School of Nursing, Midwifery and Nutrition, James Cook University, Cairns QLD
James Cook University, Mornington Island Hospital, Townsville QLD
PP: 107 - 108
This special issue of Contemporary Nurse on Advances in Contemporary Indigenous Health Care has finally come to fruition. It has been a difficult and challenging journey, but the outcome has made it worthwhile. Importantly, this area of health care is one that deserves special attention and we commend the editors on the decision to once again make this a feature of the journal. The authors submitted a range of interesting and important papers covering issues of direct relevance to clinical health care, such as anti-smoking projects (Robertson, 2010; Thompson, 2010), issues surrounding access to health care services (Van Herk, Smith, & Andrew, 2010), nurses' experiences caring for circumcised patients (Mangena, Mulaudzi, & Peu, 2010), and other important areas such as education of nurses, ways to increase the numbers of Indigenous students (Biles & Biles, 2010; Meissner, 2010; Stuart & Nielsen, 2010; West, West, West, & Usher, 2010), and issues related to culture (Blackman, 2010; Downing & Kowal, 2010; Rigby et al., 2010). While most of the papers submitted were from Australian authors, we were very pleased to receive and accept two papers from international authors for the special edition (one from Canada and one from South Africa). Of course there were also three invited editorials from Australian nurse leaders, including an Indigenous nurse, a Professor of Nursing, and the Chief Nurse of Australia, which set the scene for the issue.
The message coming from this body of work calls for rethinking the way Indigenous health care is delivered to ensure better health outcomes for Indigenous people. The significant gap in health outcomes between Indigenous and non-Indigenous Australians is of considerable concern, and while the Government has funded strategies to address the relevant issues, it remains relatively constant (Australian Bureau of Statistics, 2008). Furthermore, it is necessary to acknowledge the impact of Western ways of knowing and traditions on Australia's Indigenous people and how colonialism has perpetuated assumptions about Indigenous people, which contributes to their ongoing disadvantage in the Australian health care system. Until this reality is recognised and acknowledged by all, the systems of oppression that have been witnessed in the past, and their consequences, will continue to impact on the health of Australia's Indigenous people (Usher, 2010). To move forward, nurses must take up the challenge to work towards changing not only the system and how it disadvantages Indigenous people, but reflect on the role of nurses in working towards a fairer and more equitable system in the future where all Australians can expect to be treated with the utmost of respect, and have the opportunity to access health services without fear of discrimination, prejudice and racism.
Furthermore, McMurray (2010) suggests the need to shift focus away from the 'gap' itself to the source of the disparities that face Indigenous people today. For example, attention needs to concentrate on the social determinants of health, including overcrowded and poorly maintained housing, and consider the implications these have on an individual's health status. In addition, the myth that Indigenous people engage in unhealthy behaviours, which McMurray (2010) suggests is fuelled by racism, is an ongoing issue that impacts on health service access and outcomes. Most importantly, the critical role that nurses play in addressing the social determinants of health needs to be recognised, and in the context of this edition, the impact nurses can have on advancing Indigenous health care; in particular, as addressed in the other two invited editorials (Bryant, 2010; Goold, 2010), the importance of increasing the numbers of Indigenous nurses in the workforce. Increasing the numbers of Indigenous nurses in the workforce has been argued as one way of improving health outcomes for Australia's Indigenous people (West, Usher, & Foster, 2010).
Australian Bureau of Statistics (ABS). (2008). Maps and census profi les, Australian Indigenous geographical classification 2006. Commonwealth of Australia, Canberra: Australian Bureau of Statistics.
Biles, J. M., & Biles, B. J. (2010). Indigenous community participation: How does it relate to student centered learning and embrace primary health care philosophies? Contemporary Nurse, 37(1), 94-96.
Blackman, R. (2010). Understanding culture in practice: Reflections of an Australian Indigenous nurse. Contemporary Nurse, 37(1), 31-35.
Bryant, R. B. (2010). Editorial: How can nursing and midwifery help close the gap in Indigenous health indicators? Contemporary Nurse, 37(1), 8-9.
Downing, R., & Kowal, E. (2010). Putting Indigenous cultural training into nursing practice. Contemporary Nurse, 37(1), 10-20.
Goold, S. (2010). Editorial: Nurses and midwives closing the gap in Indigenous Australian health care. Contemporary Nurse, 37(1), 5-7.
Mangena, M. P., Mulaudzi, F. M., & Peu, M. D. (2010). The experiences of nurses in caring for circumcised initiates admitted to hospital with complications. Contemporary Nurse, 37(1), 71-83.
Meissner, V. G. (2010). Students' corner: Exploring Indigenous health using the clinical reasoning cycle: A student paper. Contemporary Nurse, 37(1), 84-91.
McMurray, A. (2010). Editorial: Naming and framing Indigenous health issues. Contemporary Nurse, 37(1), 36-39.
Rigby, W., Duffy, E., Manners, J., Latham, H., Lyons, L., Crawford, L., & Eldridge, R. (2010). Closing the gap: Cultural safety in Indigenous health education. Contemporary Nurse, 37(1), 21-30.
Robertson, J. (2010). Reflections on tackling tobacco: A call to arms for remote area nurses. Contemporary Nurse, 37(1), 50-58.
Stuart, L., & Nielsen, A.-M. (2010). Two aboriginal registered nurses show us why black nurses caring for black patients is good medicine. Contemporary Nurse, 37(1), 97-102.
Thompson, M. (2010). The best bang for our buck: Recommendations for the provision of training for tobacco action workers and Indigenous health workers. Contemporary Nurse, 37(1), 92-93.
Usher, K. (2010). Indigenous higher degree research students making a difference to the Indigenous health agenda. Contemporary Nurse, 37(1), 103-107.
Van Herk, K. A., Smith, D., & Andrew, C. (2010). Identity matters: Aboriginal mothers' experiences of accessing health care. Contemporary Nurse, 37(1), 59-70.
West, R., Usher, K., & Foster, K. (2010). Increased numbers of Australian Indigenous nurses could make a significant contribution to 'closing the gap' in Indigenous health: What is getting in the way? Contemporary Nurse, 36(1-2), 121-130.
West, R., West, L., West, K., & Usher, K. (2010). Tjirtamai - 'To care for': A nursing education model designed to increase the number of Aboriginal nurses in a rural and remote Queensland community. Contemporary Nurse, 37(1), 40-49.