Written Case Study - 40%

This prijrct is designed to develop students critical thinking and responsiveness

to the impacts from the social determinants of health that are impacting the
health of Aboriginal and Torres Strait Islander people’s and the culturally
responsive nursing care.

Weighting: 40% of total mark

Length: 1500 words (+/-10%). Note: only the first 1650 words will be marked,
this includes headings and in- text references but excludes the reference list.

CASE STUDY

Marli is a 7-year old Aboriginal girl from a remote community in the North
West Region of NSW. Marli attends the local primary school with her 3
brothers and 2 sisters and has never been to the city before. Over the last 2-3
weeks, Marli has not been feeling well, she has had sharp, stabbing pains in her
chest when she breathes and experiences periods where she runs out of breath
quickly when playing with her brothers and sisters. Marli also has a cough that
makes her light-headed and has a medical history of Asthma. When her mother,
Sharon asked her when she last used her ‘puffer’ she couldn’t remember, Marli
thought that not using her puffer was maybe why she was unwell. Sharon,
Marli’s mum, is a single mum and has had trouble getting Marli into see the
Doctor at the local Community Health Centre. Sharon doesn’t have a car and
her extended family members live out of town. Sharon has been quite worried
about Marli’s pains in her chest when she breathes and that she has
discolouration to her lips, they go blue after she had been coughing for a long
time. A family member offered to take Sharon and Marli to the hospital in the
neighbouring town after hearing Sharon’s concerns over the phone. The small,
10 bedded hospital has one Doctor available at all times, the Doctor was very
concerned about Marli and felt she needed urgent referral to a larger hospital
that has more resources and medical attention for Marli’s current condition.
Marli and Sharon were flown to a metropolitan hospital by the Little Wing’s
safe flight transport for treatment within 4 hours of presentation to the
neighbouring local hospital.

You are working on the Paediatric ward while on your student placement at a
metropolitan children’s hospital. The Registered Nurse you are working with
has informed you, that you are allocated a new admission from ED, a young
Aboriginal girl who has been flown in from ‘somewhere out bush’ for queried
pneumonia and potential of uncontrolled asthma. The In-Charge Nurse handing
over, seems to be unhappy about this admission, she continues to make ongoing
remarks about the appearance of the young girl and her mother and how ‘I bet
they don’t even look Aboriginal’. She continued on laughing and discussing the
admission to the other nurses on your shift and suggests that ‘they will just want
everything for free’. The Registered Nurse you are working with went bright
red and whispered to you ‘this is very inappropriate’ and she quickly turned and
rushed away from the nurse’s station. Marli and Sharon arrived at the ward soon
after, you introduce yourself and asked if you can check Marli’s vital signs.
Marli doesn’t look at you but looks at her Mum. Sharon apologises and states
that Marli has never been on a plane and they are both feeling scared as they
have never left their hometown before and never seen a hospital this size.

Please answer the following questions and consider what you have learnt from
weekly learning materials:

*DON’T FORGET:

In your answers you must consider:

 -  The social determinants for Aboriginal and/or Torres Strait Islander

peoples, including access to healthcare,

funding, housing, employment, infrastructure and education.

 -  Present health care inequalities and strategies/promotion/frameworks

that are current in today’s health care

system.
- Potential personal biases and/or personal lens relating to Aboriginal and
Torres Strait Islander peoples.

Your work must be supported by relevant, contemporary literature (from

within the last 10 years) and a minimum of 8 references, 2 of these references
must be from Aboriginal and/or Torres Strait Islander authors.
THIS IS NOT A CLINICAL CASE STUDY AND IS NOT TO BE
ANSWERED WITH CLINICAL TREATMENTS OR CLINICAL
DIAGNOSISES. THIS IS ABOUT CULTURALLY APPROPRIATE
CENTERED CARE.

Questions

1. Identify what health services and resources that you could access to help
support the care of Marli and Sharon during their hospital admission?
And why it is important to use culturally appropriate resources? (350
words)

2. Identify and describe how you could encourage and engage a culturally
safe environment for Marli and Sharon throughout their admission? (400
words)

3. Briefly describe the social determinants of health and inequalities that

Marli and Sharon are facing to receive adequate health care for Marli?
(400 words)

4. Reflect on the actions and conversations from the In-charge nurse and
how you felt about the situation. Consider your own personal biases/lens
that may impact this. (350 words)