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!

About Hugh Heggie

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

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.

About Monica Lawrence

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.

About 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

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

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

On my very first day as a graduate nurse in a major metropolitan teaching hospital in the ‘big smoke’ I was assigned to care for an Aboriginal woman from a traditional background from the remote community of Gali’winku, Elcho Island in the Northern Territory.

As I entered her sixth floor room, she sat cross-legged on the bed gazing out the window.  She greeted me with a shy smile and barely looked at me as I introduced myself.

I felt very apprehensive and unsure about how to communicate with her because I didn’t know if she could understand me or if I could understand her. How then, could I give her the best of my nursing care? Upon reflection, I actually felt really scared. Not only was this my first nursing shift, but I had to look after a very sick and vulnerable woman and I didn’t think we would understand each other.

This woman – Mary – was at our major metropolitan teaching hospital because she had been referred for coronary artery bypass grafting as a result of cardiovascular disease. She had travelled here on her own, over vast cultural and geographical boundaries. Before then, Mary had never left her community, never left her family, never boarded a plane, and never been admitted to a major hospital. She was grieving for her young children back home and English was her fourth language.

I strongly believe that this woman sensed my apprehension and tried to make my first experience easier. She talked to me about her family at home and about her community. After a while, she played me music from her tape recorder of the choir she was involved in. This prompted me to share some of my personal stories with her about my family and life in general.

As I sponged Mary in her bed, and packed dressing in her wounds, I felt compelled to spend a lot of time with her. It was really important that I just be myself, I did not have to pretend to be something I wasn’t and I did not have to act any differently. I just had to be myself, so this was actually quite easy.

About Monica Lawrence

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.

About Hugh Heggie