Welcome to the first 2015 edition of our newsletter – we have much to share with you. In the last few months CATSINaM has been very active on a national level, raising the profile of Aboriginal and Torres Strait Islander nurses and midwives, cultural safety, the ‘Close the Gap’ campaign, and the importance of recruiting Aboriginal and Torres Strait Islander Australians into the profession and – critically, retaining them.
We have been preparing for the post-June 2015 period, as our current funding contract ends in June this year, which included meeting with Senator Fiona Nash and her office, as well as the Department of Health. Like many Aboriginal and Torres Strait Islander organisations our future funding is uncertain as the Australian Government decides on its budget priorities. However, we are forging ahead with the belief that the work we do should continue, so we must progress our current work and lay foundations for new initiatives. Please see our articles on the CATSINaM Mentoring Program and the National Professional Development Forum.
As we write, we await the outcomes of the CATSINaM 2015-2018 funding proposal to the Department of Health. We will notify our Members of the outcome as soon as it comes to hand.
As always, I hope you enjoy reading our newsletter and that you take the opportunity to participate in our initiatives.
Cultural Safety and Respect Training
Our work to advocate the importance of cultural safety to our stakeholders begs an important question: Do they know what it is? Quite frequently we find that people are not clear or they mix it up with cultural awareness. For this reason, CATSINaM offers a two-day workshop for stakeholders – the first was in November 2013 and the second in July 2014. We plan to hold our fourth workshop in July 2015 provided we are refunded.
We encourage senior people in national nursing and midwifery organisations, educational organisations and state/national government to participate. We want them to develop a shared understanding of what cultural safety is, and what they need to consider in creating cultural safety for Aboriginal and Torres Strait Islander nurses, midwives and community members.
Our third workshop was held on February 17-18th
2015, once again facilitated by Sharon Gollan and Kathleen Stacey. We were delighted to have a diverse range of 19 people from our stakeholder groups attend, and also complete a brief evaluation survey about their experience. Most participants commented on the value of self-reflection and gaining new personal insights.
“The workshop provided me with a deeper insight to the situation of our society, into myself and where I sit on my journey.”
“It invoked deeper thought and consideration of the history of Australia, my heritage and the everyday experiences of what it is to be Aboriginal or Torres Strait Islander.”
Participants can find the workshop challenges their previous worldview or what they thought they knew and understood, but they described it as “directional, probing and confronting in a positive supportive way”, which “enabled the challenging questions to be addressed both internally and with my peers.”
Importantly for us as Aboriginal and Torres Strait Islander nurses and midwives, participants consider what they need to or can do differently – for example:
“I have been able to process ways that I can be more inclusive at personal, team and organisational levels to support Aboriginal and Torres Strait Islander people I care and work with.”
“How to make my service Aboriginal and Torres Strait Islander friendly.”
“Better consultation is required with our Aboriginal and Torres Strait Islander colleagues and stakeholders.”
It is important that our stakeholders take responsibility for providing cultural safety training to all of staff in their organisation, particularly if they are larger organisations. This is starting to occur – the University of Sydney, School of Nursing and ANMAC have done this. The Australian College of Midwives has now put almost all of their small staff team through the CATSINaM workshops, and they are working closely with us on a joint policy position paper on ‘Birthing on country’ – we will share more about that in our next newsletter.
We also received this testimonial from Christopher Cliffe, the CEO of CRANAplus
, soon after he attended the February workshop that he shared with the CRANAplus
"I was very fortunate to attend a ‘Cultural Respect Training Program’ last week that is provided by our close friends at CATSINaM. I, like many of you, have done many sessions over the years around ‘cultural awareness’, however this was not like any other I’ve ever done! It was an engaging couple of days that not only spelt out the four dimensions of racism (prejudice, discrimination, ideological and institutional), but also provided real life day-to-day examples. The concept of ‘white privilege’ was also unpacked, but not in a derisive way, that gave clarity to the lens in which the dominant white culture in Australia views the effects of colonization and racism.”
National Summit on Cultural Safety in Nursing and Midwifery
In November 2014, CATSINaM hosted the first National Summit on Cultural Safety in Nursing and Midwifery to be held in Australia. It was attended by almost 50 people over two days in Canberra representing nursing and midwifery peak bodies, universities, state/territory health departments and the Australian Government Department of Health.
We were delighted that it was opened by Dr Tom Calma, after a Welcome to Country from Matilda House, with Dr Gregory Phillips facilitating it. You may know Gregory from his involvement in establishing and running the Leaders in Indigenous Medicare Education (LIME) network, and as the consultant who researched and wrote the 20089 report ‘A blueprint for action: Pathways into the health workforce for Aboriginal and Torres Strait Islander People’.
We had two objectives for the Summit. The first was to “explore the strengths and weaknesses of current work on cultural safety in nursing and midwifery”. We heard from experienced Aboriginal and non-Aboriginal presenters about how they are doing this in their services and universities. We also invited participants to self-assess their organisation’s cultural safety practices so they could think about what else they need to do in strengthening cultural safety – participants found this valuable and sometimes surprising.
The second objective was to identify how we can work together so these three areas can be achieved:
- increased understanding and shared commitment to cultural safety in the nursing and midwifery professions
- enhanced recruitment and retention of Aboriginal and Torres Strait Islander nursing and midwifery students and graduates in the health workforce
- better health outcomes for Aboriginal and Torres Strait Islander Australians through all nurses and midwives providing culturally safe services
In short, we wanted to gain support from participants for establishing a ‘Leaders in Indigenous Nursing and Midwifery Education Network’ or LINMEN. We heard the story of the LIME Network and gained participants opinions about whether nursing and midwifery should do this. The decision was a resounding yes, so we explored how we could make it happen. We finished the day with a decision to establish a lead steering group of six people representing CATSINaM, ANMAC, ANC, ACM and the Council of Deans of Nursing and Midwifery.
Not only was the Summit well attended – it was well received. Participants paid tribute to CATSINaM’s leadership in promoting cultural safety and making the Summit possible. Further, participants reinforced the importance of CATSINaM maintaining leadership on cultural safety, although the work to improve the professions’ integration and implementation of cultural safety is a shared responsibility
2015 Member CPD Forums - bring a student!
We are back on the road this year, this time to provide half-day Continuing Professional Development Forums to Members and potential Members. The focus is on ‘cultural safety and resilience’, as well as gaining an update on what CATSINaM is doing. We learned from our consultations with Members and students over the last 18 months that this is a high priority topic.
Last year we visited Nhulunbuy, Cairns, Townsville, Newcastle, Perth, Adelaide and Melbourne. This year’s schedule is:
- Melbourne, April 13th
- Sydney, May 6th
- Adelaide, May 18th
- Brisbane, June 10th
- Perth, July 21st
- Broome July 22nd
We are contacting universities in these locations so they can encourage their students to attend. BUT, we would love your help to ‘talk up’ the Forums with other Members and potential Members, and especially with student nurses and midwives. This is a unique opportunity to bring them into the CATSINaM fold and provide them with collegial and cultural support from an early stage in their career.
2015 Stakeholder meetings
We are also holding formal stakeholder dinner meetings in most of the forum locations. We held our first one in Canberra in December 2014. This was well attended, with 10 participants from three universities, Australian Government Department of Health, ACT Health, one hospital, a nursing/midwifery peak body and an Aboriginal peak body.
Participants heard about the previous and current work of CATSINaM, our priorities and future directions. Through this they discussed what were shared priorities and opportunities for possible collaboration. We will repeat this process with invited stakeholders in Melbourne, Sydney, Brisbane, Adelaide and Perth over the next four months. As this turns into greater support and collaboration with CATSINaM, hopefully joint projects that address our priorities, we will let you know.
Mentoring program update
We are continuing our work to turn the CATSINaM Mentoring Program into a reality – this is what we are currently doing.
- We are engaging curriculum developers to write the Mentor Training Program, and help us develop the formal documents we require for running the program.
- We have established a Mentoring Course Advisory Group that will start meeting in April.
- Through our new membership application forms, we ask new Members if they are interested in receiving mentoring or being a Mentor.
- We are talking about the Mentoring Program at the 2015 Student and Member Forums, and Stakeholder Dinners.
- We are talking with universities and employers about the importance of mentoring, including through the Stakeholder Dinners, and identifying if they want to be involved in the CATSINaM Mentoring Program – in particular, in funding it so their students or graduates can participate.
Getting these foundations in place is vital so we can move ahead with more certainty once we know our funding situation beyond June 2015.
CTG Parliamentary Breakfast
On March 4th
, CATSINaM held an official ‘Close the Gap’ Parliamentary Breakfast, at which Senator Fiona Nash, Assistant Minister for Health, and Senator Claire Moore on behalf of Warren Snowdon MP, Shadow Parliamentary Secretary for Indigenous Affairs spoke. We were delighted to have over 60 guests, including 20 parliamentarians, in attendance – feedback from Parliament House staff was that this is a good turnout!
Janine Mohamed addressed the audience, along with two wonderful CATSINaM Members. Sye Hodgman is a proud Palawa man from Tasmaina who lives in Melbourne working as a Project Coordinator focused on Aboriginal health in the public health sector. Katarina Keeler is a proud Kokatha woman from South Australia who now works as a Registered Nurse at the Royal Darwin Hospital. They shared why they chose a nursing and midwifery career and the importance of the Close the Gap campaign, while linking this to CATSINaM’s priorities. Here are some excerpts from their speeches.
Simon Hodgman: “Close the Gap is important to me because my family and my community are full of kind and generous people and they deserve parity. I chose this career because I have always wanted to give back to a community that has provided so much support to me.
I have been fortunate to be surrounded by truly inspiring positive role models, from my family to my friends, who have been true drivers for change in Aboriginal health. I hope I can provide the same inspiration to others as they have for me. This career has benefited me by allowing me to be a voice and driver for the change I envision. Not waiting and hoping on others to do it for me.”
Katarina Keeler: “I wanted to become a nurse as I had many experiences with sick family members and early deaths. These early morbidity and mortality rates were being normalised in Indigenous communities but, I knew this wasn’t right. I wanted to help prevent these things from happening, so from then on I knew that being a nurse was the way to help Indigenous people achieve a long and healthy life and no longer be just a statistic.It wasn’t an easy transition to move away from my community and family, and let alone being the first person in my family to go to university.
I faced many hardships when I moved to Adelaide however, my strong passion and dedication to give back to the community and to help reducing the gap in Indigenous health, helped pushed me through these obstacles.”
Janine Mohamed: “In opening today, I emphasised CATSINaM’s deep commitment to recruiting and retaining more Aboriginal and Torres Strait Islander nurses and midwives in health services, and playing an active role in collective efforts to address health inequity and Close the Gap. This requires shared effort and commitment, so we greatly appreciate the work that our partners do in this regard.In closing, I want to share two other areas of passion. First is getting our young people to believe that becoming a nurse or a midwife is a real possibility. This creates other outcomes such as employment, economic opportunities, and better health literacy at personal, family and community levels.The second area is about creating a health system our people want to access. This is a culturally safe health system. Aboriginal and Torres Strait Islander Australians interact with all parts of the system, not just dedicated Aboriginal and Torres Strait Islander health services or programs. Due to the limited numbers of Aboriginal and Torres Strait Islander nurses and midwives, they usually work with non-Indigenous staff – staff who need to both understand the meaning of cultural respect and offer services that are experienced as culturally safe.We are working hard to assist non-Indigenous nurses and midwives to be better equipped for working with our people, through collaborative work with our partners and other national Aboriginal health organisations, including the National Health Leadership Forum.”
CATSINaM wants to acknowledge our stakeholders who supported us in this event by their presence and contribution of time and/or resources to make this happen. They include the Australian College of Nursing, Australian College of Midwives, Australian Primary Health Care Nurses Association, Australian Nursing and Midwifery Accreditation Council, Australian Nursing and Midwifery Federation, CRANAplus and the Australian College of Mental Health Nurses.
Senator Fiona Nash, Assistant Minister for Health
Representation on the ANMAC Board
CATSINaM owes a deep vote of thanks to Faye Clarke, our then Victorian Board Member, who represented CATSINaM on the ANMAC Board for five years. As of April 2015, she handed over this role to Janine Mohamed. In reflecting on the personal highlights and the next steps for ANMAC in their relationship with CATSINaM, Faye said:
“Being on the ANMAC Board allowed me to see from a national and peak level what it means for our priorities in CATSINaM to get more Aboriginal people through nursing, to see how that big system worked. I got to see their governance as a mainstream organisation, which was quite different to our approach, with many senior people - CEOs, the Chair of the Council of Deans, and heads of each partner organisation. The personal learning was a fantastic opportunity.”
“In terms of ANMAC and CATSINaM’s relationship, they were very used to having CATSINaM at the table, they were pro our causes. Having said that, a focus on Aboriginal nurses and midwives did not have its own agenda item, more of those considerations for happened at the sub-committee level….The Board were starting to realise they needed to do that if the CATSINaM representative is going to contribute to their full capacity.”
“I think that attending the National Cultural Safety Summit [in November 2014] opened their eyes to more things they could do as an organisation, so they are looking now to go deeper. So, having the CATSINaM CEO on the Board is a good move. Janine will help them progress what ANMAC can do at a strategic and operational level to contribute constructively to strengthening the presence of Aboriginal and Torres Strait Islander nurses and midwives in the profession.”
Making a difference - nursing in mental health and drug and alcohol contexts.
An interview with CATSINaM Member, Dr Rhonda Wilson
From the simple question of “Why did you choose nursing?”, Rhonda Wilson shared the following story about having a sense of purpose and desire to make a contribution to families and communities impacted by mental health challenges and drug and alcohol use. Through it she has put out a call to all of us, both Aboriginal and Torres Strait Islander and non-Indigenous nurses and midwives, to step up into what is frequently considered a less popular area of nursing, as we have significant capacity to make a difference. As Rhonda says, be a “tall poppy – we need more tall poppies”.
“I grew up in a rural area,
on a sheep property, not knowing my Aboriginality until later in life. I have always identified very closely with rural communities in general, and as I reflect back on my childhood, I recognise that my mixed cultural identity is also part of my intrinsic make up. My connection to country, place and people has always been inherent. Later, I discovered my Grandmother’s story and her (and my own) Wiradjuri descent, a secret held by her in a time where the freedom of women, and especially Aboriginal women, was extremely limited. I think she did what she needed to do in her time; however, in her own way, she passed on culture which I now hold (and share) with pride. Because of her sacrifices I am now able to do what I need to do in my time. My Grandmother’s actions, no doubt, her survival strategy, have provided me with a legacy and the privilege to choose to contribute to the health and well-being of Indigenous people as an insider – an Aboriginal woman myself.
My identity as a rural Aboriginal woman and nurse, mother and wife is the fabric of who I am and this helps to explain my passion for caring for rural young people in particular. My rural upbringing has influenced me to care for people, community, environment and country – for me, all are infused together. Today we call this health ecology, but I didn’t know about this as a child. I just knew people and the environments they interacted with influenced health and wellbeing. I always had wanted to help out someone or something that was unwell, and try and make that right. I think nursing has been part of my make-up as a person.
I didn’t know what I wanted to do when I left school at Year 10. I worked in retail and a range of different areas, including hospitality, while I worked out how to make meaning of my life in my country town. I saw an opportunity to do enrolled nursing, which I took and discovered that I absolutely loved nursing. In fact, I loved everything about it, helping people, making people well, the whole health environment. So I always knew from the first moment I put my little purple button-up training enrolled nursing uniform on that I needed to do nursing, and that eventually I would do it at a high level.
I had a moment in an orthopaedic ward during my trainee enrolled nursing time back in 1987 - it is still as crystal clear today as it was then - that I needed to become a PhD in Nursing. A very brave thing for a country girl to dream – especially one who didn’t finish school! That took until last year to come to fruition. A long time to follow a dream! I knew I had a contribution to make. It was a crystallising moment that this was what I had to do. There were lots of bumps along the way. It wasn’t easy to get into university to study nursing and it is a hard course of study. I was the first person in my family to go to university.
I have since spent my entire career in rural and regional areas, places like Townsville, Mildura, Dareton (an Aboriginal community near Mildura), Goondiwindi, Boggabilla, Toomelah and Armidale. What I discovered was that I really loved working in mental health. The people who needed help in this area were the most vulnerable people I could imagine. I had a sense of compassion that went out to people and I also worked with people with drug and alcohol problems, so I specialised in mental health and drug and alcohol, probably the most unattractive aspect of nursing from a professional point of view.
What I have learned from my time specialising in this area, is that of the 100s, probably 1000s, of people I have helped, I never met a single person who set out in their life to become addicted to drugs and have their life spiral out of control. No one wants to have that happen. So to have the opportunity to help people get out of a downward spiralling situation and restore some hope in their life has been enormously satisfying personally.
What I discovered in my clinical practice in rural areas was that people had durations of untreated early psychosis of between two and ten years. We were seeing people up to 10 years later than if they lived in urban areas! It meant that people who were late 20s/early 30s were seeking help for the first time. This became my Master’s degree - looking at barriers to accessing services for early psychosis in rural areas. That led on to my PhD on rural young people and their emergent mental health problems, and my current teaching specialty on mental health nursing.
We have large populations of Aboriginal Australians where I do my research. The things I have noticed have led to my new proposed research work on how we can build strength and resilience among young Aboriginal people around mental health problems, particularly methamphetamine use and early psychosis. This was apparent in my doctoral research where young Aboriginal people were using drugs like ice or methamphetamine at levels I hadn’t seen used before, and causing an incredible amount of harm.
The situation is quite hopeless for people who are caught in using and misusing addictive drugs, as they are highly addictive, associated with very significant mental health problems like early psychosis, and a great deal of violence and anger. When those things all start to happen, vocational delay and disrupted brain development result. People don’t complete education and don’t make a transition into vocations. They don’t develop lifelong ‘significant other’ partnerships and there is a decay of community in a profound way. These types of problems lead to risks for children in communities and families. I heard some horrendous things that people were reporting in the research I did.
It’s quite clear that the social determinants for health and wellbeing will continue to plummet until we can address and strengthen resilience for rural young people. The context is quite hopeless. I read the Closing the Gap Report Card and the report on drug use in Australia. The profile for Aboriginal young people is extremely poor, and the profile for them being incarcerated is extremely poor. While that remains, there is a great deal to be done and those young people need opportunities for the future.
My passion about nursing and mental health nursing is long-standing and as far as I can see into the future, this is what I will be doing. The mental health of young people is absolutely critical. Getting that right, intervening early, having communities that are strong and resilience, and harnessing that resilience is absolutely critical to improve Aboriginal health and wellbeing. People can’t make good decisions about their lives and communities unless they have healthy minds. Drug and alcohol problems and mental health problems rob our young people of these opportunities.
There is much to be done in mental health nursing. It is absolutely critical we have Aboriginal nurses who are highly trained and able to address this situation. We need more people to step up and do this extra study, to contribute to making bigger improvements. I get very concerned about how Indigenous health intervention in Australia is at a very low level of health system structures and seniority. I don’t think that is good enough for Indigenous people in Australia. We really need more Aboriginal nurses with higher degrees who are able to contribute a higher level of very complex thinking, research and practice to make a difference. That is really hard work, it’s not easy, and it will take a lot of support for those nurses to do that, as no post-graduate study is easy but it desperately needs to be done.
I want to encourage people to not just stop at enrolled or registered nursing, but to go on and do more study because that is what we need. It is so important. Now is the time that nurses need to step up into the not so glamourous areas of nursing and make some changes. We need to recognise that drugs and alcohol are linked to so much disadvantage, health problems and social problems for Aboriginal people. We have to be part of stepping up and making sure that young people are not just responsible for their own health and wellbeing, but are passionate about looking after it for the longer term. I think it is nurses’ jobs to promote health and wellbeing in community – that is what nursing is all about. As Aboriginal nurses, it is absolutely critical to step up to that mark and deliver health promotion and wellbeing, finding ways to say no to things like drugs, alcohol, smoking, and junk food, and be passionate about being healthy. Until we have that investment in our young people and children, we will continue to struggle to close the gap as we are not closing it at the moment.
There is a great deal of scope for improvement. Nurses, and Aboriginal nurses as well, are the biggest proportion of health professionals at over 50% of the health workforce, so if anyone has the opportunity to make a difference and bring change, then nurses do. It is no good sitting around and engaging in horizontal violence or chopping down tall poppies. We desperately need tall poppies. We need to find ways to help each other thrive to support health and wellbeing in our communities.”
2015 National Professional Development Forum
Our first ‘National Professional Development Forum’ will be held on September 22nd
in Darwin. This event will replace our previous Annual Conference; as we explained earlier this year, the Department will not fund conferences but are supportive of professional development. So there will be a change in format, although we will include a session in the program that brings all participants together and also hold our Annual CATSINaM Awards Dinner.
CATSINaM staff are working on the design of the National Forum in liaison with the Board. We are drawing on Member input from the consultations we held over the last 18 months about priority professional development topics.
It was a such positive and rewarding experience to have a dedicated program for students at the 2014 Conference, so we are working on strategies to help students to participate in the National Forum. We hope to fund some bursaries, pending the decision on our funding future. Like last year, we will liaise with universities to support their students to attend – we see this as an important strategy for retaining students in their studies and building our representation in the nursing and midwifery profession.
We are excited about the event and want to see you. So, please mark event this in your diary and start planning now to join us!
Over the past few months, we explored the idea of offering webinars – web seminars - for Members, particularly to support Student Members with academic skills. If you are not familiar with a webinar, it is a live meeting that takes place online over the Internet. It is hosted by an organisation and promoted to potential participants who register to attend. The meeting can be a presentation, discussion, demonstration or instructional session. Participants can view documents and applications via their computers, while shared audio allows participants to ask questions and be involved in discussion.
In exploring this possibility, we talked with several universities about their interest in participating. We discovered that they have often developed webinars for their students on academic skills or on particular topics. Once a webinar is run it creates an ongoing resource that students can download and view at any time, like YouTube, but of course, they do not get to interact with the presenter or participants.
We also identified that other nursing and midwifery peak bodies offer webinars for members – one example is the webinar series on mentoring that we advertised in a recent ‘Friday News’ being offered by APNA.
This remains a ‘work in progress’ for CATSINaM. Our exploration has helped us develop two new strategies that we can start on now. We are investigating how we can arrange CATSINaM Member access to existing webinar resources within universities, and work with universities to develop online video-clips where current students talk about their experience of university and strategies for being successful. CATSINaM would use the clips to support recruitment into the profession and assist students to navigate their university experience.
CATSINaM developed webinars are still on our agenda, but we will wait until we know our funding future before progressing them further.