Introduction
Cultural safety in healthcare is a critical principle as it builds patient trust in medical professionals, improves the quality of services and health outcomes. However, this practice is promoted and followed by different medical institutions to varying degrees and is part of their policies. This paper will propose the Cultural Safety position statement of Family Planning Victoria and the rationale for applying it as an example of such a practice in Australian healthcare.
The Cultural Safety Position Statement
Family Planning Victoria is an Australian organization that provides services for reproductive health. Family Planning Victoria clinics provide health services to help people conceive, carry, and deliver healthy children, support sexual health, and prevent sexually transmitted diseases (“Our clinics,” n.d.). In addition, the organization provides training for professionals, educational activities for schools, and communities. Family Planning Victoria believes that health literacy and sexuality education is one of the key elements for people’s reproductive health, since most diseases of the reproductive system are preventive and curable with timely treatment. Thus, Family Planning Victoria aims to enchase Cultural Safety for all patients in Australia regarding their race, gender, religious and ethical background by providing quality communication.
Family Planning Victoria affirms that all Australia residents have the right to receive quality services concerning their cultural beliefs. Family Planning Victoria also believes that a respectful and culturally safe environment contributes to the reproductive health literacy of patients and better health outcomes. Thus, Family Planning Victoria advocates mandatory education and training programs for medical professionals to improve their cultural competence and communication skills. The organization also engages the quality communication of healthcare providers with patients to provide the best treatment options and information to improve their health literacy, considering their cultural background. Family Planning Victoria confirms its intentions to provide quality care for all patients by creating a culturally safe environment with these measures.
The rationale underpinning the position statement
Communication is a critical element in the process of enhancing the health literacy of patients, which ensures better health outcomes for them. Patients get most of their knowledge of their health problems and ways of their treatment from doctors and nurses, since although general issues are covered in the literature, all patients have their own specific nuances. For this reason, quality communication is essential for the health care provider to assess the patient’s health literacy and offer him or her the necessary knowledge. One can note by considering Australia’s cultural diversity that this feature is especially required in the local environment, since in addition to various ethnic groups of migrants, it has a cultural minority of indigenous Australians. Hence, the concept of cultural competence is also crucial for healthcare professionals as they must understand and respect the cultural differences of patients (Purnell & Fenkl, 2019). However, as cultural competence is not a static quality, communication is a way of developing it and understanding patients’ needs (Curtis et al., 2019). Consequently, cultural competence, communication, and patient health literacy are interrelated and critical concepts for Cultural Safety in Australian healthcare settings.
Moreover, the specificity of Family Planning Victoria demonstrates that these elements are central to its Cultural Safety. Family Planning Victoria is an organization that provides services and educational resources about reproductive health. However, people are sensitive to the topic of sexual health and education, childbirth, and relationships between partners in a different way. The perception of these issues depends on the patients’ cultural characteristics. For example, Aboriginal women still often refuse abortion due to fear of stigma. (Farhart, 2019). For this reason, listening and understanding the needs of patients is essential to ensure Cultural Safety and provide the best quality of services.
In addition, communication is essential to increase the patient’s health awareness of safer sexual behavior. Most diseases of the reproductive system are avoidable and curable, but lack of knowledge prevents people from taking precautions. For this reason, cultural competence and communication are necessary to ensure Cultural Security in the dissemination of knowledge about a sensitive topic. Hence, communication and patient health literacy are essential for establishing Cultural Safety at Family Planning Victoria due to the specific health issues it covers.
Therefore, establishing high communication standards and a culturally safe environment for all patients will increase health awareness and bring positive results. Laverty et al. (2017) note that an increase in culturally safe clinical care for the indigenous population significantly contributes to their health improvement. A similar statement applies to other nations as well, since respect for the patient’s culture and his or her traditions builds trust in the healthcare professional. Thus, specific outcomes of Culture Safety at Firstly Family Planning Victoria will have resulted in the reproductive health area. Firstly, spreading knowledge about contraceptive methods and safer sexual behavior among young people and adults helps to reduce the level of sexually transmitted diseases and unwanted pregnancies. Secondly, promoting knowledge about the need for regular checks and debunking the stigma around disorders of the reproductive system will reduce the development of complications and infertility and increase the birth rate of healthy children. In addition, culturally safe environments and communication promote a more informed approach to treatment among patients and increase its effectiveness. Consequently, establishing a culturally safe environment will enhance sexuality education and improve the reproductive health of the population.
However, there are some external and internal barriers to establishing Cultural Safety in Family Planning Victoria. External factors include language barriers and patient preferences about the gender of the doctor or nurse. The first aspect is related to the fact that indigenous peoples live in Australia, speaking 100 dialects, as well as migrants from other countries (Li, 2017). Consequently, these patients often need translators for quality communication and understanding, but their number in the clinic is limited. Ratna (2019) also noted that patients with language barriers are less likely satisfied with the quality of services. The same feature applies to gender, since quite often, the clinic cannot satisfy the request of patients about the preferred gender of the doctor and nurse, especially in urgent cases. Thus, the level of cultural safety for patients can be reduced. Internal barriers can be a lack of cultural competence or communication skills of health professionals and their cultural stereotypes. These disadvantages can be overcome through staff training; however, they will hinder quality communication in the early stages.
Conclusion
Therefore, the sensitivity of the topic of reproductive health and Australian society’s cultural diversity demonstrates the need for a culturally safe environment in Family Planning Victoria. The primary method to achieve this goal is to increase staff’s cultural competence and the quality of their communication with patients. This approach will build patient confidence in the health care system and convey important reproductive health messages to them in a culturally safe manner. Thus, adopting this practice will improve the health outcomes for the clinic patients.
References
Curtis, E., Jones, R., Tipene-Leach, D., Walker, C., Loring, B., Paine, S.-J., & Reid, R. (2019). Why cultural safety rather than cultural competency is required to achieve health equity: A literature review and recommended definition. International Journal for Equity in Health, 18(2019), 1-17.
Farhart, C. (2019). Abortion reform welcome but Indigenous women still concerned. NITV.
Laverty, M., McDermott, D., & Calma, T. (2017). Embedding cultural safety in Australia’s main health care standards. The Medical Journal of Australia, 207(1), 15-16. Web.
Li, J.-L. (2017). Cultural barriers lead to inequitable healthcare access for aboriginal Australians and Torres Strait Islanders. Chinese Nursing Research, 4(4), 207-210.
Our clinics (n.d.).
Purnell, L. D., & Fenkl, E. A. (2019). Handbook for culturally competent care. Springer.
Ratna H. (2019). The importance of effective communication in healthcare practice. Harvard Public Health Review, 23, 1-6.
Advanced Practice Nurse Professional Development
Introduction
Scope of practice defines the range of possibilities within the professional framework for nurses, and it is important to understand it properly. In turn, NP competencies determine the extent of professionalism of a nurse; hence, it is important to develop these competencies continually. Finally, leadership skills serve as a great foundation for success and proper organization of workflow in nursing. This paper aims to provide APN professional development plan by discussing APN scope of practice in the intended state of practice, nurse practitioner (NONPF) core competencies, and leadership skills required for nurses.
APN Scope of Practice
Given the fact that I am planning to successfully graduate from Chamberlain University, I intend to practice in the Illinois state as I have gained significant practical experience here, as well as have already got acquainted with the essential regulatory provisions here. It should be noted that the chosen state has an advanced and sophisticated legal environment for APNs that, nevertheless, is clear and understandable, with no visible and critical contradictions. Educational requirements are as follows; Potential APNs are to obtain a graduate degree or post-master certificate. They should accomplish a program that provides preparations for advanced practice certification. It should also be stressed that the selected graduate program is to be accredited by a specialized establishment that the US Department of Education recognizes. Then, there are some specific provisions as well – depending on one’s career goals as an advanced practice nurse, his or her graduate studies can include specialized programs and a particular educational focus – starting from Clinical Nurse Leader and ending with Nurse Midwife.
The Illinois Department of Financial and Professional Regulation states that one must obtain his or her national certification before getting an APN license. All the general areas of specialty categories allow certifications from one or even more national certification establishments. One should meet his or her chosen organization’s educational and examination requirements to get the national certification. The Department of Financial and Professional Regulation licenses advanced practice nurses within the following categories: “Certified nurse practitioner (NP), Certified nurse-midwife (CNM), Certified registered nurse anesthetist (CRNA), and Certified clinical nurse specialist (CNS)” (Graduate Nursing, 2021, para. 18). At this point, it seems reasonable to identify whether the state allows full, limited, or restricted NP practice.
First, a written collaboration agreement is to be signed, as well as describe the relationship between the nurse practitioner and the supervising physician. This document should include the categories of care, treatment programs, and procedures that can be provided by the nurse practitioner. Such a state of affairs allows assuming that in Illinois state, there is a restricted scope of NP practice. However, it must be emphasized that “an Illinois-licensed advanced practice registered nurse certified as a nurse practitioner, nurse midwife, or clinical nurse specialist shall be deemed by law to possess the ability to practice without a written collaborative agreement” (Nurse Practice Act, sec. 65-43(a)). Hence, there is an opportunity to have the privilege of full practice authority, according to the relevant legislation of the state. It seems apparent that the Illinois state has flexible regulatory provisions for ANPs, which is of great benefit for the latter ones.
Then, the character of the prescriptive authority of NP in the state is founded on the discussed scope of practice. NPs’ prescriptive authority is to be described in their collaborative agreements. “NPs may prescribe prescription drugs and Schedules III-V controlled substances. Schedule II controlled substances may be prescribed if delegated by the supervising physician and if certain requirements outlined in the rules are met” (NCSLSOP, 2021, para. 8). However, when it comes to the full scope of practice, there is an opportunity to “prescribe both legend drugs and Schedule II through V controlled substances,” as well as “to prescribe benzodiazepines or Schedule II narcotic drugs, such as opioids, only in a consultation relationship with a physician” (Nurse Practice Act, sec. 65-43(c)). Thus, it might be assumed that NPs in Illinois have a substantially broad prescriptive authority in terms of full practice. Nevertheless, in the collaboration agreement, there is also a possibility to provide a nurse with a wide range of prescriptive authorities.
Nurse Practitioner (NONPF) Core Competencies
It might be rational to claim that my personal strengths in the framework of NONPF core competencies are the ones of leadership and ethics. The latter implies realizing the ethical implications within the scope of science, as well as studying to resolve ethical issues particular to my patient population (NONPF, 2012). In this regard, I should state that I always tend to analyze the ethical influence of my decisions during practice. I believe that it is the only appropriate way to achieve significant patient outcomes. Still, I fully recognize that ethical considerations cannot be perceived as a simple aspect to learn and deal with. There is a necessity to continuously enrich the personal experience and theoretical knowledge in this vein in order to be ready for the variety of complexities in this area.
Then, leadership competencies may be considered my strength as well. I have consistently demonstrated notable results in liaising efficiently between various parties – starting from patients and ending with healthcare teams. This assumption comes from the fact that there always has been positive feedback from my patients, supervisors, and colleagues regarding my abilities as a leader and notable communicator. I have never missed the opportunity to elevate the practice of my team by implementing different innovations, which also speaks in my favor in this regard (NONPF, 2012).
Moreover, it may be noted that I have opportunities for growth in scientific foundation and technology and information literacy competencies. The former is essential for applying the best practices of the evidence-based approach. Given the fact that I am still a student, I have a plethora of possibilities to be involved in the scholarly dimension, which will contribute to the development of my abilities to think critically about data, use knowledge from the humanities and other subjects to improve performance in nursing and utilize relevant research findings properly. All these are included in the scientific foundation’s core competencies. Technology and information literacy implies that I am able to deliver healthcare information to various users, apply modern technologies to manage this process, and motivate patients and care providers to make significant shifts in the healthcare environment (NONPF, 2012). Currently, I have almost unrestricted access to the related technologies and resources to advance my skills in this area.
The first scholarly activity that is likely to help in achieving NP competencies is participation in different research projects. Such an approach is expected to enrich knowledge within diversified themes and improve project-management and leadership capabilities. The involvement in continuous exploration of crucial findings in nursing – as well as many other scientific dimensions – inevitably leads to development as both a professional theoretician and practitioner. Then, it seems important to thoroughly learn provisions that regulate nurses’ practice at both the state and national levels. Realizing a legal environment in which one acts professionally is critical to providing high-quality services without any unexpected issues. Moreover, these legal provisions may contribute to a better understanding of a chosen profession.
Leadership Skills
The first leadership skill required to lead as an NP within complex systems is communication capabilities. Indeed, the way a nurse is able to deliver the necessary information and negotiate various issues with patients and colleagues determines the efficiency of the provided healthcare services and the extent of cooperation within a team – factors that considerably correlate (Lamb et al., 2018). Second, it is problem-solving; the ability of NPs to figure out appropriate decisions under stressful conditions is crucial for guiding a healthcare team to success and top-quality services provision. A true nurse-leader is to possess this leadership skill as it contributes to a smooth workflow (Lamb et al., 2018). Third, it is interpersonal skills; the degree to which a nurse can interact with others shows his or her potential to lead these people by finding a suitable approach to each one.
Furthermore, there are some strategies I could use to help develop NP leadership skills. First, it is the development of critical thinking, which would contribute to advanced problem-solving. It would include the acquaintance with many reliable publications, resolving case studies, and involvement in different nursing activities that imply the occurrence of unexpected issues. Second, it is the enrichment of nursing practice, which results in significant experience. This would involve participation in a number of voluntary nursing activities, such as taking part in non-profit organizations that aim to alleviate the consequences of Covid-19.
Conclusion
To conclude, the APN professional development plan was provided. It was achieved by discussing critical aspects in the framework of the following themes – APN scope of practice, nurse practitioner core competencies, and leadership skills. In order to support the rationale given above, evidence from reliable sources was applied.
References
Graduate Nursing. (2021). Steps to becoming an APN in Illinois. Web.
Lamb, A., Martin-Misener, R., Bryant-Lukosius, D., & Latimer, M. (2018). Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study. Nursing Open, 5(3), pp. 400–413.
NCSLSOP. (2021). State overview: Illinois. Web.
NONPF. (2012). Nurse practitioner core competencies. Web.
Nurse Practice Act, 225 ILCS 65/ (2018). Web.
Should Behavior Be Made Illegal Because It Is Considered Immoral?
Morality and legality are different terms, which stem from a similar concept of judgment on the basis of violation or adherence to certain norms and values. Hart’s views are based on distinguishing moral values from laws because morality cannot be fully reliable. Devlin suggests that these two systems should reflect each other and be unified, where a value is backed by legislation. Legal realism is centered on revealing the major flaws of laws and jurisprudence. Considering the imperfect aspect of both morality and legality, it is evident that laws should not reflect moral values, and these notions must be separable.
In order to fully understand the key distinctions between legality and morality, it is important to overview various notions on the topic. The Hart-Devlin debate is a critical aspect of evaluating pragmatism and idealism. Devlin’s views are based on the idea that any highly immoral behavior should be condemned on a legal basis in both public and private life, which meant that there needs to be a collective judgment. Hart’s perspective promotes legal positivism and pragmatism, where laws do not necessarily support morality regardless of they had overlapping areas. In other words, Devlin insisted on the inseparability of morality and law, whereas Hart encouraged distinction.
The main strength of Devlin’s philosophy is the fact that essential moral values are highly important to manifest through laws. For example, murder, theft, or torture are some of the most immoral acts, which must be prohibited by law through severe consequences. However, the weakness is the overreliance on populism, which can disenfranchise and subjugate minority groups, such as homosexuals or transgender people. Therefore, the argument that society is fully entitled to defend a shared moral structure is not convincing when these practices lead to social failures, such as segregation. This flaw stems from morality itself because the set of values is built by society. In the case of Hart’s philosophy, strength is the provision of equality for all groups. The main weakness is that a fully legal positivistic system might design immoral laws by abusing the separability of these two elements.
It is important to note that natural law theories are comprised of two major components. These are natural laws of morality and the natural rule of positive law, where the latter addresses legality or illegality. Legal positivism does not agree with the second aspect of the concept because it states that laws are mere rules imposed by certain individuals, such as kings or legislators. They do not necessarily reflect the moral values of society, and thus, they need to be separated. However, the natural law is based on goodness for people, which is righteous in itself, and therefore, laws promoting morality make them inseparable.
One should be aware that there are different schools of thought in regards to the core nature of laws. Wendell Holmes initiated the concept of legal realism, which argued that legislations on their own are inherently subjective, and judges cannot make accurate applications on the basis of a situation. In other words, the approach attempts to make jurisprudence rely solely on empirical evidence and built around its applicability rather than depending on judges for their capability for interpretation.
Moral systems have inherent issues that make them unreliable as a reflection of legality. Morality or ethics is a set of historically defined norms and views expressed in the actions and actions of people. They regulate their relationship with each other, to society, the state, a particular class, social group, supported by personal conviction, tradition, upbringing, and the strength of public opinion. From this and other definitions, it is clear that moral consciousness covers the broadest range of social relations, practically all socially significant ties. In terms of development, the distinction between ethical and legal norms is not difficult to draw. Moral standards, reflecting social life, are formed spontaneously, imperceptibly, gradually in the very public consciousness of a certain social group, class, nation, or society as a whole.
Based on the given analytical assessment, it is possible to conclude that although essential moral values are critical, they can easily lead to populism and oppression. In addition, legal realism shows that legislations on their own cannot be fully immune from flaws, such as inapplicability or misinterpretation. Therefore, laws do not necessarily reflect morality, which means that they should not be inseparable. In other words, the unification of these ideas can only be discussed if laws and jurisprudence become a perfect system that cannot be abused by outside influences. However, the unreliable nature of both rules and moral procedures leads to the fact that they need to be distinct.
In conclusion, morality and legality are different terms that possess a wide range of overlapping areas. Devlin’s ideas revolve around unifying laws and moral values, where they both become reflections of each other. However, Hart’s claims are centered on the separability of these notions due to major risks of populism and oppression, which shows the weaknesses of morality. In addition, legal realism indicates that legislations on their own have a number of limitations. Therefore, these two imperfect systems should not be inseparable, which means that they must be distinct.
Reference List
Owen, S. et al., Foundations of Criminal Justice, 3rd edn., Oxford, England, Oxford University Press, 2019.