Culture encounter with Aboriginal and Torres Strait Islander patients in palliative care is one of the most challenging issues in nursing practise in Australia. They have strong core values of community, central place of land and family obligations. Compounding this is the fact that different groups have different languages, traditions and customs that result in diversity and complexity in their behaviour, as well as their beliefs and attitudes on healthcare. In order to provide the optimal palliative care to Aboriginal and Torres Strait Islander patients, nurses must encounter and interact with them appropriately with cultural knowledge and awareness. This can not only reduce cultural misunderstanding and conflict, but also minimise any preventable adverse events for these patients with different cultural norms (Johnstone & Kanitsaki, 2006). Pam is a 39 years old Indigenous Australian who has been diagnosed with metastatic disease. She is currently staying at the regional cancer palliative care service with an expression of returning home to pass away, with accessibility to traditional healing methods. This paper will use the case of Pam to explore the cultural aspects of Indigenous Australians in healthcare delivery with evidence-based literatures. It will firstly illustrate the Indigenous Australians' view of traditional healing methods, body language, and culturally competent nursing approaches; secondly, explain two reasons why Pam may want to return to her community at this end-stage of her life; and thirdly, discuss the discharge information that nurses should provide to Pam and her family under culturally competent nursing practice. Indigenous Australians have their own path of healing approaches in their culture. Bush medicine is the herbal remedy which is commonly used in the remote areas of Australia (Clarke, 2007). There are different methods of applying these medicines, including drinking, washing, massage and aromatherapies (Clarke, 2008). Indigenous Australians believe that bush medicines can make them healthy by cleaning the internal body : which is considered as an essential part of well-being (Shahid, Finn, Bessarab & Thomas, 2009). Traditional healing is another ancient holistic approach used by Indigenous Australians to cure illness. It is a spiritual ceremony that can only be performed by a traditional healer. The methods for curing a sick person vary in different groups of Indigenous people depending on the traditional healers' beliefs in the causes of the respective disease such as breaching of religious sanctions or social rules of behaviour, loss of own soul, lodgement of foreign objects like evil spirits, wood, bone, shell, stone, etc (Clarke, 2008; Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women’s Council Aboriginal Corporation [NPYWCAC], 2003). The methods of traditional healing include singing, blowing, breathing, massaging, sucking and restoring the well-being of the person's soul by using a set of ‘sacred tools’ (Clarke, 2008; Dobson, 2007; NPYWCAC, 2003). In Indigenous communities, traditional healers are highly ranked and recognised as ‘doctors’ or ‘powered man’ (Clarke, 2008). Their exceptional knowledge and special power were believed to be derived from their spiritual ancestors for healing, not only physical, but also mental, emotional and spiritual (Clarke, 2008). Indigenous Australians therefore deeply trust and respect them with strong traditional beliefs in the supernatural causes of disease and their power of healing. It can be illustrated from these strong cultural beliefs and traditions that an imperative in the palliative care of Pam must include the assimilation and accommodation of these Indigenous ways. Her nursing care needs to incorporate the acknowledgement and respect of the cultural needs and beliefs of bush medication and traditional healers. Accordingly, Pam’s wishes must be respected and she needs to have accessibility to...
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