Culturally safe care and communication is imperative to person's having effective person-centred care. Nurses are required to consider how they engage and will approach situations in which individuals have experienced previous harm. This harm may be related to healthcare, previous life trauma or generational behaviours. The use of person-centred therapeutic skills in integral to providing safe care that aligns to the registered nurse standards for practice. The use of the case study below allows students to consider how they will approach situations where individuals are reluctant to seek care.  

 

Learning Outcomes

• Identify verbal and non-verbal communication strategies and standards that enable therapeutic communication and interprofessional relationships
• Explain how cultural sensitivity and cultural safety aid in the establishment of effective communication with Aboriginal and Torres Strait Islander people and other multicultural communities.
• Demonstrate a high level of written and spoken English according to academic conventions and professional nursing standards.
• Identify, access and effectively utilise relevant and credible evidence-based research for person-centred practice.
• Demonstrate effective communication through clinical handover and the legal documentation of essential information in healthcare records to ensure patient safety.

 

Task Instructions

Read the following case study.

Leo is a 50-year-old man living in your local community. Leo has a past history of Type 2 Diabetes, Coronary Artery Disease and Hypertension. Leo is Aboriginal and Torres Strait Islander and lives with his wife and three children (aged 12 - 20). Leo disengaged from healthcare due to a previous bad experience where he felt judged due to his cultural background. He has heard you are a new nurse working in his area and has been convinced by his wife and children to attend for a health check-up and care plan. 

1. Discuss how you will utilise communication, cultural sensitivity and safety to develop a therapeutic relationship with Leo, using your knowledge of communication and culture learnt from this unit. The discussion should also include key information and requirements for documentation of your nursing interaction with Leo
2. Discuss the therapeutic communication tools that you will utilise to develop a connection with Leo
3. Discuss how will you develop a culturally safe and sensitive interaction with Leo? The written work should also include what strategies/ approach you will take to record your interaction with Leo providing clinical reasoning (explaining why)
4. Read the following instructions for writing an essay:

• Introduction: gives background to the topic and states precisely what the essay intends to cover.
• Body Text: shows evidence of critical thinking and analysis; and uses current evidence-based research to support the argument
• Conclusion: draws evidence together, does not over-generalise or introduce new material
• Correct referencing technique

Answer:

1. Discuss how you will utilize communication, cultural sensitivity and safety to develop a therapeutic relationship with Leo, using your knowledge of communication and culture learnt from this unit. The discussion should also include key information and requirements for documentation of your nursing interaction with Leo.

Therapeutic communication skills is an integral part of nursing process. Taking into account the medical and personal history of Leo, as a nurse it is best to to prioritize the the physical and emotional well-being of Leo. Trust is the most important aspect in the nurse-patient relationship. Considering Leo's condition and experience, he needs an empathetic approach. In order for me to gain his trust and cooperation, I will establish rapport with him, and in doing so, I will incorporate professional strategies and humane manner in our nurse-client interaction. Through therapeutic communication, I will utilize the Cognitive Behavioral Therapy, this will help me elicit essential information from Leo. Using this therapy, I will be able to recognize Leo's feelings from his thoughts. It is very important to acknowledge Leo's thoughts, he needs to feel that his emotion is valid in relation to cultural sensitivity. Leo must be able to feel the sense of acceptance and understanding coming from me as his healthcare provider. 

In my nursing interaction with Leo, the following information must be obtain: 

1.) Chief Complaint - Patient is experiencing sense of shame and hopelessness due to unpleasant experience.

2.) History of Present Illness - None

3.) Past Medical History - History of Type 2 Diabetes, Coronary Artery Disease and Hypertension.

4.) Past Surgical History - None

5.) Family History - Aboriginal and Torres Strait Islander and lives with his wife and three children (aged 12 - 20)

7.) Social History - Patient suffered emotional setback due to lack of awareness in cultural sensitivity on the part of his previous healthcare provider

2. Discuss the therapeutic communication tools that you will utilise to develop a connection with Leo.

Using the therapeutic communication tools, I will be able to address the issue of Leo by providing himo education and support, while maintaining objectivity and professional distance. These tools are the following.

1.) Using Silence - It will give Leo the time to process his emotion. 

2.) Giving Recognition - It will make Leo feel that his problem is being acknowledge.

3.) Offering Self - Availability will suggest interest and willingness to provide assistance to Leo.

4.) Active Listening - It has the potential effect to increase positive emotion, it encourages openness.

5.) Seeking Clarification - It promotes deeper understanding.

6.) Placing the Event in Time or Sequence - It will help Leo to specifically manifest the main point of his problem or issue.

3. Discuss how will you develop a culturally safe and sensitive interaction with Leo? The written work should also include what strategies/ approach you will take to record your interaction with Leo providing clinical reasoning (explaining why)

To develop a culturally safe and sensitive interaction with Leo, I will utilize the RESPECT MODEL. This model promote awareness on cultural biases that will  eliminate any form of prejudices and culture selectivity. Using this model, I will be able to establish rapport with Leo despite our cultural background differences.  Rapport must be establish first, harmonious relationship must be the set up of my interaction with Carlo. Empathy is a vital tool in communication with Leo. It will help me to connect with Leo through understanding and promoting positive behavior. Support must always be present in the nursing process. Support builds self-esteem, helping Leo to achieve emotional and behavioral development. Leo must be able to recognize and feel the partnership with his healthcare provider. This will improve the system of information sharing with him. As a healthcare provider, I need to have cultural competence. This

can break down barriers, improve access to services and support better health outcomes for Leo.

4. Read the following instructions for writing an essay:

• Introduction: gives background to the topic and states precisely what the essay intends to cover.
• Body Text: shows evidence of critical thinking and analysis; and uses current evidence-based research to support the argument
• Conclusion: draws evidence together, does not over-generalise or introduce new material
• Correct referencing technique

In answering this question, sets of writing skills are required.  Essay in nursing parlance are considered documents, and documentation is an indispensable tool in nursing process. Nursing documentation is essential for good clinical communication. Appropriate documentation provides an accurate reflection of nursing assessments, changes in clinical state, care provided and pertinent patient information to support the multidisciplinary team to deliver great care. A standard essay has an 1.) Introduction 2.) Body Content/Paragraph/Text 3.) Conclusion and 4.) Correct referencing technique. As a nurse, it is expected from us to follow this standard format in writing an essay. Essay is a type of document. Accurate and effective documentation ensures continuity of care, saves time and prevent duplication or error in the patient care. Essay as document is a permanent written communication that documents information relevant to a client's health care management.