Guest Editorial
Nurses and Aboriginal heath workers: A more meaningful partnership
Lois O'Donoghue
Aboriginal and Torres Strait Islander Commission
PP: 099 - 100
Article Text
When I became the first Aboriginal nurse to graduate from the Royal Adelaide Hospital, I never then contemplated that history would prove me a pioneer in this area and more importantly, that I would eventually head up the Aboriginal and Torres Strait Islander Commission, an organisation whose goal is to secure empowerment of Aboriginal and Torres Strait Islander peoples. Although it would be true to say that injustices for Aboriginal and Torres Strait Islander peoples begin in the cradle, I encountered my first real obstacle when I was denied entry to the Royal Adelaide Hospital's School of Nursing.
I wanted to do nursing but was denied entry because I was an Aboriginal. That was my take off point. I was not prepared to accept this set back. I lobbied members of Parliament. I confronted the State Premier and the matron of the hospital. I even spoke in the Adelaide Town Hall.
As a result of all the publicity, the matron of the Royal Adelaide Hospital allowed me to do nurse training and I graduated, became a charge nurse and stayed at the Royal Adelaide another 10 years. Since my graduation, the role of nurses has developed in many significant ways. The traditional caring role of the nurse now combines a sophisticated understanding of human behaviour, sociology and psychology, with intuition, compassion and personal commitment. Furthermore today's nurse is not only skilled in complex technical clinical interventions based upon medical and nursing diagnoses, but is also skilled in human and material resource management, planning, policy development and implementation.
The formal training and employment of Aboriginal and Torres Strait Islander peoples as Aboriginal health workers began in the late 1950s. Their role at this time was one of assisting medical and nursing staff in the provision of primary health care to Aboriginal and Torres Strait Islander communities and secondary health care in some special hospital wards.
Today Aboriginal health workers are major health care providers for Aboriginal and Torres Strait Islander communities and are essential to ensuring a more effective delivery of these health services. That is why Aboriginal health workers are demanding recognition as health professionals in their own right, for nationally accredited curricula, education and national award wages. To assist in meeting these needs, ATSIC's Board of Commissioners has endorsed 10 principles for incorporation into the development of a national ATSIC policy in relation to the education, training and development of Aboriginal and Torres Strait Islander health workers. The development of this proposed national policy position for ATSIC will involve further consultation with relevant stakeholders and when finalised, I hope it will be seen as being fundamental to policies adopted and decision making by any agency involved in Aboriginal health workers' education, training and employment.
Although Australia has one of the healthiest populations in the world, there is significant disparity between the health status of the indigenous and non-indigenous populations. Despite improvements in some aspects of Aboriginal and Torres Strait Islander health over recent decades-such as infant and child mortality rates-there has been an alarming increase in the incidence of so-called lifestyle diseases. Overall the health status of many Aboriginal and Torres Strait Islander people continues to be unacceptably low. The appalling health status of Aboriginal and Torres Strait peoples has been well documented in any number of community and government reports including the National Aboriginal Health Strategy Working Party Report, the Royal Commission into Aboriginal Deaths in Custody and the South Australian Health Statistics Chartbook.
The working relationship between nurses and Aboriginal health workers has in many cases been fruitful and rewarding for those concerned, but it does vary and difficulties have occasionally arisen. Through no fault of the people concerned, there has in some cases been mutual confusion about roles and responsibilities, and in other cases there has been a mutual sense of being threatened or undermined by the perceived role of the other.
It is vital that these misunderstandings are resolved, as both professions have important and complimentary roles to play in the delivery of health care to Aboriginal and Torres Strait Islander peoples. Indigenous health workers are a significant key to improving the health of Aboriginal and Torres Strait Islander peoples but they cannot achieve this in isolation from other health professionals. Both professions need to work together in harmony, participating in each other's education and training and complimenting each other's skills so that a best practice model of indigenous primary health care can be further developed.
To this end it may be of value to incorporate within cross-cultural and primary health care components of nurse education curricula, extensive discussion about the complementary roles and responsibilities of Aboriginal health workers and nurses.
This could be done as an affirmative action for the Reconciliation Process for Australia's Indigenous peoples in this, the International Year of the World's Indigenous peoples.
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