Overview

Guest edited by:

Kim Usher
James Cook University

and

Rhonda Marriott
Murdoch University

This Special Issue is focused on closing the gap In Indigenous health outcomes. The gap represents the accumulated, appalling statistics that compares the state of Aboriginal and Torres Strait Islander peoples' health and life expectancy to the health and longevity of all other Australians. Close the Gap is a concerted and directed campaign with many signatories including Government, organisations and agencies to reduce the level of disadvantage among Aboriginal and Torres Strait Islander peoples. The Council of Australian Governments (COAG) and Close the Gap identified key areas that require immediate funding and action - health, healthy homes, education, early childhood, safe communities, economic participation and governance and leadership.

Early deaths of Aboriginal and Torres Strait Islander people is known to be the long-term result of policies of removal of children, removal from land and culture, and loss of language and lore. In addition, there are chronic illness, including diabetes, cardiac and lung diseases (due in no small part to changes in lifestyle); poor nutrition and poor access to high quality food; poor mental health, alcohol and substance abuse and increased rates of incarceration and suicide.

While nurses and midwives have made some advances towards closing the gap in Aboriginal and Torres Strait Islander health as described in the articles included in this special edition, there are significant steps nurses and midwives must yet take in order to start to make a real contribution to closing the gap. Some of those steps are personal while others are the responsibility of the nursing and midwifery professions.

Rather than continue to be overwhelmed by these statistics, it is time for nurses and midwives to begin to make a difference by thinking of Aboriginal and Torres Strait Islander people as people who belong to a family and a community; as real people with real lives and not just a statistic.

Professionally, closing the gap hinges on education as a way of changing professional behaviours and attitudes to ensure nurses and midwives are aware of the disadvantage faced by Aboriginal and Torres Strait islander peoples and work in a culturally safe and respectful manner. Nurses and midwives who have recently undertaken their education are likely to be familiar with the gap - these statistics are commonly incorporated into undergraduate curricula. Those who were educated in nursing or midwifery more than ten years ago are unlikely to have encountered these statistics in their undergraduate courses, or in their training. In the future, nursing and midwifery undergraduate education will consistently and reliably encompass Aboriginal and Torres Strait Islander health, history and culture. Courses will have Aboriginal and Torres Strait Islander health, history and culture as a fundamental requirement for accreditation of each and every nursing or midwifery course across Australia. A modern nursing and midwifery workforce must understand the concepts of - and the importance of working within - a culturally safe and respectful health system. Nurses and midwives must be professionally and academically prepared and required to provide care in a manner that will not further harm Aboriginal and Torres Strait Islander people. Importantly, this is now a specific aim of nursing and midwifery education.

The importance of closing the gap is not merely to improve the statistics. Closing the gap can only be achieved through active, sustained and inclusive professional thinking and deeds. This Special Issue aims to contribute to this.

Table of Contents

Editorial: Closing the Gap: Nurses making a difference
Kim Usher, Odette Best

Editorial: Nurses and midwives closing the gap in Indigenous health care
Sally Goold OAM, A Wiradjuri woman

Editorial: How can nursing and midwifery help close the gap in Indigenous health indicators?
Rosemary B Bryant

Putting Indigenous cultural training into nursing practice
Rosie Downing, Emma Kowal

Closing the Gap: Cultural safety in Indigenous health education
Wayne Rigby, Elaine Duffy, Lorraine Lyons, Jan Manners, Heather Latham, Laurie Crawford, Ray Eldridge

Understanding culture in practice: Reflections of an Australian Indigenous nurse
Renee Cecilia Blackman

Editorial: Naming and framing Indigenous health issues
Anne M McMurray

Tjirtamai - 'To Care For': A nursing education model designed to increase the number of Aboriginal nurses in a rural and remote Queensland community
Roianne West, Leeona West, Karen West, Kim Usher

Reflections on tackling tobacco: A call to arms for remote area nurses
Jan Robertson

Identity matters: Aboriginal mothers' experiences of accessing care
Kim Van Herk, Dawn Smith, Caroline Andrew

Experiences of nurses in caring for circumcised initiates admitted to hospital with complications
Mack Phega Mangena, Fhumulani Mavis Mulaudzi, MD Peu

Students' corner: Exploring Indigenous health using the Clinical Reasoning Cycle
Victoria Grace Meissner

The best bang for our buck: Recommendations for the provision of training for Tobacco Action Workers and Indigenous Health Workers
Marlene Thompson

Closing the Gap: Talented Indigenous scholars leading the way
Kim Usher

Epilogue
Kim Usher, Roianne West