Documenting and understanding the unique and personal experiences of Aboriginal people from remote communities who access specialty cardiac services in hospital formed the basis of my Master of Nursing, in research I did from 2004-2007.

 I thought this was a great opportunity for Aboriginal people to share their stories about what it was like for them to leave their country to access health care in the ‘big smoke’.

 This research identified several concerns the patients had, including an intense fear and anxiety of dying. The patients said that they died during the surgery and would be resuscitated by the doctor after the surgery. This intense fear may be compounded by the experience of kin who may have had relatives leave their community for hospital care, never to return home.

 One of the elderly men that I talked to described his experience of coming to Adelaide:

 “Sometimes when they get there, they lose their memory. Their memory won’t wake up again. Adelaide, you get to Darwin, you wake up.” (Mr. H, 2006)

 One of the men told me that the reason for his sick heart was as a result of some wrong doing by a relative in the past and he needed to suffer the consequences.

Another man said to me that his son’s heart condition resulted from climbing up the side of the house as a young boy and when he fell down, he injured his left foot. The father then proceeded to draw an imaginary line with his finger, from his left foot up to the left side of his chest, connecting the left foot injury with the heart.

As a nurse, I needed to listen to the patient, respect their cultural understandings and also spend some time talking about non-Aboriginal understandings of ill health.

Using visual aids and drawing pictures was a useful way to explain to the patient about the nature of their heart disease

Monica Lawrence

Orientating patients to the ward and introducing them to other patients will help with breaking the ice. If there are other Aboriginal patients on the ward, you will need to find out if it is culturally appropriate for introductions to be made. The patient will firstly ask you for the other patients’ surnames and the community the other Aboriginal patients come from before they decide whether it is culturally appropriate for communication to occur.  Working in partnership with the hospital’s Aboriginal liaison team is also really important to make sure phone calls to the patient’s family back home are made regularly.

Personally and professionally, I have felt greatly enriched by my experiences over more than 12 years providing nursing care for Aboriginal people from remote communities.  It has set the foundation for my career and resulted in the passion I have to dedicate myself to work in Aboriginal health.

About Monica Lawrence

Monica Lawrence

On a busy ward, it’s not always possible to take the time you’d like to get to know patients, but building rapport vastly improves the quality of care we provide, so we need to think creatively on how we can achieve this.

Over time, a reciprocal partnership between a patient and their nurse will more likely lead to trust, minimise fear and anxiety, and facilitate disclosure of important personal information to assist with decisions based on their care. The more vulnerable the patient, the more trust is needed, the harder it is to generate.

From my experience, building rapport and eventually, trust, can be achieved through sharing information with your patient while you are assisting them in the shower, making their bed or attending to their wound dressings. Quite often, I would take patients for a walk outside in a wheel chair during my lunch break so we could both enjoy the fresh air and sunshine. In between attending to the care of my other patients, I would frequently pop in to see if they were okay to minimise feelings of isolation and reassure them that I will return.

 About Monica Lawrence