The Experiences of Indigenous Health Workers Enrolled in a Bachelor of Nursing at a Regional Australian University

Abstract

In Australia, the Indigenous health workforce is in urgent need of Indigenous health professionals with credible qualifications in higher education that they can draw upon when attempting to influence government policies and health strategies. One way that this can be addressed is by Indigenous health workers gaining a Bachelor of Nursing degree. This paper reports on a study that focused on the experiences of Indigenous health workers, and how they have met and overcome significant and specific challenges in higher education to become registered nurses. The active involvement of five Indigenous health worker participants is described and their experiences discussed in relation to cross-cultural awareness; financial, cultural, academic, family and peer support; stress factors; staying motivated; and the many and varied issues that impact on confidence levels. The paper provides a number of recommendations for improving the student support mechanisms for Indigenous health workers to overcome barriers to successfully participating in, and graduating from, higher education degree courses.

Beyond enrolments: a systematic review exploring the factors affecting the retention of Aboriginal and Torres Strait Islander health students in the tertiary education system

“…Students identified skills required to succeed at university and developed those skills.HighSchulz et al (2018) [49]Queensland (Australian Catholic University)Qualitative Focus groups10 Indigenous midwifery students.Response rate: 77% of Indigenous students enrolled in the Away-from-Base Bachelor of Midwifery degree.NursingEvaluates two enhancements to a Midwifery course: appointment of an Indigenous Academic Liaison Midwife (IALM) and an additional clinical placement in a high-volume tertiary hospital.Regular contact with the IALM helped students stay connected with and focussed on their study.Students respected the IALM as a culturally appropriate professional role model, who provided encouragement, cultural support and advocacy.The one week placement in a high-volume tertiary hospital was designed to minimise time students spent away from community. Students were supported by hospital staff and the IALM to ensure close supervision and culturally sensitive support.HighStuart et al (2015) [50]Queensland (Not specified)Qualitative Interviews, focus groups5 Indigenous nursing students (former Indigenous Health Workers).Response rate: 100% of eligible students.NursingEnablers and barriers experienced by Indigenous Health Workers studying Bachelor of Nursing.Recognition of prior learning and course exemptions alleviated workload stress and enabled students to complete their degree faster.Support from the Indigenous nurse academic and receiving financial support were cited as essential for students to remain at university.Other sources of support included: the Indigenous student support centre, a personal desire to make a difference and the support of family, workplace and other Indigenous students.All participants reported encountering racism during their course, which impacted on their desire to remain at university.HighUsher et al (2005) [51]Australia (multiple)Qualitative Interviews22 Indigenous nursing students.Response rate: unspecified.Purposive sampling.NursingEnablers and barriers experienced by Indigenous student nurses.Adequate financial support was cited as critical for students to continue with their studies.Other important sources of support included: Indigenous Student Support Centres, support from non-Indigenous academics, support from family and other students and flexibility within the course.Challenges faced by students included racism, isolation and homesickness, family obligations and lack of adequate educational preparation.HighWest et al (2013) [28]Australia (multiple)Mixed methods Data analysis and interviewsQuantitative: 25 schools of nursing.Sample size: 65% of nursing schools.Interviews: 8 Indigenous nursing students, 13 nursing academics (5 Indigenous, 8 non-Indigenous).Response rate: unspecified.Purposive sampling.NursingEnrolment and completion rates for Indigenous student nurses across Australia. Student and staff perceptions of enablers to successful course completion.National average completion rates are 36.3% for Indigenous nursing students and 64.6% for non-Indigenous nursing students (a difference of 28.3%).Individual student characteristics such as motivations for study, personal attributes (such as seeking support) and previous life and work experiences strongly affected their likelihood of successful completion.Family support, support from both Indi...…”

“…A range of personal support networks were pivotal to students’ well-being and to their remaining at university. Family support was the most frequently mentioned enabler for retention [20, 28, 43, 46, 47, 50–53, 60] with family providing support, even when they hadn’t had educational opportunities themselves. Family support included emotional, financial and physical support, including when students were far away geographically, and it gave participants the confidence to go to university and encouraged them to remain there.…”

“…Family support included emotional, financial and physical support, including when students were far away geographically, and it gave participants the confidence to go to university and encouraged them to remain there. Peer support from fellow Indigenous students, particularly those studying a health course, was also very important [28, 46, 48, 50–52, 60]. The value of support from workplaces and professional networks such as the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) and the Australian Indigenous Doctors’ Association (AIDA) was also identified [44, 47, 50–52].…”

Choosing a nursing career: Building an indigenous nursing workforce

“…[16] Opportunities to promote nursing as a career option and participate in decision making processes that affect Indigenous people regarding health policy should be created and encouraged. [19] Building and growing an Indigenous nursing workforce will support the "Closing the Gap" initiative yet without significant efforts to achieve this, the initiative will continue to struggle in achieving its outcomes.…”

“…There are limited studies that have investigated Indigenous representation in the Australian nursing workforce despite the profession recognising that this group are necessary if the needs of Indigenous Australians are to be met. [16,17,19] Indigenous people who have successfully achieved a higher level of education by becoming a nurse should be celebrated and promoted as role models for Indigenous people. [16] Opportunities to promote nursing as a career option and participate in decision making processes that affect Indigenous people regarding health policy should be created and encouraged.…”