Health Care in Practice
According to your textbook, “health care providers commonly associated and anticipated violence with poor and racialized people, despite the fact that they were aware that violence crosses all socioeconomic levels and cultures. Paradoxically, although they were likely to assume abuse as an issue among poor and racialized women, they also tended to view poor and racialized women as less deserving of care and support” (Strohschein/Bolaria, 2014, pp. 364).
1. For this discussion exercise, answer the following questions:
a. Do you believe the paradox identified in quote above occurs and persists in health care practices. Remember to consider the power of stereotypes, prejudice and discrimination in Canadian society.
b. “In a disturbing example [of the use of power], nurses reported that a physician refused to call the sexual assault team to examine a First Nations woman who had been drinking, calling her a ‘social derelict’ (Strohschein/Bolaria, 2014, pp. 364). Discuss who had the power in this situation, and why you think the doctor could not call the sexual assault team.
c. Research findings have also shown that “support was often not offered or was withdrawn from women who were perceived as not making decisions that health care providers thought best” (Strohschein/Bolaria, 2014, pp.365). Explain why this occurs and how culturally safe nursing practices can assist in stopping this from happening.
Opposition to Cultural Safety
There are many barriers that health care practitioners face when trying to provide culturally safe care. One of the most powerful barriers is the dominance of bio-medicine. Cultural safety challenges the current power structures within the institution of medicine. It challenges some of the traditional teachings of nursing.
It requires that “culturally safe practitioners…move beyond the critical self-reflective to engage in actions that address the broader sociopolitical and economic determinants…of health and challenge the taken-for-granted processes and practices that continue to marginalize…this demands, therefore, advocacy and the creation of multiple clinical pathways for clients that extend beyond biomedical models” (Smye et al., 2010, pp. 15).
This is not an easy task. Challenging dominant power relations never is.
For this discussion, answer the following questions:
1. If it is possible to improve the wellbeing of a client by implementing the principles of cultural safety, why would anyone oppose doing so?
2. Culturally safe practices challenge existing power relations in many ways. Describe how.
3. Most of the burden (as well as the opportunities) involved with implementing cultural safety is currently being placed onto the shoulders of individual nurses. Explain why you think this is.
4. Given what you have learned, do you think it is possible to practice cultural safety in nursing at this moment in Canada? Why or why not?