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NUR1203 Cultural Safety and Professional Practice Assignment Help

Brief task description

This assessment task supports you to be an effective Bystander in the workplace and will hopefully extend beyond this. It is a requirement that student nurses and registered nurses are Culturally Safe practitioners. Part of this is when we witness culturally unsafe practice, that we have the skills to navigate this and bring change to the workplace setting.

Length 1500 words +/-10% (word length includes in-text referencing and excludes your reference list and appendices)

Task information

This Assessment requires you to respond to the following case scenario.

You are to identify ONE of the culturally unsafe care points within this scenario and use the four components of the Bystander Intervention Framework as the basis of this essay.

Case study

You are doing a clinical placement on a busy surgical ward, and you are working with a Registered Nurse (RN). Both of you attend to an adult patient, Elliott, who has been admitted for a surgical procedure and requires a blood transfusion intra-operatively. The family identify their religious faith as Jehovah’s Witness, where the belief in the administration of blood and blood products via transfusion is against their faith. Elliott has no vision and is able to communicate using speech.

The RN assumes that Elliott is unable to communicate for himself and talks only to her mother who is in attendance for admission.

The RN turns to face the mother and makes the following comment, “Hello there – who do we have here today? Thanks for bringing Elliott in for his admission. How long has he been unwell for? Do you know? I have his chart here with me and just want to ask you some questions regards his medical history if that’s OK? It says something here about him not consenting to a blood transfusion.... we’ll need to sort that out, because he’s going to need it you know!”

After finishing off admitting Elliott to the ward, you walk back to the nurse’s station with the RN. The RN turns to you and states “What a weird religion that stops you from having a blood transfusion. Why would anyone want to be in that religion?”.

1. Identify ONE of the culturally unsafe care points and explain its relevance to this case study and explain why it is culturally unsafe.

2. Identify 2 Direct interventions that you could use in this scenario. Your response cannot be a replication of any responses that have been provided with, in your Bystander training

3. Identify 2 Indirect interventions that you could use in this scenario. Your response cannot be a replication of any responses that have been provided in your Bystander training.

4. Identify 2 Distraction interventions that you could use in this scenario. Your response cannot be a replication of any responses that have been provided in your Bystander training.

5. Protocol intervention/s: Identify the NMBA Codes of Conduct that this culturally unsafe care is breaching.

Writing Style

• This assessment piece to be written as an report and in third person.
• Do not use headings
• Correct Academic writing as per USQ guidelines
• All discussion is to be appropriately referenced using APA 7th Edition Referencing
• Contemporary Literature must be sourced (no more than 7 years old).



As per professional standards for registered nurses (RN), nurses must reflect dignity and professionalism through their practice and ensure patient right over person-centred and well-informed treatment practice. This report focuses on identifying culturally unsafe care reflected by RN in the case of Elliot, who belonged to Jehova's Witness believers and denied blood transfusion as per religious belief. This report also highlights 2 direct interventions for this case and 2 indirect interventions for this case, and 2 distracting interventions for nursing assignment help.

Culturally unsafe care points

In the case of Elliot, culturally unsafe care practice has been witnessed by an in terms RN responsible for the care of patients disrespecting the religious belief of the patient for not consenting to intra-operative blood transfusion rather than making the patient and family members of the patient agree on the procedure through empathy. The RN has also breached patients' right to the confidentiality of personal information as RN has communicated about patients' religious beliefs and treatment outcomes openly in nurse stations and reflects disrespect towards the religion. As mentioned by Poorchangizi et al. (2019), nurses have the responsibility of safeguarding patients' right to confidentiality. This right has been breached here by the RN, along with disrespect to the patients' culture. The RN has also avoided directly communicating with the patient even though the patient can talk. These are the areas where RN has reflected culturally unsafe care practices, lack of dignified behaviour, and respect towards patients' cultural needs and health conditions. This incident reflected unprofessional behaviour by the RN's breach of patients’ rights.

Direct intervention

The case here is to ensure a culturally safe care environment for Elliot. Direct interventions that can be considered in this case include training RN to deliver care in a culturally competent manner and ensuring collaboration with community health service providers. Authority of care service-providing organisations can consider arranging training for RN to enhance their cultural competence. Cultural competence among nurses can be enhanced by making them aware of different cultures and the importance of reflecting respect for the culture and religion of patients in the nursing profession (Kaihlanen et al., 2019). For example, during training sessions, the RN can be made aware of legal consequences associated with not respecting the religion of a patient, as well as improve the RN's ability to communicate with patients in a culturally competent way for incorporating changes in the RN's behaviour. Further such training can also improve other RNs' perception regarding the importance of maintaining culturally safe care practices to avoid the recurrence of such incidents.

On the other hand, including community healthcare professionals in the care team of Elliot can be beneficial for reducing the cultural barrier in care. The main concern here is no consent for the intraoperative blood transfusion, which is necessary for the patient. Community health service professionals can communicate with the patient and his family to make them understand the consequences of which blood transfusion becomes necessary during treatment and ways the patient can avoid breaching their religious values without impairing the treatment requirement (Bolcato et al. 2021). The community health professional can also help RN to understand patients' perspectives associated with treatment measures that can help to solve complications associated with the treatment plan

Indirect interventions

As the RN has reflected on culturally unsafe behaviour in terms of not respecting the cultural beliefs of patients and not prioritising patient confidentiality, strict measures can be taken against RN by making management aware of the situation. Further, appointing a different RN with professional knowledge of cultural competence and knowledge of managing patients with Jehovah’s Witness beliefs can be beneficial. RN can lose their license and job for not following professional standards and ensuring respect toward the cultural needs of patients. As mentioned by Handke et al. (2019), cultural competencies-related practices in healthcare settings allow limiting cultural disparities associated with treatment specification and help to minimise the consequences of inequality. Thus the respective case reflecting the poor understanding of cultural competencies highlights the presence of inequality in the case of the patient belonging from a significant religious belief only for not providing consent to a treatment requirement. Thus making authorities aware of the situation and taking strict action against the RN can help to limit the recurrence of such a situation in the future.

As the current RN appointed for Elliot has reflected a poor understanding of cultural competence thus, another RN having profound knowledge about the requirements of cultural competency can be appointed to manage this case. Ensuring a cultural competence care environment for the patient can help to limit the cultural barriers arising in the treatment plan as well as the dignity of the patient can be maintained. Further, replacing the existing nurse with an experienced professional will provide understanding regarding patients’ consent redefining other treatment methods that can be applied to replace the intraoperative blood transfusion. Thus it can be considered a strategy for dealing with the current situation.

Distracting intervention

Application of cognitive behavioural therapy (CBT) and counseling sessions with family members of patients in the presence of community service providers knowing dealing with issues of care associated with a patient with Jehovah’s faith can be considered in this case. As mentioned by Babiano-Espinosa et al. (2019), CBT allows the development of an interacting treatment environment for service users and service providers for better delegation and patient care needs. In the current case of Ellitor thus CBT based approach can be applied to reduce resistance to blood transfusion. Under this approach safety of blood transfusion in terms of their religious values and consequences for not considering the blood transfusion can be communicated. The CBT approach focuses on including changes in the behaviour of patients by encouraging and guiding them to judge a situation from a positive side. Thus this technique can be beneficial for making Elliot and his family members provide consent for blood transfusion.

A set of counseling sessions can be arranged for Elliot and his family members, and during the secession, it will be ensured that privacy and confidentiality are maintained. During the counseling session, it can be ensured that the patient and the family members actively participate in the communication to clarify the issues of not considering blood transfusion and the current health condition. Such sessions can also be used for reforming their existing experience due to poor behaviour of RN to ensure the trust of the patient and his family member over the services provider. It will help to ensure a cultural safety care environment and limit the issues associated with consent.

Protocol interventions

NMBA code of professional conduct forces nurses' duty to ensure patients' rights and respect for patients' decisions. In this respective case of Elliot, there are certain arise that RN has avoided and neglected. The first area neglected was the patient's condition, as Elliot could speak; however, the RN preferred to communicate with his family rather than the patient, which highlighted impairing patient-centered practice and informed-making. This activity of RN breaches the first code of conduct of NMBA, which is focused on nurses' practice safely and competently. As per this code of conduct, nurses must act safely and competently without being compromised by patient health limitations (Nursing and Midwifery Board of Australia, 2022). In this case, RN neglected Elliot’s personal views on the matter of blood transfusion though can communicate this code of conduct 1 has been breached. Code of conduct 4 NMBA standard focuses on ensuring nurses respect and dignity towards patients' culture, ethnicity, and values as well as beliefs while receiving care (Nursing and Midwifery Board of Australia, 2022). However, in this case, Elliot, while communicating with his family member RN considered a very informal way of communicating, reflecting the less interest in the patient's cultural and religious identity.

Further, while communicating with other RN, the respective nurse became very disrespectful to Jehovah's Witness's religious beliefs by saying the religion was weird and questioning the following religion. This incident signifies disrespecting the cultural and religious identity of the patient, thus breaching the code of conduct 4 of NMBA standards. Code of conduct 5 has also been breached in this unsafe cultural practice as this code highlights nurses' responsibility to maintain the confidentiality of the personal information of patients as per the National privacy principle 2001 and Privacy Act 1988 (Nursing and Midwifery Board of Australia, 2022). However, the RN, in this case, avoids confidentiality of the patient's details, such as cultural and religious specifications, by openly communicating about it in the nurse station. This code of conduct 5 of the NMBA standard has been breached in this culturally unsafe practice.


Thus it can be concluded that here RN has breached the NMBA code of conduct 1, 4, and 5 through culturally unsafe practice. The issue that arises can be solved through training sessions to improve RNs' knowledge regarding cultural competencies and CBT, as well as community healthcare service providers' engagement for making such patients and their families actively involved with care requirements. These techniques can help to ensure patient rights without impairing treatment specifications.


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