The+Contemporary+Health+Practitioner+-+Physician,+Psychiatrist,+Priest+and+Spiritual+Counsellor+All+in+One

Name: Liam Eagle(n8300836) Tutor: Katie Page

__**Origin of the Grim Reaper**__ The Grim Reaper known throughout western societies is personified by a humanoid shape garbed in a hooded black cloak holding a scythe. The Grim Reaper’s origin can be traced back to the time preceding the medieval era, however it wasn’t until the outbreak of the plague in Europe that this symbolic creature became synonymous as a universal message of death and suffering. This came about during the plague when several stories emerged from the less populated regions of Europe depicting hooded men in the fields with scythes and cloaked figures knocking on doors. Not too shortly after these occurrences the town and the inhabitants of the house became ill with the plague. From their on in it has become a popular western embodiment of the harbinger of death and transporter of souls to the afterlife.

__**The Link to Western Society**__ Taking into account that the Grim Reaper is considered to be more of a symbol rather then a way of life, it does however signify how views upon death can affect the way an individual will live. Cultural or primarily religious persuasions tend to influence an individual and their views on death, their own mortality and what will happen to them once they have died. This relatively simple concept is however inherently complex when the amount of differing views on death and dying is taken into account. When applied to the Australian health care system, an institution designed solely for dealing with the prevention and coping processes surrounding death. It becomes clear how issues may arise when it comes time to deal with individuals whose ideals differ from those of the health practitioner and the governing body they are employed by.

At what point in time did it become commonplace to expect doctors and nurses to be able spiritually and emotionally counsel their patients? It would appear from the extensive amounts of research on the topic that this ideology is becoming more prevalent. Throughout history generally the doctor was considered the practitioner of the body and any religious, emotional and spiritual needs were met elsewhere (Erricker & Erricker, 2001). Similarly, in Western society there was a time when spirituality was synonymous with religion, however, recent research indicates that spiritually is emerging in new contexts and can be quite separate from mainstream religious influence. Erricker and Erricker attribute this rise in spirituality to the migration of Eastern cultures into western societies who are impacting western cultural ideology.
 * __Current Research__**

Regardless of wether this rise Western contemporary spiritualty is considered beneficial or detrimental to an individual’s life, or irrespective of the perceived positives and negatives of multicultural immigration. It is the research on the patient-healthcare interactions in Australia which is relevant to understanding the methods health practitioners use or should be using to apply spiritual and cultural understanding and the important benefits it brings for a patient. Romeo (2007) argues that this sudden calling for an increase in cultural competence by health practitioners stems not only from the influx of migration but also nurses reporting cases of unequal treatment due to this lack of cultural understanding. From the brief analysis of the articles below, deductions can be made that this is clearly a prevalent and highly researched topic issue in western society.

As mentioned before there is a plethora of research being done on the health practitioner- patient interaction. The copious amounts of evidence would appear to make it difficult to argue that this is not in fact and issue that needs to be addressed. When looking at the research, in particular three research articles or predominantly aimed at promoting a higher knowledge from health practitioners on spiritual and cultural understanding, it would appear one of the reasons why a nationwide plan for Australia has not been introduced is for a lack or a realistic and thorough solution. Articles by Puchalski, Campinha-Bacote and Ekman and Emani are all similar in the fact that they focus on the spiritual and morality issues. They also look into health care interaction with patients and issues that the patient may face in the time preceding death or whilst battling serious illnesses. They highlight cases where poor communication between health practitioner and patient can lead to the patient feeling insecure and unsure of their health practitioner’s capabilities. Pulchalski proposes that a patient should be allowed to die in the comfort of their own home rather and avoid invasive treatments. Whereas Camphina-Bacote suggests that instead of forcing culturally diverse patients to conform to the dominant cultures health care system, it is the health care system that should be flexible with the culturally diverse patient. Out of the three article on Ekman and Emani provide a means of implementing there solutions in the way of a five factor model which the author believes can be used as a bridging solution between health practitioners and culturally diverse patients. It does not recommend changes to the medical system but rather a change to how health practitioners handle and perceive patients with cultural specific needs. The model encourages health practitioners to have cultural awareness, which is knowledge of their own culture and cultural knowledge and skill, which is investigation into other cultures and knowing how to apply that knowledge gained. It also emphasises cultural encounters and desire, which promotes positive attitudes and encourages direct engagement and open mindedness when dealing with culturally diverse patients.

An aspect which all of these articles like many others agree on, is the need for an increase in cultural and spiritual competency when dealing with differing beliefs. They all stress the importance for all health care practitioners, be it nurses, doctors or paramedics to have a high level of cultural knowledge. These articles also propose that from this cultural knowledge they will be best equipped to perform not only their medical duties but also spiritual and emotional counselling. The issue however, is that apart from the article by Ekman and Emani, none of the articles propose methods to overcoming these concerns.

Like the majority of articles written to promote cultural competency, the methodology used by all three of these articles is primarily theoretical. They use small scale data to validate their proposed argument and do not spend considerable effort proposing how to apply their theory in a practical scenario. A foreseeable disadvantage when writing from such a far off standpoint could be that when time comes to apply practically, the articles theoretical basis would falter as they do not take into account certain requirements that could have been ascertained if they had incorporated not only the patient’s needs but also the health care practitioners. One such example where these theories can be found lacking is the case of the paramedic. Paramedics are trained to deal with violent high stress scenarios in short periods of time (Smith & Roberts, 2003). Apart from that research has proven that paramedics as well as most other emergency personnel are prone to sleeping-disorders, depression and post-traumatic stress (Smith & Roberts, 2003). In terms of prioritising aspects which need to be addressed it would appear that for paramedics, cultural awareness is a lesser factor when taking into account the big picture.

Whilst these three articles analysed may have been found lacking in terms of the required scope of information to support the theories, the abundance of evidence that is becoming more prevalent as time goes by confirms that this is indeed an issue that will need to be addressed (Romeo, 2007). The defining factor which will determine when in the future this will happen will rely on the introduction of practical solution that not only takes into account the needs of patients but also implements realistic expectations on the medical staff as health practitioners first and cultural experts second.

“I don't dawdle. I'm a surgeon. I make an incision, do what needs to be done and sew up the wound. There is a beginning, a middle and an end.” – Dr Richard Selzer

Once being a culture which shunned cross-culturlisation, contemporary Australia now prides itself for its diversity and multiculturalism (Teicher, Shah & Griffin, 2002). From enforcing the xenophobic ‘White Australia Policy’, Australia is now showing increases in non-western religions and spirituality such Buddhism and Islam (Australian Bureau of Statistics, 2004). With this rise of ethnic and cultural minorities the issue that contemporary research is arguing, is that health practitioners do not require the skills to continue providing the same level of care for those of all cultures. Some of the argued outcomes that may occur if the issue is not addressed are the misdiagnosis of patients due to miscommunication or on a larger and long term scale the eventual deculturalisation of smaller cultures that will eventually be forced to conform to the Australian health system.
 * __Social Implications__**

There are however several levels of the healthcare system that will have to be reformed if there is any chance of avoiding the previous results. There is the responsibly that the health practitioner has to their patient as proposed by Ekman and Emani, however something rarely addressed is the responsibility of the health system as a collective agency. The regulations of the governing body to a large extent are what can determine the extent that a heath practitioner can administer care. This refers to situations where a health practitioner may have to go against regular practice procedures for the proposed benefit of the patient. An example of this in terms of a cultural scenario can be seen using the Islamic religion. When an Islamic individual is close to death they are required to face Mecca and anyone deemed ‘unclean’ should leave the room (Gatrad, 1994). They also prefer to pass in the comfort of their own home rather then a hospital (Gatrad, 1994). The obvious issues surrounding this example can clearly be seen. For most doctors, they have limited time and resources determined by the individual or individuals in control of the hospital (Geoffrey, 2007). Considering they may already be having difficulties empathising with the patients cultural views, it is easy to see how with all the restrictions applied to them, they may find it a waste of resources.

Is there any evidence on the behalf the Australian Government and health care system of making an effort to accommodate for the large number of minority cultures prevalent in society? It appears Australia’s health system is tending to favour less the one on one interaction time with patients. This can be seen with the expansion of the new super clinic program. The mission statement from a super clinic in Strathpine, Queensland which opened in January claims that they offer a wider array of diagnosis for treatment to a range of medical illness and injury whilst providing a holistic care for all patients. Yet, with only a condensed appointment window it remains to be seen if health practitioners working at these clinics are capable of giving the same amount of medical attention as well as the individual needs of the patient.

Further research into the origins of the Grim Reaper shows that western culture is not the only society throughout time that has personified death into a universally known figure. Depicted in Norse mythology, the Valkyries were female carriers that transported the souls of soldiers who died in battle. Similarly Azreal, the Angel of Death, a menacing embodiment of Islamic views surrounding death quite similar to that of the Grim Reaper. From these varying examples it shows that cultures have differing views on relatively similar concepts. Ultimately these examples of embodiments of death illustrate whilst every culture has its own view on death everybody eventually it reaches all of us regardless of our culture. Taking into account now the current conditions and discussion surrounding the drive for health practitioners to attain higher levels of cultural knowledge and application. With so many superstitions and cultural beliefs widespread in society it is easy to understand why cases of health practitioners struggling with cultural miscommunication and understanding are becoming more and more prevalent.
 * __Further Analysis of the Grim Reaper__**

**__Reference List__** Australian Bureau of Statistics. (2004). Australian social trends: Religious affiliation and activity. Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/1020492cfcd63696ca2568a1002477b5/fa58e975c470b73cca256e9e00296645!OpenDocument

Campinha-Bacote, J. (2002). The Process of Cultural Competence in the Delivery of Healthcare Services: A Model of Care. Journal of Transcultural Nursing, 13, 181-185 doi: 10.1177/10459602013003003

Ekman, S. & Emami, A. (2007). Cultural diversity in healthcare. Scandinavian Journal of Caring Science, 21(4), 417-418.

Erricker, C & Erricker, J. (2001). Contemporary Spiritualties: Social and Religious Contexts. London: Continuum International Publishing

Gatrad, A. (1994).Muslim customs surrounding death, bereavement, postmortem examinations, and organ transplants. //British Medical Journal, 309//, 521.

Geoffrey, L. (2007). Judging doctors. //ANZ Journal of Surgery, 77// (10),824–830. doi: 10.1111/j.1445-2197.2007.04252.x

Puchalski, C. (2002) Spirituality and End-of-Life Care: A Time for Listening and Caring. Journal of Palliative Medicine, 5(2), 289-294. doi:10.1089/109662102753641287.

Romeo, C. (2007).Caring for culturally diverse patients: one agency's journey towards cultural competence. Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional, 25(3), 206–213. doi: 10.1097/01.NHH.0000263439.97759.cb

Schott, J. & Henley, A. (2000). Culture, religion and patient care. //Nursing Management, 7//(1), 6-13.

Smith, A. & Roberts, K. (2003). Interventions for post-traumatic stress disorder and psychological distress in emergency ambulance personnel: a review of the literature. Emergency Medicine Journal, 20, 75-80. doi: 10.1136/emj.20.1.75

Teicher, J., Shah, C. &, Griffin, G. (2002). Australian immigration: the triumph of economics over prejudice?, //International Journal of Manpower, 23//(3), 209-236. doi:10.1108/01437720210432202

Marianna Bork - Girl please, my mascara runs faster than you do. As a male who for most of my life has played sport and enjoyed watching it, it suprises me that such one sideness can be shown against women. In particular the fact that two horses were considered in the top 10 female athletes is ridiculous. I regularly supported female sporting events at high school and enjoyed them just as much as the male events. My only question would be are you supporting the ideal that we need to compare male and female sport or should we acknowledge them as separate entities and praise women for the respective accomplishments rather then always comparing them to their male counterparts?
 * __Reflection of Articles__**

Sarah Carrol - It Ain't Easy Being Green-The politics of climate change and the public health. Don't get me wrong I whole heartedly agree with you that more emphasis needs to be put on the environment and the action required to sustain it. However, you say the Greens have the right ideas but do they have any substantial solutions to these the problems they highlight and why is that if they are so on the money they hvae trouble getting the the required votes? I know you have written to an extent why they have trouble getting the votes but have they made any attempts to cater to this fact? Other then those questions your article was quite an interesting read!