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  • 'Take pride in it' - the extra, silent workload of an Aboriginal nurse

    Author: Charlotte Mitchell

Despite the challenges and additional responsibility that comes with working as an Aboriginal nurse, Lesley Salem still reckons it is “the most exciting job on the face of the Earth”.

Ms Salem, who currently works as a generalist nurse practitioner in a remote Aboriginal community called Doomadgee in far north-west Queensland, told HealthTimes, that “when you’re an Aboriginal nurse, there is a secret and silent workload that you carry on top of everything else.”

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“If somebody comes into a hospital and you're known to be there, you are always responsible for kin and community, and it doesn't matter whether you're looking after the patient or not, if something goes wrong, you are held responsible.”

“You’re always expected to provide extra help, even though they might not be on your ward. There's still that additional responsibility for what happens and the welfare of that patient while they’re in there.”

Ms Salem said that young indigenous nurses are told early on about what is expected of them, so that it does not come as a shock down the road.


“And we've got a lot of younger ones who have grown up without being responsible for those kinship relationships, so it can come as a surprise to learn that this will be a part of their work.”

“We have to teach them that cultural links still exist, that we are responsible for kin and community. And more so when people become sick, and when they recognize you as an Aboriginal person, you have that duty.”

“Some Aboriginal nurses don't identify as Aboriginal because they don't want to take that on.”

“But my advice is to stand up and make sure people are getting culturally safe care and that they're not being discriminated against. Ensure that they are getting all the care that they need –socially and emotionally, as well as medically.”

“Take pride in the fact you do extra.”

While nursing is undoubtedly her passion, it wasn’t Ms Salem’s initial career choice. “Becoming a nurse was actually an accident!”

“I was going to go into electrical engineering and applied to all the universities, because my father was an electrician and I just idolised him”, she said.

“But I needed to make some money before I went to university and a friend said, look, just say you want to be a nurse and they'll employ you straight away – this was back in the day.”

“So, we finished school in November, and I went up and said to the matron, 'I want to be a nurse'. She told me I could start tomorrow.”

“On day one, there was a death. So that was a totally new situation for me. Then we had a cardiac arrest and we saved the person.”

“Just three days later, I was asked to run and see why somebody was blowing the car horn out the side of the building. And I went to open the door and caught a baby, as the woman delivered a baby in the back of the car.”

“And I thought, this is the most exciting profession on the face of the earth. And I just fell more and more in love with it."

Ms Salem had trained at a country hospital, in a time before seat belts became law and drinking under the influence of alcohol was not illegal.

“My training was so hands-on. From a very early time, I was intubating patients, sewing them up, canulating, running IV fluid. It was part and parcel of what you did in a country hospital.”

“For me, it was all about becoming knowledgeable, being skilled clinically, and keeping abreast of things was really important.”

“It was all up to you if you were on duty when people presented. Especially before seatbelts became law, you’d be seeing children and adults coming in and you were responsible.”

Ms Salem said that aside from being an Aboriginal nurse, the nursing profession collectively still suffers from discrimination and prejudice.

“Being a nurse, there’s discrimination and it's ongoing. You’re seen as just a handmaiden because less education is needed than being in the medical profession.”

“I've been a nurse practitioner for 19 years and I'm usually employed in areas where there's no medical officers, so I'm totally taking care of patients for Aboriginal medical services.”

“And it doesn't matter how well we do this job, the government will still not see us as an equal, alternative healthcare provider to this nation.”

“There's still a monopoly on that by the medical profession – despite the fact we've had 20 years of nurse practitioners providing pharmacological treatments and nursing treatments. It doesn't seem to matter.”

Despite the ongoing challenges, Ms Salem has loved each and every one of her roles.

“I've loved being a nurse practitioner. I love being the one to call the shots and do the right thing.”

“As nurses, we are absolutely committed to evidence-based practice and we're not allowed legally to do anything else, whereas I see so many doctors coming up to the practices where I work, and they will do things that are out of date.”

“I'm very proud to be part of a profession where we are evidence-based, and we don’t have all the litigation that the medical community has”, Ms Salem said.

“Really, how much more do we have to prove ourselves?”

Recently, Ms Salem shared more of her story with HESTA as part of an initiative to shine a light on the personal experiences of Aboriginal and Torres Strait Islander nurses and midwives.

Caring and Community: Stories from Aboriginal nurses and midwives is a new publication which celebrates thousands of years of birthing and healing practice by acknowledging the contributions and journeys of 11 nurses and midwives.


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Charlotte Mitchell

Charlotte is a published journalist and editor, with 10 years of experience in developing high-quality content for national and international publications.

With an academic background in both science and communications, she specialises in medical and science writing. Charlotte is passionate about creating engaging, evidence-based content that equips the community with important information on issues around healthcare, medicine and research.

Over the years, she has partnered with organisations including the Medical Journal of Australia, Cancer Council NSW, Bupa, the Australasian Medical Publishing Company, Dementia Australia, MDA National, pharmaceutical companies, and state and federal government agencies, to produce high-impact news and clinical content  for different audiences.