Open Source Handbook of Nursing/Cultural Security

Riverina Aboriginal Health Centre

Cultural security recognises the legitimate cultural rights, values and expectations of diverse people [1]. Having some shared understanding of cultural terminology can help nurses to specify their meaning. For example, culture itself has come to mean ethnic variations around heritage, place, belief and behaviour. The need for nurses to accommodate and accept differences is increasing as global diversity increases.

Madeleine Leininger Laid out the foundations for inter-cultural understaninding in nursing in the seventies.

Nursing Australian Aborigines

Identity

It is not possible to identify an Aboriginal or Torres Strait Islander based on their appearance, as their characteristics will vary from person to person. There are various ways of encountering whether a person is from an Aboriginal or Torres Strait Islander background. These include if the person themselves considers to be a part of that particular culture, if other people within that cultural group considers them to be the same culture as them, they can also be identified by the language they use as English may be a second language. Many aboriginal people carry a strong sense of themselves as either gender and this is observed in some taboos against blended gender activities. These may be referred to separately as "Men's business" and "Women's business".

Stereotypes

Nurse should be aware that racial stereotypes are an issue between the non-indigenous population and the indigenous population. Nurses are in a good position to counteract this tendency and ensure we treat every patient with a clear open willing manner. Avoid making an issue of anything that may relate to their health condition, based on stereotypical thinking. Alcohol consumption, for example. It is often a misperception that all indigenous members are “alcoholics” so it may be easy to base a health diagnosis on this stereotype, stating “due to alcoholism”, but this would be a negative nursing outlook. Nurses should be aware that traditional aboriginal culture has many elements connected with spirituality, such that the boundaries between everyday reality and dreaming can be perceived as fluid. Consequently events may be perceived differently by aboriginal nurses and their non-aboriginal clients and vice versa. This aboriginal world view may appear at odd with the more rigid causal structures expected in the biomedical model. Nurses and clients may have widely varying views on timeliness, urgency, monetary worth, independence, self-care and so on.

Cultural sensitivity

Whilst practicing nursing in Australia, it is critical to remain sensitive to the Aboriginal culture. Aboriginal people have a variety of cultures that combine contemporary and traditional thoughts and practices [2]. Some significant cultural requirements are dream time, sorry business and traditional activities that are restricted to certain parts of the aboriginal community. For example, men's and women’s business are kept separate. When communicating to an Aboriginal person, you should be considerate that English may not be there first language, be sensitive about non-verbal cues, there may be a delay in response and direct or blunt questions may not always be answered.

Body language

In some Aboriginal cultures, it is considered rude or disrespectful to look someone straight in the eye. If an Aboriginal person does not want to make eye contact with you, this does not necessarily mean that they are lying or are being rude. Also, pointing at people when trying to emphasise something should be avoided. It is usually best to avoid being "noisy" and keep a conversational tone of voice. Positioning you body level with or lower than the client will avoid an imposing presence. Nurses may like to familiarize themselves with common terminology from Aboriginal Enclish or Creole used in their area.

Family

Many Aboriginal families live in combined households. When establishing a care plan, bear in mind that things are shared, such as food, clothing, money, and space. Don’t assume that Aboriginal patients can easily keep track of possessions, medications, or money, or manage their time. Aboriginal people do not necessarily have the same conception of marriage. For example some couples develop an informal relationship gradually accepted by the community, or some may prefer to observe an arranged marriage.

events

In organizing an event for an aboriginal community the nurse should consider the following aspects [3]

• building rapport with the people
• use of appropriate language
• use of communication techniques
• ensure participation
• acknowledge traditional land owners
• announce before using any resources relating to people who may be deceased
• consider the type and preparation of food

The calender includes several events of significant for aboriginal people, which may depend on regional affiliations. For example, a regional horse racing event may have no significance, or it may be connected with rodeo and stockriding events with a special place in the hearts of aboriginal people.

• NAIDOC week
• Sorry Day
• Crocfest