specialty focus
specialty focus
Dr Odette Best says that all nurses , not just students , need to be taught cultural safety . Image : News Corp Australia
Health bias
‘ Racism is alive and well ’: lack of cultural safety in nursing
By Erin Morley
Improving unequal healthcare starts with addressing individual bias and racism , according to former nurse Dr Odette Best , who is pro-vice chancellor of First Nations education and research at the Australian College of Nursing ( ACN ).
“ Racism is alive and well . That ’ s the reality ... our research has looked at racism experienced by both Aboriginal and Torres Strait Islander nurses and patients ,” Dr Betts told Nursing Review .
“ Cultural safety lets us understand people can be more than just their ethnicity ,” she said .
The Goreng Goreng , Boonthumurra and Yugambeh woman explained these include not asking the most basic questions . Often Indigenous patients aren ’ t asked whether they are Aboriginal or Torres Strait Islander when admitted to hospital . Instead , assumptions are made based on appearance or stereotypes .
“ What still astounds me is the lack of curriculum time [ in nursing education ] given for cultural safety and learning about Indigenous health ,” she said .
The Australian Institute of Health and Welfare published a 2018 study that found the burden of disease for Aboriginal and Torres Strait Islander people is 2.3 times that of non-Indigenous Australians , and
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Indigenous Australians were 2.5 times as likely as non-Indigenous Australians to die early , and 2.1 times as likely to live with poor health .
WHAT ARE THE GAPS ? Dr Best stressed that all nurses , not just student nurses , need to be taught about Indigenous health and safety by looking at and addressing their individual biases , along with adopting a genuine interest in culturally safe learning .
“ It ’ s about you , your values , your assumptions and your stereotypes . It ’ s not okay to be a nurse or doctor and be racist , misogynistic , homophobic or transphobic ,” she explained .
“ Cultural safety is about looking at your own behaviours and how that impacts the care you give to patients .
“ It seems to me a lot of people just don ’ t have an interest in Indigenous health to undertake research around it .”
She added that nurses who have completed their study in the last three or four years have been taught about Indigenous-specific healthcare and cultural safety , but she is concerned about nurses who weren ’ t given that opportunity when they were students .
Dr Best said there needs to be online , accessible learning opportunities that are part of nurses ’ continuing professional development hours , which are opportunities for the remainder of the nursing workforce to catch up and learn about Indigenous health .
“ Cultural safety is about looking at your own behaviours and how that impacts the care you give to patients .
“ I wasn ’ t taught anything about Indigenous health during my training , I knew it because it ’ s a lived experience for me , but I copped a lot of racism during my nursing training ,” Dr Best said .
“ We also need to support our Indigenous nurses and midwives better , because research shows we also cop racism as healthcare providers .
“ We need to have the tough conversations about calling out racism ... because whistleblowing in the nursing profession can be really difficult ; we need to provide the skills to be able to call out that behaviour .”
All ACN Indigenous curriculum content has to be endorsed by the Australian Nursing and Midwifery Accreditation Council ( ANMAC ), the regulatory authority that provides annual accreditation and professional development to nurses and midwives .
WHAT IS BEING DONE There are a number of different organisations supporting Aboriginal and Torres Strait Islander healthcare , and Aboriginal care training for all health