Pharmacist Tobias Speare outlines how you can encourage culturally safe and responsive practice in your pharmacy
Australia is home to a multitude of cultures, including over 250 unique and distinct cultures of Aboriginal and Torres Strait Islander peoples.
Culture may be defined as the beliefs and behaviours of family and social groups and influences the way people view and experience health and illness. It impacts the beliefs, attitudes and decisions around access and engagement in healthcare.
Being healthy in the Aboriginal and Torres Strait Islander context is not only related to the physical wellbeing of an individual. It encompasses the social, emotional and cultural wellbeing of the whole community and requires healthcare to be delivered in a culturally safe and responsive manner.
Cultural safety in healthcare means ‘to provide care in a manner that is respectful of a person’s culture and beliefs, and that is free from discrimination’. Cultural safety requires individuals to reflect on their own culture acknowledging the power imbalance brought about by dominant systems and actively seek to ensure no ‘cultural harm’ is done through actions which may impact on individuals and communities. Culturally responsive care expands on the concept of cultural safety and is an extension of patient-centred care.
It requires a health professional to reflect and respond appropriately to the unique attributes of the person, family or community with whom they interact, paying particular attention to social and cultural factors.
Culturally safe and responsive practice is critical in enhancing personal empowerment and in improving health and wellbeing of Aboriginal and Torres Strait Islander peoples. Ensuring culturally safe and responsive pharmacy services requires actions on many levels;
- Pharmacy education providers must ensure graduates attain necessary skills, knowledge and attitudes in the course of their studies
- Pharmacy service providers must demonstrate leadership and ensure governance structures are in place that support culturally safe and responsive practice; and
- Individual pharmacists, pharmacy interns and pharmacy students must seek the necessary knowledge and skills to enable them to practice in a culturally safe and responsive manner.
There are many cultural awareness, cultural competency and cultural safety courses available, both online and in-person, to assist in developing an appreciation of Aboriginal and Torres Strait Islander culture and history. However these courses are only a starting point. It is important to recognise that Aboriginal and Torres Strait Islander culture from one region is likely to be different from that of another area and the practices and beliefs will differ. Which means previous cultural orientation may not be appropriate and guidance in relation to local knowledge and practice should be sort from an appropriate person.
Occasionally cultural differences may highlight a conflict between the values and ethics which you hold and those of a patient, carer or health provider. Practicing in a culturally safe and responsive manner will assist in dealing with these occurrences and is vital in ensuring the health services you provide are appropriate to people of all cultures, not just with Aboriginal and Torres Strait Islander peoples. Culturally safe and responsive practice demands a life-long commitment to self-reflection and adaptation.
Maintaining culturally safe and responsive practice involves continuous self-reflection so that you always:
- Consider the power relationship between yourself and the client.
- Respect and value a client’s culture.
- Be ready to observe differences and learn.
- Seek clarification from someone from the culture if you are in doubt.
- Consider how to assist decolonisation through learning about the history of the local people and effects of colonisation.
Tobias Speare is the Rural Pharmacy Liaison Officer and Pharmacy Academic at the Centre for Remote Health in Alice Springs, and is a member of the Rural Pharmacy Support Network