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It is clear from the 2018 Closing the Gap Report tabled by Prime Minister Turnbull in February 2018 that Aboriginal and Torres Strait Islander Peoples still experience poorer health outcomes than non-Indigenous Australians. It is well understood these inequities are a result of the colonisation process and the many discriminatory policies to which Aboriginal and Torres Strait Islander Australians were subjected to, and the ongoing experience of discrimination today.
All healthcare leaders and health professionals have a role to play in closing the gap.
The approach the NMBA has taken for nurses and midwives (the largest workforce in the healthcare system) by setting expectations around culturally safe practice, reflects the current expectations of governments to provide a culturally safe health system. (For more information please see the COAG Health Council 4 August 2017 Communiqué).
Culturally safe and respectful practice is not a new concept. Nurses and midwives are expected to engage with all people as individuals in a culturally safe and respectful way, foster open, honest and compassionate professional relationships, and adhere to their obligations about privacy and confidentiality.
Many health services already provide cultural safety training for their staff. 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.
Nurses and midwives have always had a responsibility to provide care that contributes to the best possible outcome for the person/woman they are caring for. They need to work in partnership with that person/woman to do so. The principle of cultural safety in the new Code of conduct for nurses and Code of conduct for midwives (the codes) provides simple, common sense guidance on how to work in a partnership with Aboriginal and Torres Strait Islander Peoples. The codes do not require nurses or midwives to declare or apologise for white privilege.
The guidance around cultural safety in the codes sets out clearly the behaviours that are expected of nurses and midwives, and the standard of conduct that patients and their families can expect. It is vital guidance for improving health outcomes and experiences for Aboriginal and Torres Strait Islander Peoples.
The codes were developed through an evidence-based and extensive consultation process conducted over a two-year period. Their development included literature reviews to ensure they were based on the best available international and Australian evidence, as well as an analysis of complaints about the conduct of nurses and midwives to ensure they were meeting the public’s needs.
The consultation and input from the public and professions included working groups, focus groups and preliminary and public consultation. The public consultation phase included a campaign to encourage nurses and midwives to provide feedback.
The Australian Nursing and Midwifery Federation, the Australian College of Nursing, the Australian College of Midwives and the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives all participated in each stage of the development and consultation of the new codes. The organisations strongly support the guidance around cultural safety in the codes for nurses and midwives.
Lynette Cusack
Chair Nursing and Midwifery Board of Australia
Ann Kinnear
CEO Australian College of Midwives (ACM)
Kylie Ward
CEO Australian College of Nursing (ACN)
Janine Mohamed
CEO Congress of Aboriginal and Torres Strait Islander Nurses and Midwives
Annie Butler
A/Federal Secretary Australian Nursing and Midwifery Federation
The following organisations also support this statement:
Download a PDF of this Joint statement - Cultural safety: Nurses and midwives leading the way for safer healthcare (147 KB,PDF)