Following two years of extensive consultation by the Nursing and Midwifery Board of Australia (NMBA) the new codes of conduct for nurses and midwives have been released. These revised codes have an important new inclusion: the principle of cultural safety.
The Australian Nursing and Midwifery Federation (ANMF), Australian College of Nursing, Australian College of Midwives and the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) all participated in each stage of the development and consultation on the new codes. Responding to publicly aired misinformation these peak organisations for nurses and midwives have shown leadership by carefully and considerately explaining the benefits for all people when nurses and midwives provide culturally safe practice.
In their joint statement with the NMBA the four organisations expressed unequivocal support for the codes’ guidance on respectful care to improve health outcomes for Australia’s First Peoples.
NMBA’s new codes of conduct feature cultural safety because ‘racial discrimination is well documented as a contributing factor to poor health outcomes for Aboriginal and Torres Strait Islander Australians’ (Australian Human Rights Commission, 2005).
The codes require that the care nurses and midwives provide eliminates racism and creates an environment in which Aboriginal and Torres Strait Islander people can feel safe to talk about their healthcare needs. In doing this, the codes are simply asking nurses and midwives to reflect, as they do in all areas of practice, about preconceived beliefs on which their practice is based, derived from ‘what is normal for non-Indigenous Australians, particularly white Australians’ (Mohamed 2018).
This means reflecting on inherent privileges associated with being part of the dominant culture in Australia and acknowledging the impact of white culture on this country’s First Peoples. In a previous column (ANMJ, 2014) we talked about nurses and midwives “acknowledging whiteness”, and described what that meant for us after doing cultural safety training through CATSINaM:
We were confronted with the privilege that our ‘whiteness’ affords us in being part of the [white] dominant culture in Australian society; the fact that we will not be discriminated against because of our skin colour; that we grow up with expectations of entitlements, often without thinking that others don’t share that privilege….While we can’t rewrite history or undo the wrongs of the past, we can commit to learning from the deep injustices of former generations and the perpetuation of discrimination by our generation [towards Aboriginal and Torres Strait Islander Australians].
On 26 January 2018, Australia Day, the ANMF posted a question to Facebook to elicit members’ views on changing the date of Australia Day, in view of sensitivities the current date has for Aboriginal and Torres Strait Islander peoples. Our colleague, Faye Clarke, a Gunditjmara, Wotjaboluk and Ngarrindjeri woman, and ANMF member, provided commentary for the post expressing her difficulty in celebrating Australia Day on 26 January, in the same way as other Australians. As she said, “this date represents the beginning of very traumatic times for Aboriginal people, so why would we want to celebrate on that day? Commemorate yes, but not celebrate.”
Responses from nurses and midwives to the ANMF post reflected those of the wider society, with both positive and negative comments. This has provided an opportunity to help our members join up the dots in making the connection between Aboriginal history, 26 January (first landing of white settlers, 1788) and the impact of this on Aboriginal health. Fellow nurse, Dr Ruth de Souza (2018), sums this up nicely:
Australia is a white settler society like the United States, Canada and New Zealand. In such settler societies, colonisation and racism have had devastating effects on Indigenous health and wellbeing. These include: the theft of land and economic resources; the deliberate marginalisation and erasure of cultural beliefs, practices and language; and the forced imposition of British models of health over systems of healing that had been in Australia for millennia.
As forefront health and aged care professionals, the importance of nurses and midwives having an understanding of Australia’s history through the lens of Aboriginal and Torres Strait Islander peoples, cannot be understated. The ANMF takes seriously our role in modelling and encouraging respect and reconciliation between Indigenous and non-Indigenous Australians (ANMF, 2016). Our business is to promote safe, competent nursing and midwifery care for all people in Australia - a culturally and linguistically diverse nation. The NMBA codes of conduct assist in the educative process needed to foster a culturally safe environment for all people receiving care, especially our First Peoples.
Joint position statement
Australian Nursing and Midwifery Federation, Australian College of Nursing, Australian College of Midwives, Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, and NMBA joint statement: Cultural safety: Nurses and midwives leading the way for safer healthcare. Issued 23 March 2018. Available at: www.nursingmidwiferyboard. gov.au/News/2018-03-23-jointstatement.Aspx
Australian Human Rights Commission (2005) Social Justice Report 2005 cited in NMBA and CATSINaM joint statement on culturally safe care. Available at: www.nursingmidwiferyboard.gov.au/ Cultural safety and respect, September 2014. ANMJ Vol 22(3), p23.
Australian Nursing and Midwifery Federation. (2016). Reconciliation Action Plan: December 2016-December 2018. Available at: http://anmf.org. au/pages/reconciliation-action-plan
de Souza, R. (26 March 2018) Busting five myths about cultural safety. Croakey. Available at: https://croakey.org/busting-fi ve-myths-about-cultural-safetyplease-take-note-sky-news-et-al/
Mohamed, J. CEO CATSINaM. (24 March 2018) Cultural safety matters – the conversation we need to keep having. @Indigenous. Available at: https://indigenousx.com.au/janine-mohamed-cultural-safetymatters/#.Wsqr4stPryd
ANMF Federal Professional Officers
Co-author - Faye Clarke, ANMF member and Aboriginal Nurse Adviser. She is a Gunditjmara, Wotjaboluk and Ngarrindjeri woman and works as a Registered Nurse at the Ballarat and District Aboriginal Co-operative