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Marli is a 7-year old Aboriginal girl from a remote community in the North West Region of NSW.

 Assessment 3 - Written Assignment Case Study - 40%

This assessment 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 1150 words will be marked, this includes headings and intext 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 lives 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 they ‘won’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 to 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 Torres Strait Islander peoples, including access, 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 that are 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 6 references, 2 of these references must be from Aboriginal and/or Torres Strait Islander authors.
Questions
1. Identify what health services and resources that you could access to help support the care of Marli and Sharon in the 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 through 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’s? (400 words)
4. Reflect on the actions and conversations from the In-charge nurse and how you felt about the situation. (350 words)

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