Acknowledging diversity in culture, values and belief systems

Acknowledging diversity in values, culture and belief systems is a crucial feature of mental health nursing. The ability to evaluate our own personal values in relation to clients and inter professional working is a critical skill, integral to the foundations of mental health nursing. A nurse must work in a non-discriminatory way that promotes dignity and self-determination (Thompson, 2016).

Beauchamp and Childress’ ethical framework, as sited by Ebbesen & Anderson et al (2012), employ the Four Principal Approach (see Appendix C for a diagram of the Four Pillar Approach). Using this frame work empowers nurses to consider Respect for Autonomy; Beneficence; Non-Maleficence and Justice, values which are expected from nurses and embodied within the Nursing and Midwifery Board of Australia’s Code of Conduct (NMBA) (Nursing and Midwifery Board of Australia, 2018). Values act as an indicator for best practice, ensuring that the care clients receive is ethical and without prejudice. Personal values and attributes effect how a mental health nurse demonstrates respect, honesty, responsibility and dignity while recognising that every individual's values are different.

My current role has a focus on ensuring that our service provides culturally safe and appropriate care to our indigenous population. In order to do so I have to had to reflect and consider what my current cultural awareness is and how my values and beliefs differ or align with that of the indigenous community. Of course, completing cultural awareness courses and attending webinars and workshops go some way to helping understand cultural differences. However, I have found that as a service provider working on the ground the best education comes from the indigenous community itself. Developing a trusting, sincere, open and non-judgemental relationship with individuals and the community seems to have an impact on health seeking behaviours and the therapeutic alliance. In some ways, everything that I have learnt about traditional evidence-based clinical interventions seems obsolete when working with this group of people. Having a “yarn” was not a clinical competency that I had to tick off. Our Indigenous clients have challenged and continue to challenge my assumptions around the engagement and delivery of healthcare to diverse groups. Many frameworks exist to help services and individuals practice in safe and culturally competent ways. However, I have learnt that it is necessary to be mindful that these practices are adapted for local use and that input from the local Indigenous communities should be sought (Taylor et al, 2018)

It would be naive and arrogant of me to think that I am culturally competent but I can argue that I am culturally aware. I believe that the most valuable learnings regarding the Indigenous people come from the people themselves and therefore it is difficult to evidence. Reflecting on these experiential learnings allow me the opportunity to demonstrate the growth of my cultural competency and awareness. I believe that services should be designed in consultation with local indigenous groups and not prescriptive to promote their dignity and self-determination. This will be a lifelong learning journey.

Ebbesen, M., Andersen, S., & Pedersen, B. D. (2012). Further development of Beauchamp and Childress’ theory based on empirical ethics. J Clinic Res Bioeth, 6, e001.

Nursing and Midwifery Board of Australia (2018). Code of Professional Conduct for Nurses in

Australia. Melbourne: Nursing and Midwifery Board of Australia.

Taylor, K., & Guerin, P. (2019). Health care and Indigenous Australians: cultural safety in practice.

Macmillan International Higher Education.

Thompson, F. (2016). The mental health nurse and recovery. Promoting Recovery in Mental Health Nursing, 144.

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