Reporting Obligations in Healthcare

To protect the public

Students

Treating practitioner, non-treating practitioner, education providers

Concern that the student will place the public at substantial risk of harm

Protection in good faith

Discuss with education provider

Yes

To protect the public

Being well intentioned or without malice

To protect notifiers from civil, criminal, and administrative liability, including defamation, if made in good faith.

No, it is consistent with professional conduct and an ethical responsibility.

Concerns about impairment that detrimentally affect or are likely to affect a student's capacity to carry out clinical training.

Physical or mental impairment, disability, condition, or disorder (including substance abuse or dependence) that detrimentally affects a student's capacity to carry out clinical training.

A person must form a reasonable belief based on reasonable grounds.

The space between the professional's power and the client's vulnerability.

To mark the edges between a professional, therapeutic relationship and a non-professional or personal relationship between a nurse and a person in their care.

To protect the community

It becomes unprofessional and is a misuse of power

The zone of helpfulness

Establish, maintain, and communicate clear boundaries

To prevent harm or misuse of confidential information

Check with the organization they are working at

A philosophy that seeks social justice and fairness

To respond accordingly and maintain a professional relationship

Epistemology is a theory of knowledge that explores the scope and validity of knowledge.

Social constructionism is a theory that knowledge is constructed by humans and is value- and power-laden.

Cultural safety is a model of practice that prioritizes flexible, responsive, and respectful healthcare that shares power and negotiates with clients.

Recognizing clients' needs is essential in healthcare because it prioritizes their unique perspectives and values their autonomy.

A culturally safe nurse is one who has reflected on their own cultural identity and social position and recognizes the impact on their practice.

Ongoing critical reflection is necessary for cultural safety because it helps healthcare professionals recognize and challenge their own biases and privileges.

The phrase means that all interactions between people, including healthcare interactions, are influenced by cultural factors.

Power sharing and negotiation are important because they challenge racism, class privilege, and ethnocentrism, promoting a human rights approach to health and advocating for equity.

physically accessible, close to home, affordable, appropriate, and acceptable

respecting cultural values, strengths, and differences, and recognizing that practices of the dominant culture are not the only or best way

by requiring health professionals and services to be culturally responsive and take action to overcome racism and power imbalances

delivering care based on individual needs, values, cultures, and beliefs, rather than expecting people to fit into a one-size-fits-all system

based on people's experiences of receiving health care, how health care is delivered, and the accessibility of services

to provide care that respects cultural values, strengths, and differences, and addresses racism and power imbalances

it improves access to healthcare and quality of care, and addresses racism and inequity

it requires nurses to be culturally responsive, respectful, and aware of power imbalances and cultural biases

The biomedical model prioritizes Western, evidence-based practices, which can disregard Indigenous and other marginalized groups' experiences, leading to healthcare disparities and inequities. This perpetuates dominant cultural norms, undermining culturally safe and person-centred care.

Criticisms of the biomedical model include its focus on individual responsibility, neglect of social and environmental factors, and disregard for cultural diversity. These limitations ignore the social determinants of health, which are critical in understanding health inequalities.

Social medicine recognizes the social origins of health and illness, emphasizing the impact of poverty, environmental factors, and social inequality on health outcomes. This challenges the biomedical model's focus on individual biology and behaviour.

Medicalisation can lead to the pathologisation of normal life processes, such as childbirth and menstruation, reinforcing patriarchal and capitalist ideologies that perpetuate social control and maintain existing power structures.

Social Darwinism's emphasis on individual survival and 'fitness' blames individuals for their circumstances, neglecting the role of social and environmental factors in shaping health outcomes.

Biological determinism oversimplifies the complex interactions between biology, environment, and social factors, implying that health disparities are inevitable and fixed. This neglects the role of social structures and agency in shaping health outcomes.

By emphasizing individual behaviour and lifestyle factors, health promotion programmes neglect the impact of social and environmental determinants on health outcomes, reinforcing biological determinism and social Darwinism.

Neglecting social determinants of health perpetuates health inequalities and reinforces dominant cultural norms. A sociological perspective recognizes the complex interactions between social structures, environment, and individual agency, providing a more comprehensive understanding of health outcomes.

The biomedical model assumes that the body is a machine, disease is located in the physical body, and medicine is a neutral and objective process. These assumptions lead to a narrow definition of health, reductionist approach to disease, and a focus on treatment rather than prevention.

The biomedical model's reductionist approach to disease reduces complex health issues to biological, cellular, molecular, and genetic levels, ignoring social and psychological aspects of illness. This leads to the medicalisation of normal human processes, such as ageing, menopause, pregnancy, and childbirth, which are then seen as medical problems requiring intervention.

The biomedical model's emphasis on individual responsibility and biological determinism resonates with social Darwinism's ideology of 'survival of the fittest'. Both frameworks imply that individuals are responsible for their own health outcomes, and that those who are unhealthy or ill are somehow inferior or less capable.

The biomedical model's focus on biological determinism leads to a focus on individual responsibility and blame, rather than addressing social and environmental factors that contribute to health inequalities. This can result in victim blaming, where individuals are held responsible for their own health outcomes, regardless of the social and economic context.

The biomedical model's dominance can lead to a lack of cultural safety in healthcare, as it prioritizes Western, biomedical approaches to health and disease, and fails to acknowledge the cultural and social contexts of health. This can result in healthcare that is not responsive to the needs of diverse populations, and can perpetuate health inequalities.

The biomedical model's treatment imperative prioritizes treatment over prevention, focusing on curing illness rather than preventing it. This can lead to a neglect of prevention strategies, such as public health initiatives and health promotion, which are critical for addressing health inequalities and promoting health.

The structure-agency debate highlights the tension between the biomedical model's emphasis on individual agency (i.e., individual responsibility for health) and the structural factors that shape health outcomes (i.e., social and economic determinants). This debate is critical in understanding the biomedical model's impact on health and disease, as it highlights the need to consider both individual and structural factors in addressing health inequalities.

The biomedical model's emphasis on 'lifestyle choices' implies that individuals are solely responsible for their health outcomes, and that their choices around health behaviors are the primary determinants of their health. This ignores the social determinants of health, such as socio-economic status, education, and housing, and contributes to victim blaming, where individuals are held responsible for their own health outcomes, regardless of the social and economic context.

The biomedical model influences discourse around health by shaping what is considered 'normal' and 'healthy'. This dominant discourse gives power to healthcare professionals and institutions to define health and determine healthcare priorities, while marginalizing alternative perspectives and limiting the agency of individuals and communities. This can lead to a lack of power sharing and a top-down approach to healthcare.

In the context of healthcare, social structure refers to the institutions and systems that shape healthcare, while agency refers to the ability of individuals and communities to influence their own health. The structure-agency debate suggests that social structure can constrain agency, leading to a lack of cultural safety. However, acknowledging the agency of individuals and communities can promote cultural safety by empowering them to take control of their own health.

Biological determinism perpetuates victim blaming by suggesting that individuals are solely responsible for their health outcomes due to their biological makeup. This can lead to a lack of accountability from healthcare professionals and institutions, and a lack of attention to social and environmental factors that contribute to ill health. This can result in inadequate healthcare and perpetuate health inequities.

Social Darwinism applies the concept of 'survival of the fittest' to human societies, suggesting that those who are most fit will thrive. In the context of healthcare, this can lead to a lack of attention to the needs of marginalized communities, who are often seen as 'less fit'. This can result in inadequate healthcare and perpetuate health inequities.

The objectification of patients reflects the biomedical model's focus on disease and treatment, rather than on the person experiencing the illness. This can lead to a lack of attention to cultural safety, as patients are seen as mere objects rather than individuals with their own cultural backgrounds and experiences.

Dominant discourses, such as the biomedical model, shape healthcare priorities by defining what is considered 'normal' and 'healthy'. This can lead to a lack of attention to the needs of marginalized communities, who are often marginalized or excluded from dominant discourses.

The medicalization of life processes reflects the biomedical model's tendency to medicalize normal life experiences, such as childbirth and aging. This can lead to a lack of attention to cultural safety, as individuals and communities are seen as mere objects to be treated, rather than as individuals with their own cultural backgrounds and experiences.

Power and knowledge are closely intertwined in healthcare, as those who hold power also hold knowledge and define what is considered 'normal' and 'healthy'. This can lead to a lack of cultural safety, as marginalized communities may be excluded from dominant discourses and have limited access to power and knowledge.

A human rights approach to health recognizes the inherent dignity and worth of all individuals, emphasizing the right to health as a fundamental human right. This approach is essential in addressing racism and inequity in healthcare as it acknowledges the historical and systemic injustices that have contributed to health disparities, and prioritizes the empowerment and participation of marginalized communities in healthcare decision-making.

Culturally responsive healthcare practices challenge and address power dynamics and privilege in healthcare by acknowledging and respecting the cultural diversity of patients, families, and communities. This involves recognizing and addressing the historical and systemic power imbalances that have contributed to health disparities, and prioritizing power sharing and negotiation between healthcare providers and patients.

Cultural identity and reflection are essential in culturally safe nursing practice as they enable nurses to recognize and acknowledge their own cultural biases and assumptions, and to develop a critical awareness of the power dynamics and privilege that shape their interactions with patients and families.

The concept of cultural safety addresses the intersection of power dynamics and privilege in healthcare by recognizing and addressing the ways in which healthcare providers' cultural identity and social position can influence their interactions with patients and families. This involves acknowledging and challenging the power imbalances that contribute to health disparities, and prioritizing power sharing and negotiation to promote equitable and respectful care.

Critical reflection is essential in addressing racism and inequity in healthcare as it enables healthcare providers to recognize and challenge their own biases and assumptions, and to develop a critical awareness of the power dynamics and privilege that contribute to health disparities.

The concept of cultural safety promotes a human rights approach to health in healthcare by recognizing and respecting the inherent dignity and worth of all individuals, and by prioritizing the empowerment and participation of marginalized communities in healthcare decision-making.

It requires healthcare professionals and services to be culturally responsive and take action to overcome racism and power imbalances.

Delivering care based on individual needs, respecting personal values, cultures, and beliefs, rather than expecting people to fit into a 'one-size-fits-all' system.

It enables healthcare professionals to work collaboratively with patients and communities, recognizing and valuing their cultural strengths and differences.

It enables healthcare professionals to recognize and challenge their own cultural biases and assumptions, and to provide care that is respectful of diverse cultural identities.

It recognizes the right to health as a fundamental human right, and seeks to address the social determinants of health that are shaped by cultural, social, and economic factors.

It can contribute to healthcare inequities, as individuals and groups with privilege may have greater access to healthcare resources and better health outcomes.

They protect the community by preventing misuse of power and ensuring a therapeutic relationship, and the ultimate goal is to serve the community.

Cultural safety recognizes the cultural dimensions of healthcare, addresses racism and inequity by promoting social justice and fairness, and seeks to confront discrimination and power imbalance.

Power dynamics and privilege can perpetuate health inequities, and nurses must be aware of their own privilege and biases to provide culturally safe care and promote social justice.

Cultural identity and reflection are essential in healthcare, as they promote cultural awareness and sensitivity, and nurses can cultivate cultural awareness through ongoing critical reflection and recognizing the cultural dimensions of healthcare.

Dual relationships and boundary violations can lead to misuse of power and harm, and guiding principles include avoiding dual relationships, establishing clear boundaries, and minimizing risks of harm.

Addressing social determinants of health is critical to promoting health equity, and the biomedical model perpetuates dominant cultural norms by neglecting the social determinants of health and reinforcing biological determinism.

Cultural safety addresses the limitations of the biomedical model by recognizing the cultural dimensions of healthcare, promoting social justice, and addressing power imbalance and racism.

Nurses play a critical role in promoting culturally responsive healthcare by recognizing the cultural dimensions of healthcare, addressing power imbalance, and promoting social justice and fairness.

Power struggles between senior nurses, doctors, and hospital management slowed the development of nursing in Australia, with doctors dominating nursing editorial content and limiting nurses' practices and pay.

Nursing was seen as 'women's work', and doctors excluded women from entering the medical profession, limiting nurses' practices and opportunities.

The public health movement gained momentum, leading to increased recognition of the importance of nursing and the establishment of nursing organizations and registration boards.

The trait theory, which emphasizes the importance of professionalization strategies, contributed to the dominance of medicine over nursing, limiting nurses' autonomy and opportunities.

These organizations established nursing registers and journals, requiring nurses to pass exams to practice, and paved the way for nursing registration boards and increased recognition of nursing as a profession.

The establishment of Nursing Registration Boards marked a significant milestone in the recognition of nursing as a distinct profession, paving the way for increased autonomy and regulation.

Cultural safety is essential in the Australian healthcare system to address the disparities in health outcomes between Indigenous and non-Indigenous Australians. Nurses can contribute to improving health outcomes by providing a high standard of culturally safe and respectful care, acknowledging the power dynamics in healthcare, and addressing the social determinants of health.

The biomedical model perpetuates dominant cultural norms in Australia by prioritizing individual behaviour and lifestyle factors, neglecting the social determinants of health, and reinforcing biological determinism. This approach has implications for culturally safe and person-centred care, as it neglects the cultural and social contexts of health and disease.

Power dynamics play a significant role in the nursing hierarchy, with healthcare professionals holding more power than patients. Nurses can address this power imbalance by recognizing and challenging their own power, empowering patients through education and autonomy, and promoting a collaborative and patient-centred approach to care.

Trait theory suggests that certain personality traits are inherent to a profession, such as nursing. In the context of cultural safety, trait theory can be limiting, as it neglects the cultural and social contexts of nursing practice. Culturally safe nursing practice requires recognizing the cultural dimensions of nursing and adapting to diverse patient needs.

The public health movement in late 1800s Australia contributed to the development of modern nursing by emphasizing the importance of sanitation, hygiene, and community health. The key principles of this movement included the recognition of the social determinants of health, the importance of education and prevention, and the role of government in promoting public health.

Gender roles in nursing have historically been influenced by societal norms and expectations. While nursing was initially seen as a female-dominated profession, gender roles have evolved over time to recognize the importance of diversity and inclusion in nursing practice.

Nursing regulations and codes of conduct influence nursing practice by establishing standards for ethical and professional behaviour. The implications for culturally safe care include the recognition of the importance of cultural sensitivity, respect, and empathy in nursing practice, and the need for nurses to adapt to diverse patient needs and contexts.

Social Darwinism contributes to victim blaming and the neglect of social determinants of health, perpetuating health disparities. A sociological perspective can address these limitations by recognizing the social and cultural contexts of health and disease, and emphasizing the importance of addressing the social determinants of health.

The Patel case highlights the systemic problem of medical dominance and the difficulty in challenging clinical autonomy of doctors, as well as the reluctance of juries and public authorities to sentence and jail members of the medical profession. This has implications for nursing professionals, as they may struggle to be taken seriously and have their concerns addressed.

Florence Nightingale's work laid the foundation for modern nursing, emphasizing ethical duties of confidentiality, communication, and meeting patients' needs in her book 'Notes on Nursing'.

Nursing services in late 19th century Australia were mainly provided by charity organizations, focusing on hygiene and morals, with informal training and minimal support from hospital management.

The power dynamics in the nursing hierarchy can limit nurses' autonomy, making it difficult for them to make decisions and take actions, as they may face resistance from more powerful medical professionals.

The public health movement in late 1800s Australia focused on addressing the social determinants of health, which had implications for nursing practice, as nurses were expected to address the broader social and environmental factors affecting health.

Trait theory suggests that certain characteristics or traits are inherent to a profession, such as nursing. This relates to the concept of professionalism, as it emphasizes the importance of specific skills, knowledge, and values that define a profession.

Big inequalities limit opportunities in the next generation, as rich parents have children who become rich, while poor parents have children who become poor.

Poverty is the biggest enemy of health in the developing world.

Real earnings for the top tenth have risen by 59 per cent, while for the bottom tenth they have risen by just 15 per cent.

Closing the gap in a generation requires addressing the social determinants of health that contribute to the gap.

Income inequality is a major determinant of health inequity, as it affects access to healthcare, education, and other social determinants of health.

Addressing the social determinants of health is crucial to reducing health inequities and improving health outcomes.

Professor Sir Michael Marmot implies that the underlying issue is not having the will to address inequities, and that we have the knowledge to reduce inequality, but it is a matter of what is in our hearts. This relates to the social determinants of health, such as poverty, housing conditions, and income inequality, which have a significant impact on health outcomes.

The Prime Minister's comment reflects a lack of understanding of the social determinants of health, as it implies that individuals have a choice in their living circumstances, neglecting the structural barriers and inequalities that prevent access to healthcare and other resources.

Cultural safety is significant in addressing health inequities as it recognizes the impact of cultural norms and power structures on health outcomes. It relates to the social determinants of health, such as education and housing conditions, which are influenced by cultural and societal factors.

Poverty perpetuates health inequities by limiting access to healthcare, nutritious food, and safe housing, among other essential resources. This has significant implications for healthcare, as it leads to poorer health outcomes and increased healthcare costs.

Income inequality is strongly linked to poor health outcomes, as it limits access to essential resources, such as healthcare, education, and housing. This relates to the social determinants of health, which are critical in addressing health inequities.

The biomedical model perpetuates health inequities by neglecting the social determinants of health, such as poverty, housing conditions, and income inequality, and focusing solely on individual behavior and lifestyle factors. This has significant implications for addressing health inequities, as it ignores the structural barriers and inequalities that perpetuate poor health outcomes.

Social determinants of health that contribute to health inequalities include poverty, socioeconomic disadvantage, imposed mobility of low-paid workers, lack of social protection, crowded housing, low occupational health standards, and unequal access to affordable treatment, prevention, and vaccination. These determinants impact access to healthcare by creating barriers to healthcare services, leading to poor health outcomes and increased morbidity and mortality.

Cultural and socioeconomic factors, such as poverty, education level, and occupation, significantly impact health outcomes. To address these disparities, healthcare providers must adopt culturally safe and person-centred care, recognizing the importance of social determinants of health and addressing the root causes of health inequalities.

Income inequality is a significant social determinant of health, leading to poor health outcomes and increased morbidity and mortality. Policymakers can address this issue by implementing policies that reduce income inequality, such as increasing access to education and job opportunities, and implementing progressive taxation.

Housing conditions, such as overcrowding and poor living conditions, significantly impact health outcomes. To improve housing conditions, policymakers can implement policies that increase access to affordable housing, improve housing quality, and address homelessness.

Food insecurity, or lack of access to nutritious food, significantly impacts health outcomes, particularly in marginalized communities. Food insecurity can be addressed by implementing policies that increase access to affordable and nutritious food, such as food assistance programs and community-based initiatives.

Education level is a significant social determinant of health, with higher education levels associated with better health outcomes. To improve education outcomes, policymakers can implement policies that increase access to education, improve education quality, and address educational disparities.

Healthcare providers play a critical role in addressing health inequalities by adopting culturally safe and person-centred care, recognizing the importance of social determinants of health, and addressing the root causes of health inequalities. They can improve health outcomes by providing accessible and equitable healthcare services.

Recognizing the social determinants of health is crucial in addressing health inequalities. Policymakers and healthcare providers can work together to address these determinants by implementing policies that address the root causes of health inequalities, providing accessible and equitable healthcare services, and adopting culturally safe and person-centred care.