Life has certainly been busy over the last few weeks. Home schooling, remote work and an impromptu "weekend warrior" bathroom renovation have detracted from writing on this blog. What has been lovely about social isolation is connecting with new and interesting people via ZOOM. These connections have supported the development of my understanding in cultural competence. During these conversations, a few people have asked about my interest in the area. Todays blog will share a little of what sparked my interest, research and blog writing!
I began my nursing career working in metropolitan and regional hospitals in neurological, intensive care, medical, surgical, nuclear medicine and Justice Health. Importantly, my early experiences in mainstream health care, led me to notice that healthcare isn’t responsive to the needs of ALL Australian. I observed the inherent racism that was evident in health services. As a new graduate nurse, I remember sitting at a nurse’s station listening in silent horror nurses sharing “jokes” that involved Aboriginal peoples. As someone that was dating (and now married) to an Aboriginal man, I was appalled, but also deeply interested. I wondered how racism existed in my profession….a profession that “cared”. Situations like this scenario, made me reflect on my own practise and consider the biases that influenced my nursing and impacted clients. These situations sparked my interest in cultural competence in healthcare and helped me find my voice (I now work hard to not be a “bystander” to racisms).
These early career situations shaped my professional identity and nourished my interest in people, behaviours and how culture does/can influence care. This then lead to my enrolment in a higher degree by research study. In 2017, I completed my PhD, a phenomenological study looking at the cultural competence development across a cohort of students within a Bachelor of nursing degree “Indigenous Australian Cultural Competence and Nursing". The PhD taught me how nursing students learnt about Indigenous Australian cultural competence and what supported/limited their learning.
After being involved in the teaching of subjects focused on Indigenous Australian healthcare, I noticed that often the pedagogical focus of teaching and learning was geared towards the deficit model. To me, this didn’t align with my personal or professional values and lived experiences. This model isn’t sustainable or successful (Sherwood, 2013). Instead the onus of responsibility should not be on the patient but instead geared towards the clinician. How can the clinician adapt to suit the needs of the client/community rather than how can the client adapt to suit the needs of the health professional? Coupled with my personal experiences raising two girls it was clear that we need to learn from history, consult, collaborate, respect and reorientate our focus to a strengths based approach.
Between 2017-2019, Brett Biles and I, co- edited a textbook with over 15 authors inclusive of community members. We were privileged that community members bravely shared their stories. In fact, each case study in the text is a real life story. Some case studies have been pseudonyms to protect the privacy of individuals.
During the creation of the textbook it became evident that there is much interest in cultural competence outside of academia. To be accessible to local health districts, community controlled organisations and community member’s information must be presented in a quick accessible format that complimented the busy lives of regional peoples.
From this, during a period of special study leave, I decided to write this blog. The blog is in its infancy but preliminary analytics indicate overwhelming support from a range of professions. Teachers, nurses, midwives, allied health professionals and local health districts have contacted me regarding the blog. While the creation of the blog has certainly challenged my skills in information technology (I now have two social media accounts and have created this website) most importantly, it has become a conversation starter, linked people together, generated research collaborations and has introduced me to some marvellous people in our community.
I am not sure where the blog will lead but hopefully it will continue the narrative of cultural competence and cultural safety in healthcare: https://jessicabilesphd.wixsite.com/jessicabilesphd.
I welcome your comments, emails or guest authorship pieces to share via on the blog.
If you would like to catch up or write a piece for the blog feel free to email me: jbiles@csu.edu.au
References
Sherwood. J (2013) Colonisation – It’s bad for your health: The context of Aboriginal health, Contemporary Nurse, 46:1, 28-40, doi: 10.5172/conu.2013.46.1.28