1. The power imbalance or power differential evident in the case study is the imbalance of medical education between the nurse and Mrs. Adams. The imbalance of knowledge leads to a dominating assertiveness by the health professionals over the patients by the presumption or judgment regarding the absence or lack of health literacy from Mrs. Adams' side (Felton et al., 2018). Such power differentials trigger the culturally vulnerable population to rely on healthcare professionals as the lack of knowledge causes the feeling of uncertainty within them. Another contributing factor to the power imbalance between Mrs. Adams and me (a healthcare professional) is the linguistic and cultural barrier obstructing effective communication (O’Toole et al., 2019). The power differential is a prominent barrier to delivering quality care to culturally vulnerable communities. To overcome this power differential between Mrs. Adams and me, I will initiate active communication to establish the foundation of trust as part of a nurse-patient interaction (Nelson & Wilson, 2018). Apart from this, I will also show my cultural sensitivity to gain the confidence of Mrs. Adams towards competence in providing her with the quality care she requires. Overcoming the power differentials help build an effective interpersonal relationship which facilitates positive recovery in the patient and provides them with psychological motivation to cope with the disease (Mbozi et al., 2020).
2. As the nurse, she is responsible for assisting Mrs. Adams in overcoming her apprehension about being admitted to the hospital and providing care to her. I formulated an efficient care strategy for Mrs. Adams, which was culturally sensitive after consideration of Mrs. Aboriginal's ethnicity. Being a nurse within a clinical setting, I understand the importance and obligations associated with Indigenous community care. Mrs. Adams belonged to the aboriginal community and had a minor amount of health literacy and being the nurse responsible for her care; it was my duty to make her aware of the health-associated risks and treatment aspects (Choudhry et al., 2019). As Mrs. Adams belonged to the Aboriginal community, my primary responsibility was to ensure that I maintained good, sympathetic, and informative communication with her to make sure she felt welcomed and could trust in the healthcare plan formulated as per her medical requirements (Gregg et al., 2022). Apart from active and effective communication, I also applied my cultural knowledge regarding Aboriginal communities to make conscious decisions for delivering culturally sensitive patient-centric care. As part of my clinical care strategy for Mrs. Adams, I will communicate while reflecting empathic behavior and give her the necessary information regarding the healthcare institution protocols to assure her that she would receive absolute cultural security within the healthcare setting. This will help her overcome her reluctance to be admitted to the hospital. I will also use art-based (ensure cultural safety) pictorial or audio-visual aids to explain the necessary information associated with her condition to remove the chances of information misinterpretation due to linguistic barriers to communication (Natale et al., 2021).
Palliative care refers to the advanced care plans implemented for providing appropriate care and support to individuals suffering from chronic disorders. Palliative care plans are built with specialized considerations of the patient's medical needs. In the case of Mrs. Adams' care, it is essential that the palliative care is based on cultural sensitivity and ensures adequate support to motivate her to improve her psychological well-being (Tziraki et al., 2020). As a nurse, I understood the necessity of assisting Mrs. Adams in getting accessibility to culturally sensitive palliative care. Palliative care aims to provide as much comfort and ease to the patient as possible during the end-of-life phase of chronic disease. Culturally specific patient-centric palliative care is an essential factor responsible for developing positivity and self-actualization and reduces the level of stress of Mrs. Adams during her survival from the rapidly progressing cervical cancer (Gazaway et al., 2019). The vulnerability of Mrs. Adams is evident in her inclination toward receiving care in her community home. To fulfill my part of the responsibility, I will ensure that her community home provides access to appropriate palliative care resources and is equipped with the necessary resources for justifying Mrs. Adams' medical requirements in terms of ethical, cultural, and moral support and enhance her psychological strength in coping with the distress due to cervical cancer (Kreitler, 2019). While receiving care at her palliative care in her community home, a prominent advantage for Mrs. Adams is that there would be no language barrier in delivering care.
Palliative care delivery requires critical considerations and should be well-equipped. The community homes of culturally vulnerable (Indigenous) communities often lack the essential resources and knowledge required to deliver effective palliative care (WHO, 2018) correctly. As a nurse responsible for the security of Mrs. Adams' quality care and enhancing her quality of life with cervical cancer, I will apply my nursing skills and formulate an efficient palliative care plan. I will try to communicate with Mrs. Adams regarding the availability and accessibility of essential palliative care resources in the healthcare setting she is currently admitted into. The lack of these components in her community home might worsen her condition and deteriorate her psychological health (Kuruvilla et al., 2018). As the healthcare setting is well-equipped with skilled and experienced nursing staff, it will be easier for Mrs. Adams to get her medical requirements acknowledged and addressed efficiently. As the nurses are trained and educated regarding cultural sensitivity, the nursing professionals are now competent in establishing effective communication, which is an integral part of palliative care for indigenous patients (Oji et al., 2022). Apart from these, I will also find substitute solutions for getting the critical care available for Mrs. Adams by incorporating patient advocacy. This would help provide quality care to Mrs. Adams by simultaneously maintaining patient autonomy in receiving care in her community home. After ensuring that Mrs. Adams has access to the essential care resources (telehealth, e-monitoring, etc.), I will maintain regular follow-ups, which will assist me in the maintenance of the quality of care. Follow-up of the resource allocation would also help me evaluate the credibility of efficient care (Seeger et al., 2018).
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O’Toole, J. K., Alvarado-Little, W., & Ledford, C. J. (2019). Communication with diverse patients: addressing culture and language. Pediatric Clinics, 66 (4), 791-804.
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