ESSAY FLASHCARDS

Question 1

What are the introductory first couple of sentences for Principle One: Of the principles of the Treaty of Waitangi.

Answer 1

Principle One: Tino rangatiratanga enables Maori self-determination over health, recognises the right to manage Maori interests, and affirms the right to development by: facilitating Maori to define knowledge and worldviews and transmit these in their own ways (indicator - 1.3). I demonstrated the application of this principle by the Whakawhanaungatanga element of the hui process. This element involves connecting with the Turoro and any whanau, at a personal level, through the understanding of Te Ao Maori and self-disclosure of relevant Maori beliefs, values, and experiences.

Question 2

What are the introductory first couple of sentences for Principle Two: Of the principles of the Treaty of Waitangi.

Answer 2

Principle Two: Partnership involves nurses working together with Maori with the mutual aim of improving health outcomes for Maori by: acting in good faith as treaty of waitangi partners (indicator - 2.1). I demonstrated the application of this principle by the poroporoaki element of the hui process. This element is based on the finishing point of an encounter and ensures clarity, for the turoro and whanau, regarding the next steps.

Question 3

What are the introductory first couple of sentences for Principle Three: Of the principles of the Treaty of Waitangi.

Answer 3

Principle 3: The nursing workforce recognises that health is a taonga and acts to protect it by: promoting a responsive and supportive environment (Indicator - 3.4). I demonstrated the application of this principle by the Mihimihi component of the hui process. This element is based on the initial greeting and encounter with the turoro and whanau.

Question 4

What are the introductory first couple of sentences for Principle Four: Of the principles of the Treaty of Waitangi.

Answer 4

Principle 4: The nursing workforce recognises the citizen rights of Maori and the rights to equitable access and participation in health services and delivery at all levels through: facilitating the same access and opportunities for Maori as there are for non-Maori. I demonstrated the application of this principle by the Kaupapa element of the hui process. The Kaupapa element is based on attending to the main purpose of the encounter i.e the clinical task.

Question 5

What element of the hui process am I using for - “The nursing workforce recognises the rights of Maori and the rights to equitable access and participation in health services and delivery at all levels through”: facilitating the same access and opportunities for Maori as there are for non-Maori (indicator - 4.1).

Answer 5

Kaupapa.

Question 6

What element of the hui process am I using for - Principle 3: The nursing workforce recognises that health is a taonga and acts to protect it by: promoting a responsive and supportive environment (Indicator - 3.4)

Answer 6

Mihimihi

Question 7

What element of the hui process am I using for - Principle 2: Partnership involves nurses working together with Maori with the mutual aim of improving health outcomes for Maori by: acting in good faith as treaty of waitangi partners (indicator - 2.1)

Answer 7

Poroporoaki

Question 8

What element of the hui process am I using for - Principle One: Tino rangatiratanga enables Maori self-determination over health, recognises the right to manage Maori interests, and affirms the right to development by: facilitating Maori to define knowledge and worldviews and transmit these in their own ways (indicator - 1.3)

Answer 8

Whakawhanaungatanga

Question 9

What element of the meihana model am I using for: Principle 1: Cultural safety aims to improve the health status of New Zealanders and applied to all relationships through: Indicator 1.2: Nurses acknowledging the beliefs and practices of those who differ from them.

Answer 9

Whanau

Question 10

What element of the meihana model am I using for: Principle 2: Cultural safety aims to enhance the delivery of health and disability services through a culturally safe nursing workforce by: Indicator 2.2: empowering the users of the service. People should be able to express degrees of perceived risk or safety. For example, someone who feels unsafe may not be able to take full advantage of a primary health care service offered and may subsequently require expensive and possibly dramatic secondary or tertiary intervention.

Answer 10

Wairua

Question 11

What element of the meihana model would I use for Principle 3: Cultural safety is broad in its application: Indicator 3.5: Concerning quality improvement in service delivery and consumer rights

Answer 11

Taiao

Question 12

What element of the meihana model would I use for: Principle 4: Cultural safety has a close focus on: Indicator: 4.1: Understanding the impact of the nurse as a bearer of his/her own culture, history, attitudes and life experiences and the response other people make to these factors.

Answer 12

Iwi katoa

Question 13

What is my example to clinical practice for Principle One: Tino rangatiratanga enables Maori self determination over heath, recognises the right to manage Maori intrests, and affirms the right to development by: Facilitating Maori to define knowledge and worldviews, and transmit these in their own ways - whakawhanaungatanga.

Answer 13

Whakawhanaungatanga is all about making a ‘connection’. It involves connecting with the Turoro and any whanau, at a personal level, through the understanding of Te Ao Maori and self-disclosure of relevant Maori beliefs, values, and experiences. “During a discussion with a Maori turoro, I asked ‘What side of your whanau is Maori, Maternal or Paternal?’. As a result, this question facilitated at meaningful discussion regarding our whenua and wairua. Through the self disclosure of our understanding of Te Ao Maori, Maori beliefs, values and experiences, the turoro felt confident enough to take control of the discussion. They were able to explain their worldviews and define their own knowledge in a way that enriched their mana and deepened my understanding of the interests of this turoro. Through this encounter I was able to form a connection with the turoro and understand the importance of Maori self-determination over health. This is important to consider as the turoro world view differs to the typical western models of health I.e the biomedical model of health”

Question 14

What is my example to clinical practice for: Principle 2: Partnership involves nurses working together with Maori with the mutual aim of improving health outcomes for Maori by: Indicator: 2.1: acting in good faith as Treaty of waitangi partners. - Poroporoaki.

Answer 14

I demonstrated the application of this principle by the poroporoaki element of the hui process. This element is based on the finishing point of an encounter and ensures clarity, for the turoro and whanau, regarding the next steps. During the end of an enchounter, I worked alongside the turoro and whanau to enable the continuation of improved health outcomes. This was achieved through discussion, planning of care, and consultation with other members of the health care team. For example, after discussion with the turoro, whanau, nurse, and MDT I assisted in booking the Turoro to meet with the Pukena Atawhai, a specialist in tikanga Maori and culturally responsive care. During this process, I ensured I understood what the turoro and whanau had told me, ensured the turoro and whanau understood what I said (re treatment plan, and suggestion to meet the pukenga atawhai), and finally ensured the turoro and whanau had understood what the next steps are following this encounter. I.e attending planned meetings or monitoring changes in mental/physical state ect. In attending to these three steps I worked in partnership with turoro, whanau, and health care team in order to improve health outcomes for this turoro and whanau, hence acting in good faith as a treaty of waitangi partner.

Question 15

What is an example to clinical practice for: Principle 3: The nursing workforce recognises that health is a taonga and acts to protect it by: Indicator: 3.4 - Promoting a responsive and supportive environment. - Mihimihi

Answer 15

I demonstrated the application of this principle by the Mihimihi component of the hui process. This element is based on the initial greeting and encounter with the turoro and whanau. The mihimihi is the foundation for the rest of the hui process hence the initial encounter with this turoro and whanau needs to be inclusive and supportive to enable a supportive and inclusive environment. This then enables self disclosure of information, aiding in whakawhanaungatanga and kaupapa. For example when I first met the Turoro and Whanau, I said Morena instead of good morning, stated my name and role, and asked the patient how they would like to be addressed. Then I introduced myself to each member of the patients whanau. Whist interacting with the whanau I gathered a sense of how much te reo this whanau used and adapted the amount I used when talking to them. In doing this I created a supportive environment by including the use of te reo in my practice. As well as including the wider whanau in the initial encounter to enhance mana for the turoro and whanau”

Question 16

What is my example to clinical practice for: Principle 4: The nursing workforce recognising the citizen rights of Maori and the rights to equitable access and participating in health services and delivery at all levels through: Indicator: 4.1 - Facilitating the same access and opportunities for Maori as there are for non-Maori. - Kaupapa

Answer 16

I demonstrated the application of this principle by the Kaupapa element of the hui process. The Kaupapa element is based on attending to the main purpose of the encounter i.e the clinical task. During my clinical placement, I was asked to work alongside a Maori turoro and non-Maori patient. I made sure to acknowledge the rights of the Maori turoro to equitable access and participation in health services, by utilizing Maori models. For example when I first met with the Maori turoro I begun the process of the hui process and used the meihana model during history taking (subjective data). We can use the meihana model to extend the standard history taking process for Maori. Using these models enabled me to look at this turoro as apart of a wider whanau that should be engaged with for both interventions and assessments.

Question 17

What is my example to clinical practice for: Principle 1: Cultural safety aims to improve the health status of New Zealanders. Indicator 1.2: Nurses acknowledging the beliefs and practices of those who differ from them.

Answer 17

Cultural safety aims to improve the health status of New Zealanders. I applied principle one, with an emphasis on acknowledging beliefs and practices of those who differ, to the whanau components of the Meihana Model. The patient identifies as Māori and whānau are support networks. By utilising the Hui Process, a Maori health framework to work with patient and whānau I ensured there was an emphasis on health gains and positive health outcomes. by including whanau in assessment, and intervention processes. Ensuring I held these encounters in a space which allowed for whanau involvement, within the clinical setting. Whanau should have the opportunity to identify what level of cultural input that they want to engage in and to give feedback to. As provided by keeping whanau ‘in the loop’, hence acknowledging the beliefs and practices of Maori to improve health outcomes for maori.

Question 18

What is my example to clinical practice for: Principle 2: Cultural safety aims to enhance the delivery of health and disability services through a culturally safe nursing workforce by: Empowering the users of the service. People should be able to express degrees of perceived risk or safety. For example, someone who feels unsafe may not be able to take full advantage of a primary health care service offered and may subsequently require expensive and possibly dramatic secondary or tertiary intervention.

Answer 18

I applied principle two, with an emphasis on empowering users of the service, to the wairua component of the meihana model. Wairua extends beyond the potentially limited focus of western paradigms. In my clinical practice I ensured the turoro felt safe and welcome by respecting tikanga. This enabled the patient to build ‘attachment’ to the service. This important as it can decrease non-attendance to the service and enable the patient to openly voice any barriers to accessing this service. In my clinical practice, this enabled the turoro I have been working with to express their concern over receiving care. They states they did not feel safe in the hospital as this was not ‘home’. I was able to utilise whanau support alongside using theraputic interventions to make their space ‘safer’ for their stay in hospital. Hence, enhancing the delivery of health services while also empowering Maori service users.

Question 19

What is an example of my clinical practice for: Principle 3: Cultural safety is broad in its application: Concerning quality improvement in service delivery and consumer rights.

Answer 19

Cultural safety is broad in its application. I applied principle three, with an emphasis on quality improvement, to the Taio component of the meihana model. This component involves ensuring services are accessible to client/whanau, encouraged health care workers to seek understanding of the physical environments of the patient/whanau, and explores client/whanau satisfaction with the service. During my clinical practice, I worked with a turoro and whanau that were from down south. Hence, to enable the mother to stay at the unit and support the admission for the turoro, I set up the whanau room i.e made the bed and provided blankets and towels. The mother of the turoro then had to leave to attend to business at their family home. I took on the roll of organising taxi and shuttle services in order to promote and enable accessible services for this turoro and whanau.

Question 20

What is an example of my clinical practice for: Principle 4: Cultural safety has a close focus on: Understanding the impact of the nurse as a bearer of his/her own culture, history, attitudes and life experiences and the response other people make to these factors.

Answer 20

I applied this principle to the Iwi katoa element of the meihana model. This dimension challenges nurses to be reflective that their own social reality may be quite different from that of Maori client/whanau, and how this difference might impact effective delivery of care within the service. During a discussion with the Turoro, I encouraged them to self-reflect and explore pt/whanau experiences around societal beliefs and values to determine the impact of things as low socioeconomic status, racism, and other prejudices and how these may at as barriers to wellness. This provided me with important information, such as previous event of racism within a healthcare service, hence enabling the development of my assessment and intervention planning, that better matches the social reality of this turoro/whanau.