Hugh Heggie

Hugh Heggie

A: I do not believe so. I’ve always had an holistic approach to patients – acknowledging diverse cultural backgrounds and beliefs, being respectful and truthful in matters discussed, and focusing on solutions. I have always taken an educative approach using a variety of formats. I have always enjoyed learning from others and being part of a team. Now I get to do all of this in a different context and landscape, sometimes in a different language!

 

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Monica Lawrence

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.

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Monica Lawrence

Monica Lawrence

It is really important to minimise the ‘power imbalances’ between a patient and nurse. When talking to your patient, never stand over them. Sitting next to them shoulder to shoulder or sitting on a chair and facing the same direction as the patient is more culturally appropriate. Allow time for the patient to respond as English will not be their first language and many non-Aboriginal concepts and meanings have no equivalent in Aboriginal world view.

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Hugh Heggie

Hugh Heggie

A: Working in a remote Aboriginal community made me feel like I was really using my skills and doing something very worthwhile – and this had lessened in my previous years as a GP. Now I want to maintain my skill level. Working with and learning from Aboriginal people, around all manner of things, is amazing. The main skill set is team participation and adaptability with respect for the client and the rest of the team. Holistic care in a culturally competent manner and developing awareness of population and community health issues and strategies are valuable skills also. There is the opportunity to receive training in emergency skills, imaging and program support such as chronic disease. Developing teaching expertise was also helpful to support health workers, nurses and a variety of students.

 

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Hugh Heggie

Hugh Heggie

A: I encourage medical practitioners not to worry – as many do – about their emergency skill set, because much of what we do is not emergencies. Most of it is around chronic disease and other problems in primary health care, with emergency response being a small part of that. A lot of people – as I did – worry about their skills in these situations, and they need not. There is lots of support and up-skilling.

About Hugh Heggie

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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

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Monica Lawrence

Monica Lawrence

When Aboriginal people have to leave their homelands for specialist care in a foreign country, strong feelings of loss of personal control are common and are associated with being disconnected from country, kin, language and spirituality. Compounding these fears, many Aboriginal people strongly associate major hospitals with death and dying as they often witness their kin leaving their community for a hospital admission, never to return. About Monica Lawrence

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Hugh Heggie

Hugh Heggie

A: I have to be realistic and truthful with people, at the end of the day it won’t be for everyone, but I encourage people to just try it and see if it works for them. The biggest and only thing I would ask is that you come with the approach of having a positive experience to remember for the rest of your life, even if you decide that this is not for you in the long term. You will have a wonderful experience in terms of working with Aboriginal and Torres Strait Islander people and getting to know them.  I have to say, everyone who has come has gone away saying they had a great time.

I have had the pleasure of teaching and training a lot of medical students and junior doctors and registrars. I get great satisfaction from seeing medical students coming to Central Australia and then returning again and again. Some came to the Top End as a medical student, then junior doctor and now they are training as registrars. To see some of them continuing to work in remote practice in Aboriginal and Torres Strait Islander health is a great story.

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