The Federal Budget must include funding to support an increase in the number of Aboriginal and Torres Strait Islander nurses and midwives.
That’s according to the pre-budget submission from the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), which is summarised below by the organisation’s CEO, Professor Roianne West of the Kalkadoon and Djaku-nde peoples.
Roianne West writes:
The 2022/2023 budget bid is informed by 25 years of Indigenous nursing and midwifery advocacy.
The Australian Government has committed to fund Indigenous-led, culturally appropriate initiatives to increase access to healthcare and to improve the health of Aboriginal and Torres Strait Islander people.
Last month, CATSINaM lodged a 2022-23 pre-budget submission to the Australian Government Treasury, presenting actionable solutions to progress the Government’s commitment and to further efforts towards addressing inequities in the nursing and midwifery workforce and health outcomes between Indigenous and non-Indigenous Australians.
At the heart of CATSINaM’s Pre-budget proposal is the need for a commitment to increase the number of Aboriginal and Torres Strait Islander nurses and midwives.
The submission also calls for prioritisation of Culturallly Safe practice when caring for Aboriginal and Torres Strait Islander people across the healthcare system. We explain that Culturally Safe healthcare and education, and the Culturally Safe practice of all nurses and midwives are key enablers for better health outcomes for Aboriginal and Torres Strait Islander peoples. These enablers should be both a national funding priority as well as a priority of national nursing and midwifery professions.
Four key recommendations
Our submission calls for funding for the following four actionable solutions to grow and strengthen our workforce:
- The development of a National Aboriginal and Torres Strait Islander Nursing and Midwifery Workforce Strategy. A major constraint to increasing the number of Aboriginal and Torres Strait Islander nurses and midwives is all forms of racism in nursing and midwifery and health systems and lack of a dedicated and nationally coordinated strategic approach for preparing, developing, and supporting our workforce.
- Establishment of the CATSINaM National Support Line for Aboriginal and Torres Strait Islander nurses and midwives “Back To Country”. Our nurses and midwives work diligently to meet the health needs of our communities; however, there are rarely systems in place to support their professional and personal needs. A national support line for Aboriginal and Torres Strait Islander nurses and midwives is needed to support Aboriginal and Torres Strait Islander nurses and midwives throughout their careers to remain in the workforce.
- Development and stewardship of the CATSINaM Aboriginal and Torres Strait Islander Health and Cultural Safety Education Standards and Endorsement Program. There are no nationally recognised Aboriginal and Torres Strait Islander health and Cultural Safety education standards or quality assurance processes for nursing and midwifery education. Aboriginal and Torres Strait Islander Health and Cultural Safety Education Standards and Endorsement Program for nursing and midwifery must be developed to provide quality Aboriginal and Torres Strait Islander Health and Cultural Safety education for nurses and midwives in Australia.
- Development and stewardship of the CATSINaM Aboriginal and Torres Strait Islander Health Care Practice Standards and Endorsement Program. The continuing prevalence of all forms of racism in nursing and midwifery and Australia’s healthcare system contributes to lower health outcomes for Aboriginal and Torres Strait Islander people. The Aboriginal and Torres Strait Islander Healthcare Practice Standards and Endorsement Program must be developed to provide explicit expectations for the delivery of quality, holistic and Culturally Safe approaches by nurses and midwives.
Crucial priorities
These Asks promote nationally coordinated initiatives to leverage the capacity and capability of CATSINaM to better support Aboriginal and Torres Strait Islander nurses and midwives and to include Cultural Safety in Aboriginal and Torres Strait Islander Health education in the repertoire of skills of all nurses and midwives. Our intent is for our People to experience the benefit of a first-class health service and outcomes along with their fellow Australians.
Our priorities have never been more crucial. It is well understood that Aboriginal and Torres Strait Islander peoples experience profound inequity in workforce and health outcomes. Despite health measures indicating positive gains in some areas of Indigenous nursing and midwifery workforce and in health, over the past decade progress has stalled or worsened in other areas.
Compounding this, the COVID-19 pandemic now poses a serious threat to our regional, rural, and remote communities, necessitating even greater investment and action to protect and support our people. Our Aboriginal and Torres Strait Islander nursing and midwifery workforce, due to its cultural knowledges, lived experiences, role diversity and extensive distribution at the forefront of healthcare, has a pivotal role in addressing these inequities.
Aboriginal and Torres Strait Islander knowledge is critical in delivering on the promise of Closing the Gap in health outcomes between Aboriginal and Torres Strait Islander peoples and other Australians. There is unexplored potential that exists for two-way learning and for new and more sophisticated ways of working together.
Just as our knowledge is not possible without our people, Aboriginal and Torres Strait Islander nursing and midwifery knowledge is not possible without Aboriginal and Torres Strait Islander nurses and midwives. We have the exclusive ability to proficiently entwine nursing and midwifery knowledge with Aboriginal and Torres Strait Islander knowledge to lead our profession in the effective delivery of care and in meeting healthcare challenges.
The pool of Aboriginal and Torres Strait Islander nurses and midwives is, however, concerningly small. Strategies, supported by investment, are urgently required to retain, grow, and strengthen our workforce and roles.
As at 2019, the National Health Workforce Data Set shows Aboriginal and Torres Strait Islander nurses and midwives represented approximately 1.27 percent of the Australian nursing and midwifery workforce. This is not only well below parity but, unless we make a commitment to increasing the numbers of Aboriginal and Torres Strait Islander nurses and midwives, the workforce won’t reach required levels to support Culturally Safe nursing and midwifery care.
When CATSINaM began, the Aboriginal and Torres Strait Islander nursing and midwifery workforce represented 0.5 percent; this equates to only a 0.75 percent increase across 25 years collectively?
CATSINaM provides leadership and a voice for Aboriginal and Torres Strait Islander nurses and midwives. We continuously work to ensure our active engagement across key domains of nursing and midwifery education and practice. While we strive to be heard with impact, our capacity is limited, and our resources are stretched. It is essential that the responsibility for addressing our workforce and health concerns does not rest exclusively with us and our Aboriginal and Torres Strait Islander colleagues.
Nurses and midwives are uniquely and strategically positioned to influence the delivery of Culturally Safe nursing and midwifery practice and have a professional obligation to take meaningful action to improve healthcare quality and access for Aboriginal and Torres Strait Islander peoples and communities.
CATSINaM’s 2022-23 pre-budget submission calls for Australian Government investments that provide critical building blocks towards our greater goals. Achieving a Culturally Safe healthcare system would be transformative; it is an immense but attainable goal requiring commitments from both the Government and our professions.
We need our non-Indigenous colleagues to partner with us to dismantle structures of racism in health education and practice, replacing them with human-rights based approaches ensuring justice and equity in health for our Peoples.
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