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Domain 1: Clinical Expert - Competency 1.2 (Trauma Informed Care)

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Domain 1: Clinical Expert - Competency 1.2 (Trauma Informed Care)

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For me the most significant part of the Culturally Responsive Clinical Practice Framework is Competency 1.2. Having read the importance of recognising trauma and applying trauma-informed care, I believe it is essential to gain this knowledge as it will guide me to provide safe, supportive and culturally responsive care to people from migrant and refugee backgrounds.

I understand that many refugee's presenting to our service may have experienced traumatic, violent events and losses, and they may have undergone hardship during journeys of escape. These experiences are likely to have had a negative impact on refugees health and mental health status (Migrant & Refugee Women's Health Partnership, 2019).

As a student nurse I am developing the understanding to apply the knowledge of Competency 1.2. I will endeavour to recognise the early signs of distress, communicate effectively, refrain from asking questions that could re-traumatise the patient, and provide reassurance by explaining they only need to share information they feel comfortable sharing (Migrant & Refugee Women's Health Partnership, 2019). Respect for patient values, beliefs, dignity, rights and culture is imperative (Nursing and Midwifery Board of Australia, 2018).

References:

Migrant & Refugee Women's Health Partnership. (2019). Culturally responsive clinical practice: Working with people from migrant and refugee backgrounds-Competency standards framework for clinicians. https://culturaldiversityhealth.org.au

Nursing and Midwifery Board of Australia. (2018). Code of conduct for nurses. Nursing and Midwifery Board of Australia. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/code-of-conduct.aspx

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The World Health Organisation [WHO,] (2025) states that determinants may affect or influence the health or well-being of Ukrainian refugees arriving in Australia. Social inclusion and non-discrimination strongly shape health outcomes. Inclusion reduces these barriers and may improve health, whereas exclusion (discrimination) may detrimentally affect the outcomes of housing, financial constraints, education, and language barriers, thereby placing limitations on health, wellbeing, literacy and health system understanding (Migrant & Refugee Women's Health Partnership, 2019).

Many Ukrainian refugees speak English poorly, or not speak English well. This language difficulty may affect ability to acquire employment, hence, due to consequential financial difficulty, ability to secure housing, healthy food and or medication. All may have a negative effect on health (Chia, 2018).

It is believed that while many Ukrainians may arrive in Australia feeling physically well, health may decline due to stressors, and may spiral because of lack of familiarity with Australian healthcare services and procedures (World Health Organisation [WHO], 2025). These difficulties are strongly influenced by people seeking care and therefore may contribute to physical and mental health deterioration (Australian Refugee Health Practice Guide, 2023).

References:

Australian Refugee Health Practice Guide. (2023). Management of psychological effects of torture or other traumatic events» Australian Refugee Health. https://refugeehealthguide.org.au/psychological-effects-of-torture-trauma/.

Chia, J. (2018). Settling in Australia: The challenges. Refugee Council of Australia. https://www.refugeecouncil.org.au/settlement-challenges/3/.

Migrant & Refugee Women's Health Partnership. (2019). Culturally responsive clinical practice: Working with people from migrant and refugee backgrounds-Competency standards framework for clinicians. https://culturaldiversityhealth.org.au

World Health Organisation (2025). World Health Organisation. WHO. https://www.who.int/.

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According to the Australian Refugee Health Practice Guide (2023), Ukrainian refugees, both adults and children on arrival in Australia commonly present with psychological disorders such as depression, anxiety and post-traumatic stress disorder - likely due to severe traumatic experiences, including torture, conflict, and family separation (Chia, 2018).

Clinical screening for emotional well-being and mental health conditions should be included in the post-arrival health assessment (Australian Refugee Health Practice Guide, 2023). Continuous reviews should take place as symptoms may surface once the patient feels comfortable and safe, and a rapport has been established between the patient and clinician (Royal Children's Hospital Melbourne, 2013).

Due to language barriers, it is important that the patient has access to an interpreter to ensure they understand the health information provided. Patients with torture and trauma-related mental health issues should be referred to a psychiatrist or a psychologist. If symptoms are sufficiently severe, and interfering with the patient's functioning, the patient should be referred to the specialised torture and trauma service. Medication may be offered to help manage symptoms (Australian Refugee Health Practice Guide, 2023).

References:

Australian Refugee Health Practice Guide. (2023). Australian Refugee Health» Primary Care for People of Refugee Backgrounds. https://refugeehealthguide.org.au/.

Chia, J. (2018). Settling in Australia: The challenges. Refugee Council of Australia. https://www.refugeecouncil.org.au/settlement-challenges/3/.

Rch.org.au (2013). The Royal Children’s Hospital: The Royal Children’s Hospital Melbourne.

https://www.rch.org.au.

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References:

Danko-McGhee, K. (1999). Talismans of the Carpatho-Rusyn Woman: The Ritual Practices and Symbol System in the Art of Pysanky. Journal of Art & Design Education, 18: 307-315. https://doi.org/10.1111/1468-5949.00188

Ignatenko, I. (2016). Illnesses of Human Body: Magic and Curative Actions, Manipulations, Exerting Influence on Body Through Clothing, and Other Healing Practices in Ukrainian Traditional Culture. Heritage: Journal of Multidisciplinary Studies in Archaeology, https://www.heritageuniversityofkerala.com/JournalPDF/Volume4/14.pdf.

Ualberta.ca (2024). The Egg Ceremony https://www.artsrn.ualberta.ca/folkloreukraine/?page_id=240.