REAKEETA Smallwood has a big dream for the health system.
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The Gomeroi woman is leading Tamworth’s contribution to a nationwide-program aimed at creating a more culturally-safe experience for Indigenous patients.
Ms Smallwood, a cardiac nurse, has a passion to increase Aboriginal representation in the health workforce and her goals are certainly big.
“One Aboriginal nurse to one non-Aboriginal nurse, so parity,” she said.
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While it’s a spirited goal, she called on the local health district to aspire high.
“Instead of just the four per cent the district is aiming for, maybe go beyond that,” she said.
“Let’s increase our numbers to 10 per cent staff for Aboriginal and Torres Strait Islanders. Maybe that’s a big goal.”
Tamworth hospital is one of just five in NSW delivering the “Lighthouse Project” which has focused on improving care and achieving better outcomes for Aboriginal and Torres Strait Islander patients who go to hospital after a heart attack.
Ms Smallwood is helping deliver program under the name “dharray mali”, which translates to “light the light” in Gomeori language.
The hospital has added Aboriginal artwork to the halls of the emergency department, identified Indigenous staff with badges, produced DVDs aimed at improving health awareness and has plans to create a cultural space.
But Ms Smallwood said increasing staff numbers would go towards closing the gap.
“If you increase your workforce, you empower your community, you educate your community,” she said.
“Increasing our health professional numbers is one step closer.” She said there was some things the hospital did quite well, but said there was still “a lot of things we need to do”.
“Yes, we’re small in numbers, but I think there is a lot of potential for growth and also to empower our non-Indigenous staff members as well,” Ms Smallwood said.
“So we learn off each other, I think that’s what reconciliation is about, we learn from each others mistakes and our strengths and from each other’s ability.”
Australian Healthcare and Hospitals Association director Chris Bourke, a Gomeroi man, said Indigenous Australians “are 30 per cent less likely to receive appropriate care after a heart attack”.
“Understanding the true history of Australia allows non-Indigenous clinicians and health administrators to be aware of the background to our current situation, learn about their stereotypes, reflect on practices and build trust with Aboriginal and Torres Strait Islander people,” Dr Bourke said.
Recognising the historic experience is key to reconciliation
Understanding the history behind why Aboriginal and Torres Strait Islander patients are five times more likely to leave hospital against medical advice is key to achieving reconciliation in the hospital system, the Heart Foundation and AHHA said.
Reitai Minogue, national manager for the Lighthouse Hospital Project, said: “Closing the heart health gap between Indigenous and non-Indigenous Australians requires understanding why many Aboriginal and Torres Strait Islander patients have a distrust of hospitals.
“Historic experiences such as racism, miscommunication and mistreatment have influenced the level of distrust, which is reflected in the fact that Aboriginal and Torres Strait Islander patients are five times more likely to leave hospital against medical advice,” she said.
The Lighthouse Hospital Project, a federally funded joint program by the Heart Foundation and the AHHA, is working with 18 hospitals around the nation to transform the experience of healthcare for Indigenous patients by trying to make their environments more culturally safe.
Examples of positive changes include improving the hospital environment with local artwork, bush gardens and cultural spaces for family, and expanding and better supporting the Aboriginal workforce.
Hospitals are developing stronger links with Aboriginal Medical Services; this means discharges are better planned, so patients are more likely to access follow up appointments, take ongoing medication and use cardiac rehabilitation services.