“We don’t always do it the same as mainstream services. With our people it might take three or more sessions to do an assessment, and we don’t count either. We also don’t use the screening tool the way you would. It could scare some of our people off”, she said.
“We yarn to engage our mob”, she added, “and we ask about family, country”.
I was talking with a colleague in a First Nations service, asking how she used the mandated assessment tools with clients, at entry point to service. Her answer was my first lesson in not doing things my way.
She didn’t let the pressure of time into her practice of engaging with clients because she truly understood why they needed to trust her and how to make them feel safe. She didn’t bombard them with ‘We need this information in order to provide you with a service’, as I might have. She waited. Letting clients get to know her and the service first, until — in their time — they felt safe enough to tell her what was going on in their life and why they needed help. She was also respectful of the boundaries around women’s and men’s business and didn’t ask questions she thought might embarrass or shame.
My colleague taught me a great deal. Most I learned by falling over my own words in conversation and my own practice, and by making incorrect assumptions about how my job and my work with her and others ought to be done. Through my mistakes, I learned another layer of understanding and a deeper level of respect and humility.
I also learned about my bias, arrogance and righteousness, and that beneath what I think is an open and willing desire to work with others, there is a need to revert to type. To follow a line of what is known, familiar and comfortable. But the space I found myself, in working with her, was unfamiliar and very uncomfortable.
There were other occasions indigenous colleagues told me I wasn’t listening and was being disrespectful. I was mortified at their feedback, because I was proud of what I thought was my ability to listen, communicate and respect. So, I tried to justify my behaviour, but it only made it harder to pause, bracket off my indignation, wait, listen and learn. A voice inside me kept telling me they were misinterpreting what I’d said, or too sensitive, and I was right. But I wasn’t.
I apologised and asked for guidance. That was another lesson.
It’s a disarming process, having to let go of assumptions about how I work. At the very core of the way I do things, is who I am and how I’ve learned to be in this world. This includes how my own experiences of racism as a child growing up in New Zealand have shaped me to become the professional that I am and try to be.
It’s been too easy to think to myself I know something of the devastation of white colonisation on my own people — Māori — and the layers of trauma that is carried through the generations. Too easy to think I can transfer my own experiences to what has happened in this country and that I have a sensitivity and understanding of the needs of those discriminated against. Truth is, I don’t know enough about my own history and know far less about what we have done (and still do) here, to our Indigenous Australian Peoples. And recent experiences working in First Nations services show me how narrow and unhelpful my own thinking and practice can be.
As a mental health nurse, I like to think I have the bones of what it takes to engage with others. Knowing it is fundamental to the development of a safe and trusting working relationship, I consider I have gathered enough skill to get alongside others and listen.
Lately though, I see that no matter what I think I have, or know, applying it to working with a First Nations Peoples, must be undertaken with a different attitude, mindset and skill. A skill set that has more to do with my values and the position from which I see and stand in the world than my qualifications or work I do.
It’s also about how I manage my frustration, anxiety and impatience. How I learn to wait and let go of how I think the work that I am involved in with others should happen. Because, more than anything, I have learned recently that engagement takes time. This can be hard for someone like me, in a hurry to get things done.
To use an analogy familiar to me, ‘Don’t Push the River, It Flows by Itself’, (Stevens, 1970) and swimming against the tide is exhausting. It makes much more sense to move with the tide and the way the water flows. It might take longer, but as long as we push, and keeping insisting First Nations services do it our way, we will not swim the distance or make the shore.
Recently I completed the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) online training program in Cultural Safety and Cultural Humility. The program is called Murra Mullangari which means ‘pathway to wellbeing’. This indeed is what it was for me.
I have undertaken a number of service-based and other introductory courses to Aboriginal Cultural Safety previously, but I found the CATSINaM training more informative, professionally beneficial and so much more personally challenging. It is specifically designed for nurses and midwives and requires participants to look at their own understanding and biases about racism and discrimination. It also puts the development of racism and discrimination of our First Nations Peoples — inherent in our professions — in context.
Our healthcare system, our organisations, our training programs, the professions we have trained in, and us as individual nurses and midwives are part of the bigger system that has continuously discriminated against our Indigenous Peoples, including our colleagues.
The training program requires a deep level of personal awareness, insight and growth. There was no hiding from our own lack of understanding, ignorance and bias. But the real outcome for me, is a personal acknowledgement that I need to keep learning — from a position that is much humbler and willing to admit what I don’t know.
The Nurse & Midwife Support team have received Cultural Safety training from CATSINaM and all found it an enormously beneficial and important learning experience. We encourage nurses and midwives of all career stages and backgrounds to check out the Murra Mullangari training program to learn how to contribute to transforming the health inequities experienced by Aboriginal and Torres Strait Islander people and creating Culturally Safe workplaces for First Nations colleagues. Find out more about this crucial professional development program.
Tessa Moriarty is a credentialed Mental Health Nurse Consultant with over 30 years’ experience across public, private and primary health care, mental health and drug and alcohol settings. She has worked in a variety of senior leadership and executive roles and is an experienced group facilitator, clinical supervisor and psychotherapist. Much of Tessa’s work in recent years has focused on supporting those working in clinical settings – providing individual and group clinical supervision and reflective practice. She also works as a mental health nurse consultant for Primary Health Networks and always tries to bring a humanistic approach to the clinical governance and service review projects she undertakes.