health condition or to save life of a client. However, in case a Jehovah See pregnant lady will not agree for blood vessels transfusion saying that it is against her spiritual values (Levy, 1999). In such a situation, nurses value the consumer`s decision; nurses cannot enforce treatment on consumer for sake of betterment of consumer`s health. If they do so, it will be culturally unsafe. Since it diminishes, humiliates and disempower the unique cultural identity of your client (NCNZ, 2005, p4). There are many models which guide nurses in providing care and attention which is culturally safe. Particularly, Campinha-Bacote`s (1999) style of ethnic competence and Walker`s (1994) `valuing difference` Model.

Becoming do it yourself aware is vital for nurses as it can help nurses in bettering their personal and professional development. To make sure that nurses are experienced to provide culturally safe attention determined by receiver of health care, the NCNZ (2005) has outlined competencies for authorized nurses. As per this criterion, nurses are expected to think about their own practice and prices that influence their practice. Nurses maintain the integrity of clients by respecting their personal values. Every person has their own beliefs which can determine their decision making process.

Nurses bring their own worth and beliefs that help them in deciding what is good or bad. Woodbridge and Fulford (2003) state that value-based practice is one of the tool of effective decision making in healthcare setting. Nurses respect the principles by demonstrating equality for many clients` values as a person, not only as a person suffering from mental condition. Nurses must be able to recognize and distinguish their personal and professional worth, because it may also have an effect on the delivery of nursing care to the customers. Chances are for a nurse to confront a dilemma choosing her personal or professional worth. The simplest way for the nurses to cope with such a problem is by deciding what prices the most in providing quality care and attention to your client. It's possible only when nurses understand the primary values of customer.

Self critiquing reflective practice is vital aspect of medical care. It helps nurses to widen their sphere of learning by determining significant and long term changes with their medical practice (Paget, 2001). Nurses echo back on their practice and critically examine that that they dealt with a situation, how their own ideals and consumer`s values afflicted the delivery of health care. Reflective practice models can guide medical practice. John`s model of reflection is one of these. It mainly focus on on describing occasions. It outlines the various factors influencing the strategies and features the significance learning after experience.

Meyst, a registered nurse, distributed her experience that checking out more knowledge about self awareness and culture protection has modified her practice (2005). She went to two-day workshop at her work place. It challenged her behaviour, values and stereotypes about providing care and attention to particular group of clients. She distributed a particular occurrence to describe its implication. A pregnant girl, Mrs. Jones (not her real name) along with her seven children appeared to day health care surgery for an elective method. She apologized that she cannot arrange your baby sitter on her behalf children.

On confronting the problem, nurse accepted that she'd have felt impatient with consumer if she would not have transformed her point of view regarding values, beliefs and cultural basic safety. She may have enforced her judgment about the customer`s seven children in relation to overpopulation on the planet. In contrast, she actually experienced the situation being more wide open minded. She welcomed consumer respectfully. As she is well aware that the concentration of her care is consumer. Therefore, she made your client comfortable and founded a constructive romance. She prepared the client for surgery. It is very clear from above example that becoming self aware and recognizing cultural diversity impact nursing practice.

In summary, the cultural protection is released in medical practice to ensure that clients receive culturally safe care and attention. Clients are empowered to decide that the good care they receive is culturally safe or not. As Maori people consist of significant proportion of health service users and their health is considered as area of priority in delivering health care. The Treaty of Waitangi, ethnical security and Nursing practice are interrelated to each other and combine the nursing health care which is satisfactory by clients.

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