University of Queensland INDH2107: Indigenous Health Reflection

This assignment is a reflective journal entry from a nursing student at the University of Queensland (UQ) focusing on the course 'Working with Aboriginal and Torres Strait Islander People (INDH2107)'. The student, an international student, reflects on their learning journey, particularly their increased understanding of the historical, social, and political contexts influencing Indigenous health. The reflection covers the impact of colonization, the Stolen Generation, and government policies on Indigenous Australians' health outcomes. It explores the importance of cultural safety, appropriate terminology, and the principles of cultural safety, including self-reflection and power differentials, in nursing practice. The student emphasizes the significance of understanding Indigenous identity, family, community, and land in providing holistic and culturally sensitive care. The assignment also touches on health inequities, social determinants of health, and the 'Closing the Gap' initiative. The student concludes by highlighting the personal and professional growth achieved through the course, emphasizing their commitment to providing culturally safe care and advocating for improved Indigenous health outcomes. The student has used several references to support the work.

Before I begin, I would like to acknowledge the traditional custodians of the country I am
studying on, the Turrbal and Jagera people, and also acknowledge Elders, past and present
and emerging.
Introduction
Aboriginal and Torres Strait Islander People form the oldest living and surviving cultural
groups in the world. Being the most disadvantaged group in Australia, they suffer from
critically poor health which requires urgent attention at both state and national levels.
Therefore, it is of utmost importance to work towards their better health (Best & Fredericks,
2014). In this paper, I aim to reflect on my learning based on the course titled ‘Working with
Aboriginal and Torres Strait Islander People (INDH2107)’ to inform my professional
practice. A key understanding from this course involves the historical, social and political
contexts of the Indigenous Australians in relation to their health. However, this has
empowered me with the necessary knowledge and skills to provide culturally safe care to my
patients. I have also gained an understanding of the concept of identity from the view of
Australia’s First Peoples.
Reflection
My journey in nursing studies at UQ begun with little knowledge about Aboriginal and
Torres Strait Islander People. This is because of the fact that I was an international student.
However, after engaging in this course, I have come to realize much of its similarity to my
own culture and now find myself well-informed and well-equipped with the adequate
knowledge and skills to provide optimal care to Australia’s First Peoples. When I began this
course, I was completely unaware of the shocking history of Indigenous Australians. The
discovery of the atrocities inflicted on Indigenous Australians post-European contact was
confronting for me. The process of colonization, dispossession, and introduction of foreign
diseases, which resulted in the loss of a large population of Indigenous Australians filled me
with commiseration (Best & Fredericks, 2014). This oppressive history has provided me with
background knowledge regarding my patients and will enable me to deliver care more
holistically to them. In addition, the knowledge about the history of the land on which I will

be providing care is further a critical step in working towards the betterment of their health
(Best & Fredericks, 2014).
I also learned about the oppressive policies and acts issued by the Government. In
particular, I found the literature on The Stolen Generation as most traumatizing which filled
me with empathy (Best & Fredericks, 2014). As a consequence of these racist and
discriminatory policies, Indigenous Australians highly mistrust the government institutes.
This mistrust leads to under-utilization of the health services resulting in negative health
outcomes for Indigenous Australians (Durey et al., 2012). So as a nurse, I will tailor my care
with the objective of developing trustworthy and respectful relationships for better health
outcomes among Indigenous Australians. I will also remain sensitive to topics, such as The
Stolen Generation. This knowledge has filled me with empathy and has moulded my
judgments of Indigenous Australians optimistically which will affect my practice positively
while delivering care to Indigenous Australians. By understanding the historical, political and
social factors that affect the health of Indigenous Australians, I will be able to conduct a
culturally safe practice. Delivering a culturally safe practice is one the nurses' code of
conduct which forms the legal requirement in all practice settings (Douglas et.al, 2014).
Prior to engaging in this course, I was unaware of the appropriate terminologies to be
used while addressing and working with Indigenous Australians (Queensland Health, 2010).
This could have led me to unintentionally offending my Indigenous Australian patients and
hurting their sentiments. It could also be viewed as racism. This could make them feel
unwelcome and would directly impact their engagement with me as a health professional
which might result in their reluctance to access health services in future for diagnosis or
treatment and hence leading to negative health outcomes (Durey et al., 2012).
I also learned about the principles of cultural safety which begin with self-reflection. I
was really surprised to realize that the ways in which my cultural values, identity,
assumptions, and attitudes could influence the care that I provide and at the same time,
‘diminish’, ‘demean’ or ‘disempower’ an individual (Eckermann et al., 2010). As a nurse, I
can avoid this unsafe cultural practice by following a non-judgmental approach while
handling the clients. Furthermore, I can avoid forming assumptions and stereotypical

attitudes towards my Indigenous Australian patients by involving them rather than making
assumptions where it’s not clear (Eckermann et al., 2010).
When I came across Power differential, another principle of cultural safety, I got quite
confused with the term. However, as I dug deeper into it, I realized that I had practiced it
unintentionally at various instances during my placement, where power resided with me
whereas my patients played a passive role in their own care. Therefore, I can improve my
practice by remaining mindful to actively minimize these power differentials between me and
my patients, particularly Indigenous Australian patients (Best & Fredericks, 2014). I can
achieve this by accepting and incorporating my patients’ values in their care which form the
core of a person-centred care (Calisi, Boyko, Vendette, & Zagar, 2016). I can also achieve
this by working with them at their pace and acknowledging their Indigenous practices (Best
& Fredericks, 2014).
Before the commencement of this course, I was only culturally aware and could
recognize the cultural differences that existed between me and my patients. However, I now
consider myself as culturally safe since I can and will always strive to provide holistic care to
my patients that is free of racism and bias while incorporating their values (Holland, 2017)
While undertaking this course, it shocked me that Indigenous workers could experience
racism yet they are the traditional custodians of the land and should be highly respected (Best
& Fredericks, 2014). Being on this land, I personally consider it as my duty to highly respect
its traditional custodians. I, therefore, consider it as my responsibility to create a culturally
safe and racism-free environment for them to work and will always challenge racist
behaviours in accordance with the available hospital policies and the staff. By so doing, my
practices will be in compliance with nurses’ code of conduct principle which urges the nurses
to ignore racism and harassment and act to eliminate them.
I gained knowledge about identity which is another important concept for Indigenous
Australians. It surprised me that identity forms a broad concept for Indigenous Australians
similar to my culture, which not only incorporates them as beings but also closely relates to
their family, community, land, culture, and history. Since it relates well to my culture and I
have a similar mindset. I can better understand the indispensable role that family, community,

and land play in the lives of Indigenous Australians. Hence, I can deliver care and cater to
their health-related needs in a much better way. This practice complies with the standard
which requires nurses to acknowledge the family and community’s role in Indigenous
Australians cultures.
In addition, I was able to learn about the way Indigenous Australians identify themselves.
Recalling my first-year experience, I had an Aboriginal patient who identified herself as ‘a
Kaurna woman’. Though I was unable to comprehend it at that point, it seemed quite similar
to the way I identify myself as ‘a Punjabi woman’. However, I am now aware that it indicated
her nation, similar to the way it indicates my region. Based on these similarities, I consider it
as my asset which I can use to better engage with Indigenous Australians. It will also help me
to develop therapeutic relationships with my patients based on the sense of mutual trust and
respect.
Prior to commencing this course, I had the stereotypical notion of Indigenous Australians
being dark-skinned. However, it was an eye-opener for me to become aware that it was a
stereotype and one’s colour could not determine their ‘indigenous identity’. This clarification
was essential for me since I could have unintentionally offended my Indigenous Australian
patients by questioning their identity based on their colour. This could hurt their sentiments
and create difficulty when engaging with the patients hence resulting in negative health
outcomes. I will always remain cautious and sensitive to topics related to colour and identity
and follow a non-judgemental approach. This holds compliance with Principle 3.1 which
focuses on providing holistic and assumptions free care.
Initially, before studying this course, I often came across the notions of health inequity
and social disadvantage among Indigenous Australians. I used to often wonder about its cause
but due to the knowledge I acquired and gained from this course, I now have a sound
awareness that it is an outcome of the colonial history and the current social determinants of
health specifically relevant to Indigenous Australians. This knowledge of the specific social
determinants will enable me to get a broader perspective of my patients’ background and
provide them with more comprehensive care by recognizing and striving to eliminate the
barriers that hinder them from accessing and utilizing the health services. It will also help me
in providing psychosocial support and building a therapeutic relationship which acts as a
major enabler for positive health outcomes. Moreover, by incorporating the positive
determinants of health in my practice, positive health outcomes can be achieved. generally,

by remaining mindful of these social determinants, I play a considerable part in diminishing
the health inequities.
Despite the fact that as a health professional, I had come across the term ‘Closing The
Gap’ during my placements, I could not understand the rationale behind the term ‘gap’.
However, I have come to the realization that it refers to the health disparity between
Indigenous and Non-Indigenous Australians. I gained knowledge regarding its targets and
their progression. As a health professional, I consider it as my responsibility to work towards
eliminating this health disparity by striving to achieve these targets. I can achieve this by
providing culturally safe care to Indigenous Australian patients. I can act as an agent of
change through a respectful and genuine partnership with them. In addition, since nurses
serve as primary educators for their patients, I will try to collaborate health education at every
point of patient contact and enable them to make healthy informed choices for themselves.
During this course, I was also acquainted with the concept of asset-based community
development which I found very fascinating. It focuses on assets based on communities to
achieve positive health outcomes. I strongly believe that as a nurse, the assets-based approach
will be highly useful for me. Since nurses play a major role in health promotion at the
individual levels and mass levels like participating in health promotion campaigns, I can
incorporate this approach while interacting with the community in order to promote health for
better patient outcomes.
Conclusion
In conclusion, learning about Aboriginal and Torres Strait Islander has not only enabled
me to effectively deliver health care to various people of the community but it has also
enabled me to develop more as an individual. I have been able to identify various ways in
which I can actively participate in order to ensure that the indigenous Australians get the best
health care services without fear of anything. I have also gained a lot of confidence in my
profession. Moreover, it has given me insights on the various roles a nurse can play towards
promoting health both locally and globally.

References
Best, O., & Fredericks, B. (2014). Yatdjuligin: Aboriginal and Torres Strait Islander Nursing
and Midwifery Care: Cambridge University Press.
Calisi, R., Boyko, S., Vendette, A., & Zagar, A. (2016). What is Person-Centred Care? A
Qualitative Inquiry into Oncology Staff and Patient and Family Experience of Person-
Centred Care. Journal of Medical Imaging and Radiation Sciences, 47(4), 309-314.
doi:https://doi.org/10.1016/j.jmir.2016.08.007
Douglas, M. K., Rosenkoetter, M., Pacquiao, D. F., Callister, L. C., Hattar-Pollara, M.,
Lauderdale, J., ... & Purnell, L. (2014). Guidelines for implementing culturally
competent nursing care. Journal of Transcultural Nursing, 25(2), 109-121.
Durey, A., Wynaden, D., Thompson, S. C., Davidson, P. M., Bessarab, D., &
Katzenellenbogen, J. M. (2012). Owning solutions: a collaborative model to improve
quality in hospital care for Aboriginal Australians. Nurs Inq, 19(2), 144-152.
doi:10.1111/j.1440-1800.2011.00546.x
Eckermann, A.-K., Dowd, T., Chong, E., Nixon, L., Gray, R., & Johnson, S. (2010). Binan
Goonj, Bridging Cultures in Aboriginal Health (3 ed.).
Holland, K. (2017). Cultural awareness in nursing and health care: an introductory text.
Routledge.
Queensland Health. (2010). Aboriginal and Torres Strait Islander cultural capability.
Retrieved from
https://www.health.qld.gov.au/__data/assets/pdf_file/0031/147919/terminology.pdf