No need to apologise
False media reports spread myths about the new codes of conduct for nurses and midwives.
The Codes of Conduct for nurses and midwives are worthy documents that rarely make headlines.
However, new the new Codes published by the Nursing and Midwifery Board of Australia (NMBA) in March got plenty of media attention.
Several news outlets repeated the startling claim that the codes require nurses and midwives to announce their “white privilege” to Aboriginal and Torres Strait Islander patients before treating them.
“Nurses told to say sorry before treating Aborigines” shouted Seven’s Today Tonight in Adelaide.
Not surprisingly, it turned out to be a media beat-up based on a misinterpretation of the code’s guidance on “cultural safety”.
The misinterpretation was promoted by one Graeme Haycroft, an anti-union businessman who has set up an alternative nurses’ association in Queensland (see box).
The NMBA told ABC TV’s Media Watch that Haycroft’s statement was “completely untrue”.
Media Watch agreed the claim was untrue but found there was “some basis” to it because of a statement in the code’s glossary – not in the code itself.
The glossary says: “Cultural safety represents a key philosophical shift from providing care regardless of difference, to care that takes account of peoples’ unique needs.”
“It requires nurses and midwives to undertake an ongoing process of self-reflection and cultural self-awareness, and an acknowledgement of how a nurse’s/midwife’s personal culture impacts on care.
“In relation to Aboriginal and Torres Strait Islander health, cultural safety provides a de-colonising model of practice based on dialogue, communication, power sharing and negotiation, and the acknowledgment of
Taking cultural needs into account
The NMBA sought to clarify matters in a statement co-signed by the Australian College of Midwives, Australian College of Nursing, Congress of Aboriginal and Torres Strait Islander Nurses and Midwives and Australian Nursing and Midwifery Federation.
“Cultural safety is about the person who is providing care reflecting on their own assumptions and culture in order to work in a genuine partnership with Aboriginal and Torres Strait Islander peoples,” the statement said.
“The codes do not require nurses or midwives to declare or apologise for white privilege.”
The CEO of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, Janine Mohamed, says cultural safety involves people learning about their own unconscious biases and how they affect the health care
“Cultural safety training does include examining how indigenous people have been locked out of the opportunities that most white people take for granted by past policies and this has resulted in intergenerational exclusion and indigenous disadvantage,” she says.
“This means that white privilege is one of the areas that people must explore and understand.
“This is what the codes are asking nurses and midwives to do – to think this through so they do not make incorrect and unhelpful assumptions based on their idea of what is normal for non-indigenous Australians, particularly white Australians.”
Janine says that instead of providing care regardless of difference, such as when people say “I treat everyone the same”, the codes require care that takes account of people’s unique needs – including their cultural needs.
She cites, for example, hospital policies about numbers of people permitted in birthing centres.
“For Aboriginal women, it’s culturally appropriate to have more than one person with the mother in a birthing centre.
“However, policies are written for the dominant culture rather than our culture.”
Aboriginal people underrepresented in policy-making
She points out that few Aboriginal people are in health care leadership positions with control over policy-making. “We are only 3 per cent of the population and we are not necessarily represented in the care requirements or policies of an organisation.”
She says the codes require nurses and midwives to recognise the importance of family, community, partnership and collaboration in the healthcare decision-making of indigenous Australians.
Janine says nurses and midwives should be aware that indigenous Australians experience “downgraded care pathways” compared to non-indigenous Australians with the same symptoms.
Dr Yin Paradies, an expert in the effects of racism on health at Victoria’s Deakin University, told The Lamp in 2017 that “more than a dozen” Australian studies found disparities in medical care experienced by Indigenous patients, compared to non-Indigenous patients, after adjusting for a range of medically appropriate factors such as age, sex, marital status, place of residence, etc.
“These studies suggest that Indigenous patients are about a third less likely to receive the medical care that non-Indigenous patients receive for the same conditions,” he said.
One study showed Indigenous patients were three times less likely to receive kidney transplants.
Self-promoter behind renegade ‘union’
Graeme Haycroft, promoter of misleading claims about the nurses and midwives’ codes of conduct, is using the issue to publicise a new “nurses’ union” he has set up in Queensland.
Haycroft has an unusual history for a union man.
The newsletter crikey.com.au noted that, in 1992 The Melbourne Age reported Haycroft provided
non-union labour to employers involved in industrial disputes.
Haycroft was, the report said, a former member of the Joh-for-PM push, a member of the anti-union H R Nicholls Society and a former chairman of the Queensland Liberal National Party’s Industrial Relations and Employment Policy Committee.
“In 1993, Haycroft spruiked a plan to get un-employed young people in southern Queensland working as contract labour for $3 or $4 an hour and set up union-free building sites on the Sunshine Coast,” Crikey reported.
“He has dabbled in his own unions before, including referring to himself as the ‘inaugural secretary of the Private Teachers Professional Association of Queensland’.”