Dr Melissa Arnold-ujvari1, Dr Kim O’Donnell, Dr Elizabeth Rix, Dr Janet Kelly
1Adelaide University, Adelaide, Australia
Biography:
I began my renal nursing career in 1990, working in haemodialysis and renal wards in Australia and the UK. I have been working in academia for 20 years and am currently the Program Director for the Bachelor of Nursing at Adelaide University. I was a co-author on the inaugural CARI Guidelines for culturally safe kidney care for First Nations Australians and completed my PhD on cultural safety education in renal nursing. I was Editor in Chief of the Renal Society of Australasia Journal (2016-2020) and Deputy Editor (2020-2023). I am honoured to be a current member of the RSA Board.
Abstract:
Background
Cultural safety is crucial for equity and inclusion for First Nations People in kidney health settings. A lack of culturally safe and responsive care remains a significant barrier for many First Nations People, who prioritise cultural identity, family, and kinship. The predominantly non-First Nations nursing workforce with a limited understanding of the importance of family, community, and Country inadvertently causes negative consequences for First Nations People.
Aim
This study investigated renal nurses’ cultural education in a metropolitan and rural health service in South Australia and how this translated into clinical and cultural safety practice when working with First Nations People experiencing kidney disease. A qualitative Participatory Action Research used semi-structured interviews with renal nurses. Participants included First Nations and non-First Nations nurses sharing their cultural education journeys and how this translated into their practice.
Methods
This qualitative participatory action research study was informed by Indigenous Institutional Theory and decolonising methodologies. Semi structured interviews were inductively and deductively analysed into themes and discussed with the AKction First Nations kidney care consumer reference team for verification and feedback.
Results
First Nations and non-First Nations nurses expressed frustration at limited access to cultural education and institutional barriers to embed culturally safer skills and practice. Five illustrative themes were identified.
Conclusion
This study identified individual goodwill of nurses and support from change champions and one effective co-designed cultural safety educational approach. However institutional inertia hindered the prioritisation and implementation of appropriate cultural safety education and improve practice within the healthcare system.