Australian Indigenous

 

This section of the Bulletin identifies recent theses, treatises, dissertations and other academic reports. If you are aware of material that would be appropriate for inclusion in this section please contact us.

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The solitary position of nurses who practise in geographically isolated communities to provide direct care to a predominantly Aboriginal population characterises nursing in remote areas of Australia. The particular nature of this practice, however, has remained shrouded in superficial descriptions and images featuring the heroic efforts of these nurses, the physical distance from hospital facilities and the autonomy by which nursing is performed. Only glimpses of the reality of nursing practice in remote areas have been revealed, mainly through the study of educational needs for remote area nurses. A key problem is the lack of a systematic description and detailed analysis of nursing as it is practised in a remote area setting.

The purpose of this study was to explore, describe and analyse the practice of nursing in a remote area. The research was undertaken at an isolated community mainly inhabited by Aboriginal people in the Central Desert of Western Australia, An ethnographic design was chosen for this exploratory inquiry into the social and cultural pattern of everyday practice. In a pre-entry study, involving a contract agreement with the Aboriginal council, a suitable setting and informants were found. Fieldwork was conducted by the researcher whilst living for one year at the remote nursing post. Data gathering techniques were participant observation together with interviewing, collection of pertinent documents and the daily chronological recording of fieldnotes, memos and a personal journal. Data analysis was performed concurrent with data gathering. Through a cyclical process of data collection and analysis the domains, taxonomies and componential variables in the culture of remote area nursing practice emerged.

Amorphous practice was the overall theme revealed in the underlying cultural patterns that shaped the practice of nursing in the remote area. The term amorphous practice is defined as the changeable nature of practice from nurse to nurse, from situation to situation, and from time to time. This was observed in the recurrent differences between nurses in their knowledge, abilities and attitudes as well as in the variability between nurses in their management of client care. Three distinct but inter-related tributary themes to amorphous practice were termed detachment, diffusion and beyond the nursing domain. Detachment explains nurses' feelings of separateness from the usual professional and organisational structures needed for the enactment of nursing. Diffusion encapsulates the outspread of parameters for remote area practice. Beyond the nursing domain describes an unregulated practice considered to be outside the responsibilities of nursing care. The substantive theory of amorphous practice provides a detailed description of how nursing is practised in a remote area context and explains why it is so different from nursing as it is generally understood by the profession. Within this analysis some of the consequences of a practice that is 'allowed to happen' are also uncovered as well as its implications for the outcomes of health care, particularly for Aboriginal clients.

Dr Jenny Cramer
Project Leader
Curtin Indigenous Research Centre
Centre for Aboriginal Studies
Curtin University of Technology
GPO Box U 1987 PERTH WA
6845 Phone (08) 9266 4192/ 9266 3588 Fax (08) 9266 2888
http://gunada.curtin.edu.au/circ/index.html

Davey C (1999) On being a young Aboriginal male in contemporary Australia. Report of public health project, 5th year medicine, University of Western Australia, Perth.

The aim of the study was to review the relevant literature on the mental health and other behavioural problems being experienced by young Aboriginal males. The review covers the psychiatric and social science literature, and focuses in particular on the social upheaval that has affected Aborigines over the last 30 years.

Many of the epidemiological studies are flawed in their methodologies, rely on small sample sizes and reach speculative conclusions. Nonetheless, certain themes emerge. Many young Aborigines have grown up with heavy parental drinking, often in families other than their own, and without male role models. Adolescence is a period marked by substance abuse and the display of provocative behaviours. Violence is common, and rates of imprisonment high. A cluster of suicides in custody in the 1980s drew attention to suicide in the wider Aboriginal population, and to relatively high rates of depression and anxiety. Despite the prevalence of mental health problems, use of mainstream services is low.

The parents of children being born today are living as their parents were, with similarly high rates of heavy alcohol consumption, and the absence of fathers due to the effects of alcohol and imprisonment. While there is evidence that a strong sense of Aboriginality persists in many communities, the generation emerging today will likely experience the same disadvantages as their parents.

Hammill J (2000) Culture of chaos: Indigenous women and vulnerability in an Australian rural reserve. Unpublished Doctor of Philosophy thesis, Australian Centre for International Health and Nutrition, University of Queensland, Herston.

Biographical and ethnographical approaches are used in this thesis to describe the endemic nature of violence experienced by Indigenous women in a Deed of Grant in Trust community. The work, influenced by Paolo Friere's participatory action research model, emphasises that people have a right to participate in the production of knowledge that directly affects their lives. Consequently, the thesis evolved as a reciprocal arrangement with women who operate a safety house and advocacy service for women and children as they struggle for justice and social change.

In exchange for assistance with a broad range of community development initiatives including staging events, producing submissions and general correspondence, staff development programs, reports and whatever else was needed to be written, the researcher was given a vivid description of the community, its problems and strengths.

The work documents the political, social and economic activities that a small group of Cherbourg women utilise to bring about change and assert their right to love without violence. It describes their membership of an oppressed group, as sole parents largely dependent on the maternal economy and the matriarchs. It narrates the stories of women experiencing violence in various situations especially that induced by alcohol and in the competition for men. It also demonstrates how the absence of male role models creates negative developmental pathways for children and leads sons into early contact with the criminal justice system.

(The information in the thesis remains the property of Jundah Aboriginal Corporation, telephone 0741 682 531, and cannot be copied or quoted without permission from the Executive Committee. However I will be glad to answer any queries and my contact details are as below.)

Jan Hammill PhD
Research Fellow
Centre for Public Health Research, School of Public Health
Queensland University of Technology
Victoria Park Road
Kelvin Grove Qld 4059
Australia
Phone: (07) 3864 5724
Fax: (07) 3864 3369
Email: j.hammill@qut.edu.au