The complex relationship between nursing and Indigenous Australians includes a long tradition of Indigenous nurses, a panel of Indigenous nursing experts told an audience on International Women’s Day this year.
Aunty Dulcie Flower, a trained midwife who was instrumental in setting up Aboriginal medical services in the 1970s, spoke of the disenfranchisement of Indigenous women from the mainstream health system, including Indigenous women in childbirth being turned away from maternity wards in the early stages of labour.
“A close relative died in child-birth and she shouldn’t have … and that was through lack of attention,” she told the audience at the panel to celebrate Indigenous nurses, organised by the University of Technology Sydney’s Jumbunna Institute.
The oldest of seven children, Aunty Dulcie said she “always had a sense of being singled out to do things on behalf of other people”. In her community she saw that “Torres Strait Islander people just wouldn’t go to hospital because they were on the mission … Cairns was the only hospital covering a whole district.”
While Indigenous people have felt marginalised from the mainstream medical system, the history of Indigenous nursing nevertheless goes back to as early as 1906, when May Yarrowick, a northern NSW woman, trained to be a midwife.
“She worked as a midwife on a horse and dray until she passed away in 1949,” said Associate Professor Odette Best, a trained nurse and now an academic and nursing historian at the University of Southern Queensland.
May’s father was Indigenous and her mother was white. When her mother died, “her mother’s family claimed May,” Professor Best explained. Growing up with her mother’s white family gave her access to education and white privileges and she trained in Crown Street Hospital. But it didn’t protect her from the racism of the hospital system, as she discovered when she found the matron’s notes in the Crown Street Hospital’s records. “She wrote that [being a] half-caste was not enough reason not to train her however, she was not to be housed with the other student midwives. So, she was actually segregated.”
Professor Best’s work, uncovering the history of Indigenous nursing in Australia is important in changing what she describes as the “discourse of Aboriginal women as passive recipients of healthcare”. In fact, as she remarks: “We’ve actually been active providers of health care for well over 120 years in this country.”
Discrimination IS common
In Professor Best’s interviews with Indigenous nurses, she has found that “racism is something that every single one of us and every single RN I have interviewed all talk about receiving since the 1940s onwards … from other nurses or patients or administrators of hospitals.”
“Aboriginal nurses haven’t been afforded the same privileges that white nurses have, due to racism. Promotions [were] always afforded to the white nurse and not the Aboriginal nurse – unless it was on missions, because white nurses didn’t want to go there – and so Aboriginal nurses were matrons there.”
Aunty Dulcie spoke about the importance of Aboriginal medical services for creating spaces where Indigenous people can exercise greater self-determination in their own healthcare. “The mainstream system is run on looking at body parts and they separate the mind from the body … and they don’t think about spirituality, except for the religious hospitals.
“And this is so contrary to the way Aboriginal people view health. Health is a state of being to Aboriginal people.” It means a holistic approach: “What affects the individual affects the community; what affects the community affects the individual,” Aunty Dulcie said.
Professor Juanita Sherwood, Deputy Vice-Chancellor of Indigenous Strategy and Services at the University of Sydney, spoke about the way “colonialisation and racism are key determinants of health” for Indigenous people. For her, terms such as “cultural competence” and “cultural safety”, are useful if they mean teaching non-Indigenous people about their own whiteness and privilege and how they actually impact upon Aboriginal health.
She sees some hope for the future though, as Indigenous nurses and advocates are beginning to have an impact on health policy and research. “We are changing the research agenda; we’re having an effect on funding bodies, the National Health and Medical Research Councils, ARCs. A whole lot of those funding and grant bodies are [beginning to be] open to our ways of knowing and being and doing.”
The panel’s advice for Indigenous student nurses
Aunty Dulcie Flower: Don’t be afraid to share the good times and the bad times. If you are getting a hard time, particularly on your placement, make sure you go and tell your senior person. Do not endure bullying.
Professor Best: I always tell our Indigenous students that there is always an expectation that you’re going to go and work in your community. I give them the exact opposite advice. Go out and have fun: get a visa, see the world, work out the speciality you want to work in. You are going to work in the community at some stage and the more skills you bring to the community, the better for your community and for yourself.
Professor Sherwood: It’s really important to debrief. Find your voice. It is difficult to be a whistleblower; you do need the protection of your association – join your association. They are only as strong as the membership, so please when you do graduate, join the local nurses’ association and please take an active role in that.