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I Will Believe, a song by Quinn on Spotify
Keep posting annotations and earn respect from LyricsMode community. Cancel Correct. Focus group 4 was facilitated via telephone conference, whereby all research participants were together face to face, including two of the principal investigators CO and BG-T while the independent consultant moderated the discussion via telephone while taking notes. Field notes, a useful method of describing and interpreting data [ 26 ], were recorded during all focus groups by a member of the research team CO to capture the expressions and interactions among the groups, in particular some valuable quotations voiced.
The consultant collated the storyboard and interview data and reported findings to the research team. All data including field notes was then organised chronologically by CO and BG-T past, present, future and conceptualised for a general pattern in cultural meaning, a form of narrative analysis [ 27 ]. Data was then coded and summarised into broad themes, enabling readers to contextualise strategies for strengthening Aboriginal employment in a healthcare setting. Local Aboriginal Elders note: all 3 Elders are also a past employee.
Stories gathered from all participants were categorised into three major learnings relating to Aboriginal employment at the health service: past, present and future. Once the verandahs were no longer used, Aboriginal mothers continued to be segregated into a designated room within the building. Traditional cultural practices and beliefs provided some comfort and an ability to soften the reported heartache that segregation triggered.
Over time, Aboriginal people did notice and question segregation, stating that the inequality created a barrier between the Aboriginal community and the health service, resulting in a level of suspicion that impacted trust and cultural safety. Passive resistance and distrust was later met with a growing movement toward self-determination, reported by participants as being in the s, when community members approached the Matron of the health service, to ask for employment. Trust was being rebuilt between non-Aboriginal health professionals and the community.
They [Aboriginal employees] took pride in the role they had in the hospital—that had a good impression on me and how I took [understood] your role as a community member. They [Aboriginal patients] never had anybody to go to … … these folks [Aboriginal employees] did those jobs … … they were domestics but they [health service] never had Hospital Liaison, so they did those jobs and extra [work duties] for our people.
Even Aunty [Aboriginal employee] who worked in the kitchen. For the Aboriginal community, a strong example of a move toward social inclusion was demonstrated through the — physical redevelopment of the health service. The redevelopment was a turning point, an opportunity to create an environment that was culturally safe from a visual perspective.
Incorporating Aboriginal artwork into the new facility was reported by an executive officer as a complementary suite of visual strategies. It was noted that historically the health service has not recorded the Aboriginal status of employees within standard recruitment processes, indicating that trends over time are not known.
The designated HR person was reported as an important link in determining the challenges through regular meetings with each trainee. As an example, the health service purchased a bicycle for one Aboriginal trainee, enabling transport to work. More than that, Aboriginal trainees disclosed that they needed someone to go to be able to discuss how difficult their day was or that they did not know what people were talking about.
Learnings however had to be mutual in character; Aboriginal trainees were encouraged to be upfront with their challenges by talking to their manager, the AHLO or the HR person who had to listen and respond sensitively. In parallel to the strategies employed to recruit and retain Aboriginal trainees, the health service Education Centre developed a greater focus on relationship building with the local secondary schools, exemplified with an annual Aboriginal Career Expo.
Promoting career pathways to secondary school students was supplemented with offering career progression such as a pipeline or a pathway to further education to current Aboriginal trainees. Having trainees enthusiastic about being able to grow their skills and knowledge was reported by the executive group as a motivation to partner with training organisations, such as the [regional] Institute. All study participants were united in acknowledging that the health service has indeed exemplified a contemporary commitment to cultural inclusion.
Promoting the health service as a culturally safe workplace was a factor that two key stakeholders stated as being vital in attracting Aboriginal people as employees. A plaque identifying all past employees, in particular AHLOs, was also suggested. A number of cultural safety factors were explored by the key stakeholders, each with a valued contribution.
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One suggestion was to allow Aboriginal people to bring an advocate to an interview. It was also thought that having an Aboriginal person on the interview panel would be valuable and should be mandatory. Local training and workforce agencies reported that Aboriginal employment could be strengthened if health services worked more collaboratively. Future workforce planning could be improved through collaboration between the health service and the local training and workforce agencies. It was suggested by a key stakeholder that skill matching could be promoted with Year 8 and 9 students in local secondary schools, to allow for appropriate subject selection and potentially foster school retention.
Four key stakeholders agreed that growing an Aboriginal workforce is a long-term vision with no immediate outcomes. Being flexible. An Aboriginal Staff Network was suggested as a means of providing Aboriginal employees with informal support, mentoring and potential opportunity for planning social activities to develop connectedness. Improvements in cultural learning would facilitate an understanding of cultural difference.
Key stakeholders encouraged the health service to learn from other Australian businesses that have had success in growing an Aboriginal workforce; both Telstra Corporation Limited a telecommunications company and the Woolworths Group Limited a major grocery store chain were cited. It was further stated that the local Aboriginal community would hold the health service in greater esteem if a Reconciliation Action Plan RAP was developed and publically announced to show an ongoing commitment to inclusion. An additional sign of cultural respect could be achieved by including the Aboriginal history on the health service timeline that has been developed and displayed in the new health service facility foyer.
A current Aboriginal employee stated that through publicising the history and including the days of segregation, the health service would be acknowledging the past and enabling Aboriginal people to feel that the future will be different. Summary of themes and strategies to mangan dunguludja ngatan build strong employment.
Embed a commitment to strengthen the Aboriginal workforce to facilitate healing within the building and external to it. Co-design buildings and physical spaces with the Aboriginal community to ensure cultural safety from a visual perspective. Participate in Aboriginal celebrations as a sign of respect and reconciliation. Regularly engage with the Aboriginal community within their organisations to learn the culture.
Embed systems of support for Aboriginal employees to ensure social inclusion and cultural connectedness both within and external to the organisation, e. Develop flexible goal directed opportunities for skill development with potential and existing Aboriginal employees. Co-design recruitment processes with the Aboriginal community to ensure cultural safety. Develop meaningful outcomes focused relationships with the Aboriginal community to enable trust.
Collaborate with the broader community to identify opportunities to develop the Aboriginal workforce together. Yarning with twelve Aboriginal and twelve non-Aboriginal stakeholders interested in the sustainable employment of Aboriginal people at a regional Australian health service, has provided significant insight into how past, present and future learnings may help to strengthen Aboriginal employment. Learnings led to the development of three significant cultural themes: safety, pathway and equity with each hereby explored in turn.
Past learnings indicated that cultural inequality as it existed throughout much of the twentieth century in Australia as a result of the Segregation Policy p22 [ 3 ] was felt by local Aboriginal people who remember birthing their babies on the verandah of the hospital [ 31 ].
Segregation meant that healthcare was delivered on the outside of the health service for Aboriginal people who at that time found solace in their cultural beliefs and their relationship with their ancestral land. The connection with the land facilitated healing, in spite of the physical divide.
Over time, however, Aboriginal people grew suspicious of mainstream health services, a suspicion that negatively impacted a sense of trust, safety and access. More than a physical divide resulted, rather a gap in health care provision between Aboriginal and non-Aboriginal people. Findings indicate that well before modern policy directives, the first step toward culturally healing past inequalities at this local health service was initiated by the very people who were negatively affected by it.
Upon reflection, it was clear to the local Aboriginal community that this powerful step enabled, firstly, a positive shift in consciousness toward historical acceptance and, secondly, the building of trust and safety for Aboriginal people to begin physically healing within the building, rather than external to it.
According to Dockery [ 32 ], both educational attainment and employment among Aboriginal people are positively associated with strong cultural attachment. Findings presented here suggest that the local Aboriginal women, who exemplified self-determination and successfully sought employment at the health service decades ago, during an era of significant cultural inequality, were women who had overcome the suspicion.
It may be implied therefore that they felt safe and well attached to their culture. Elders remember that concerted efforts led to six Aboriginal people being employed at the hospital. Today, it is unknown how many Aboriginal people work at the health service, given the on boarding processes do not capture Aboriginal status. Without recording Aboriginal status, attempts to strengthen the Aboriginal workplace cannot be measured.
Kareeta Yirramboi launched a concerted effort into developing economic growth among Aboriginal people [ 33 ], enabling the health service to review their local relationship with the Aboriginal community. Strength was evidenced by the longstanding membership of an Aboriginal person on the Board and Chairperson for much of the current tenure. According to the first domain of the Cultural Respect Framework , as developed by AHMAC, Aboriginal inclusion in governance reflects a systemic organisational approach to cultural safety and responsiveness [ 34 ].
Three additional health service milestones reflected organisational leadership, namely, the cultural engagement during the physical redevelopment of the site, the signing of a MOU with each local ACCHO and the introduction of the AEP. The health service was uniquely placed during the redesign and rebuild of the facility, to strengthen existing relationships with the Aboriginal community.
An Art Acquisition Advisory Group was engaged to support the appropriate use of artwork, the installation of Acknowledgement of Country plaques at all entrances and the development of the Malka Room , a safe place for Aboriginal people.
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Foley [ 35 ] reports that prominently placed Aboriginal visual statements provide a philosophical, political and intellectual foundation pertinent to building inclusive pride, thus representing a commendable step forward in developing inclusion. Using artwork and displaying both the Aboriginal and Torres Strait Islander flags are both examples of communicating a culturally safe environment to the community—domain 2 in the Cultural Respect Framework [ 34 ].
Participating in Aboriginal-specific cultural celebrations, for example NAIDOC week, was also considered a step toward reconciling the past by the Aboriginal stakeholders in this study. Aboriginal career expos, traineeships that incorporate a pipeline or pathway into higher education close to home, were described in this study by health service executive officers as major achievements. Certainly, building the capacity of Aboriginal employees and offering career progression is recognised as an organisational commitment to growing and retaining Aboriginal people [ 34 ] thus exemplifying a dedication to the AEP.
A regional Queensland health service identified in their — Cultural Capability Plan that fostering relationships with training providers and nurturing employment pathways for Aboriginal people is a key priority in building a dependable and sustainable healthcare system [ 37 ]. Carson and McConnell [ 38 ] found in their examination of Census data relating to remote NT Aboriginal health and community service employment that workforce growth can be sustained if Aboriginal people are engaged in educational opportunities pertaining to professional practice within their community, more so than accessing education outside of their community.
It was also found in this study that when training providers are close to the home of an Aboriginal person, enhanced engagement results. The Heart Foundation in Western Australia WA found that both trust and flexibility are essential ingredients in supporting the personal development of an Aboriginal employee in a mainstream workplace [ 39 ]. It was clear from present findings that supporting Aboriginal young people in their career development requires consideration of their home life and provision of support unique to this population group.
Stories heard through the Roche et al. Many had experienced significant bereavements, domestic violence and personal or family problems with alcohol or drugs. The high prevalence of premature deaths and suicides in communities resulted in profound loss and grief Although the complexities of the personal lives of an Aboriginal person may be an important consideration for mainstream employers, it is worth noting that the Aboriginal employees studied by Roche et al. Similarly in this study, mutual learning regarding cultural difference led to a realisation that true engagement with Aboriginal employees can lead to rewards that outweigh the challenges.
It is a learning that is reciprocated, revisited regularly and ongoing to ensure equity in the workplace. Aboriginal AOD employees declared that it was vital to job satisfaction that they felt a strong level of support in their workplace, where peers and managers are culturally aware [ 41 , 42 ]. Aboriginal health workers employed in a mainstream health service experience little separation from their community and their workplace duty to continuously advocate and create cultural safety, ultimately increasing the risk of emotional exhaustion and burnout [ 41 , 42 ].
Over time, the mutual learnings about cultural difference were found to enable the employer in this study with an ability to have reciprocal conversations with Aboriginal employees, where clear expectations are discussed. Watson et al [ 45 ] also found in their Queensland study with Aboriginal child health workers CHW that performance was considered better if clear roles and responsibilities were outlined, learning was supported and suitable resources were made available.
Peer mentoring was discovered by Browne and colleagues [ 46 ] in their evaluation of a mentoring relationship between Aboriginal health workers AHWs and allied health assistants AHAs as a valuable means to improving practice through two-way learning and importantly reciprocity in developing cultural competence. Reciprocal cultural learning in itself provides justification and value for collaborating with local Aboriginal organisations, conducting workforce planning together and seeking dual positions between the health service and local agencies, a suggestion made by key stakeholders in this study.
It was equally important to the Aboriginal employees in this study that they too develop meaningful relationships with their community through both local agencies outside their organisation and each other within the health service.
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Mainstream employment was reported as being isolating when only few Aboriginal people are employed, indicating that an informal Aboriginal Staff Network would bridge that gap by ensuring interaction. Wood et al. Both Karreeta Yirramboi and the national strategic framework for developing the Aboriginal health workforce indicate that mentoring support and Aboriginal networks are important for retaining Aboriginal employees by facilitating career progression and knowledge development [ 8 , 33 ].
However, little attention has been paid to having a network simply for connection with one another to mitigate isolation in mainstream workplaces, an outcome that warrants acknowledgement.
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Importantly, however, Westwood and Westwood [ 47 ] found in their evaluation of either half or two full days of CAT programs offered in New South Wales NSW , that CAT is often too broad and, at times, inadequately overcomes any predisposing attitudes or stereotypes toward Aboriginal people. Authors did however emphasise that embedding CAT for all staff, with an extended version of training in cultural competence offered to key staff, particularly managers, where broader leadership and accountability in improved health outcomes are expected, may be beneficial [ 47 ].
In contrast, however, Ferdinand et al.
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