While I was working as a nursing director, I was admitted to a large tertiary hospital as a patient. I was diagnosed with a double ear infection, which required hospitalisation for intensive intravenous (IV) antibiotic treatment and pain management. I had a cannula inserted to receive IV antibiotics in the emergency department and was administered Fentanyl subcutaneously. I was prescribed Endone for pain relief. When I was admitted to the ward, I was not asked whether I identified as Aboriginal nor was I asked about my occupation.
Four hours after being admitted to the ward, my pain began to escalate. I requested Endone from the Registered Nurse (who had not introduced himself at the beginning of his shift). He looked at my medication chart and went to get the pain relief. He returned and offered me two Panadeine. I questioned him about what medication I was being offered, and he explained that ‘these are Panadeine’. I stated that the doctor in the emergency department had written me up to receive Endone.
The nurse replied that ‘We don’t give Endone out willy nilly and Panadeine should hold your pain’. My pain soon escalated severely, and I became highly agitated. The nurse avoided me.
Shortly after this encounter, the Aboriginal Hospital Liaison Officer arrived. I asked how she knew I had been admitted and she explained, ‘You identified within the emergency department and the box had been ticked’.
I rang a friend who worked at the hospital as an anaesthetist. In my highly distressed state, I asked him to come and see me. Simon (the anaesthetist) took my chart and read through my notes to ascertain my clinical history and reason for admission. He then took my chart to the nurses’ station and asked why I was not receiving adequate pain relief, as written up. Within a few moments the nurse appeared with the prescribed dose of Endone. The Registered Nurse in charge of the shift also arrived, and apologised for the error. I then asked not to be looked after for the rest of the shift by my designated nurse.
Critical Reflection – Applying the Cultural Safety Principles
1. Reflect on your own practice
Considering the practice of the Registered Nurse in the scenario, what areas of practice should he reflect on and why?
What potentially were the beliefs, values and attitudes that influenced his culturally unsafe practice?
2. Seek to minimise the power differentials
Describe eamples of how the nurse used power differentials in his care giving
Describe examples of how the nurse could have minimised power differentials
3. Engage in discourse with the client
Describe the discourse in which the nurse should have engaged – what important conversations did not happen?
4. Undertake a process of decolonisation
Describe the lack of understanding about decolonisation demonstrated by the nurse
5. Ensure you do not diminish, demean or disempower others through your actions
Name the actions of the nurse that are diminishing, demeaning and disempowering.
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