Whatever your interests and motivations, nursing is certain to be a career that rewards, challenges and inspires you. It requires the seamless blending of theoretical and technical knowledge with a way of being and behaving (moral comportment), leading to clinical wisdom or deep understanding that supports the highest possible quality of care for individuals, families and communities. We present a range of nursing knowledge and perspectives that are important for professional nursing practice in contemporary Australian healt hcare, but encourage you to engage in your own reflections about what it means to be and act as a nurse, with the aim of discovering and nurturing your personal passion for nursing (Benner et al. 2010, Gottlieb & Gottlieb 2012, p. 4). This opening chapter sets the scene for your undergraduate nursing journey. We welcome you to the wonderful, dynamic and diverse profession of nursing and encourage some initial thinking about what nursing is, why you have chosen this career and the sort of nurse you hope to be. We also outline the purpose, structure and features of this book, and introduce you to the key concepts and ideas underpinning your learning journey.

One of Florence Nightingale'slegacies was her advocacy for, and establishment of, a formal system of training for nurses. This vocational or apprenticeship model of training rapidly spread, with hospital-based training schools being set up across the country.This chapter introduces you to core elements and considerations in ‘contemporary’ nursing education. We link this to the notion of ‘capability in nursing’ and provide an overview of what you can expect in your degree program, with links to other chapters where these concepts and ideas are explored in more depth. We conclude the chapter with a brief look at some of the resources and strategies that can be used to optimise your learning success.

This chapter discusses the health of Aboriginal and Torres Strait Islander peoples from a gendered perspective, considering the different health needs and outcomes experienced by men and women. It begins by unpacking the construct of gender and discussing how gender and gender variations are viewed and accepted by Aboriginal and Torres Strait Islander communities. The Indigenous understandings of women’s business and men’s business are discussed from historical and contemporary perspectives, with a strong focus on the National Aboriginal Health Strategy’s definitions of the two. The chapter then discusses the differences in health outcomes between Indigenous and non-Indigenous men and women, and how the different views they have of health may affect them, before considering how nurses can best provide gender-appropriate care to their Aboriginal and Torres Strait Islander patients. The chapter concludes by considering how Australian policies have varied in meeting the gendered needs of Indigenous Australians, and how the health of Aboriginal and Torres Strait Islander men and women is changing and will continue to do so into the future.

This chapter provides a contextual overview of Torres Strait Islander’s health and wellbeing. It begins by discussing the location and pre-colonisation history of the Torres Strait Islands and their peoples and notes that there is a shift back towards calling the region by its local name, Zenadth Kes. It considers Torres Strait Islanders connections to Country, including the sea, and Kin, and their belonging within tribes and clans. It then discusses Torres Strait Islanders’ perspectives of health and wellbeing both before and after invasion and colonisation and makes suggestions for culturally safe practice that incorporates Torres Strait Islanders’ history. It outlines the current provision of primary health care in the Torres Strait and looks at how this can holistically incorporate traditional medicine practices. The final section of the chapter considers the threat of climate change and its impact on Torres Strait Islanders’ physical and spiritual connection to their Country and consequently their health and wellbeing.

This chapter focuses on the different health needs and outcomes of Indigenous children and their families. It begins by discussing the national policies aimed at improving Indigenous child health, including the National Framework for Health Services for Aboriginal and Torres Strait Islander Children and Families, and by considering the cultural and social considerations when providing healthcare to Indigenous children. The gap between mortality and morbidity rates of Aboriginal and Torres Strait Islander children and non-Indigenous children is established as the authors call for nurses and midwives to understand the stories behind these statistics, before considering the programs and initiatives aimed at improving health outcomes of Indigenous children. The chapter discusses ways to promote health, and considers common health issues experienced by Indigenous children, including poor nutrition, oral and ear health, and infections. The chapter provides concrete ways in which nurses and midwives can care for Indigenous children and also discusses examples of community programs working to reduce the rate of accidents and self-harm in Indigenous children.

The health outcomes and health needs of Aboriginal and Torres Strait Islander peoples living in remote communities are different to those living in regional and urban communities. This chapter discusses the role of remote area nurses (RANs) and their scope of practice, along with the challenges they may face while working in remote Indigenous communities. It establishes the need for RANs to integrate with the community and lead health initiatives. The work RANs may undertake is discussed, as well as the additional qualifications, including immunisation, sexual health endorsements and x-ray licences, which may be of benefit. The chapter discusses the different burden of disease and injury in remote Aboriginal and Torres Strait Island communities, and the holistic way these communities often perceive health. The chapter calls for cultural safety in remote area nursing, and suggests that respecting differences in culture, communication and health education is critical. The author concludes by reflecting on her own experience as a remote area nurse.

This chapter introduces nursing and midwifery students to the history and current state of Aboriginal and Torres Strait Islanders’ health. It considers the deficit discourse that is often used to describe Indigenous health, which negatively contrasts Indigenous health with the health of non-Indigenous Australians. The chapter emphasises the importance of understanding the history of Indigenous health, both from pre-colonisation and in the years following. It discusses the recent Uluru Statement from the Heart and the history of the Stolen Generations, and examines the effects on Aboriginal and Torres Strait Islander health. The chapter discusses the current health gap that exists between First Nations people and non-Indigenous Australians, and how the Closing the Gap initiative aims to improve Indigenous health outcomes to the level of non-Indigenous Australians. The chapter portrays health as a social justice issue and encourages a human rights approach to health. It concludes by detailing the personal stories of two First Nations nurses to demonstrate the positive effect Indigenous nurses and midwives can have on the health of Aboriginal and Torres Strait Islander peoples.

This chapter introduces readers to Indigenous-led research, with a particular focus on qualitative methods. It begins by discussing the history of Indigenous research, which has not always been ethical or culturally appropriate, before discussing the relatively recent push for change as Indigenous people advocated for research by, for and about Indigenous people. This has seen an increase in culturally safe research, where the needs of Indigenous communities are considered throughout the research process. It provides guidance for nurses and midwives to begin research projects, and considers how they can apply ethical research in Aboriginal and Torres Strait Islander communities. The chapter then considers common qualitative methods that can be used, before discussing how to undertake a culturally safe qualitative research project by understanding community protocols and engaging the community. The chapter guides readers through the process of ethics approvals, identifying and recruiting participants, conducting focus groups and displaying findings.

This chapter discusses Indigenous birthing practices in remote locations. It begins by considering the traditional practices of Aboriginal and Torres Strait Islander women and the importance of Grandmothers’ Law. It explores traditional practices and taboos around diet, labour, family and breastfeeding for pregnant and post-partum women. It then discusses the changes implemented after colonisation as missionaries became more common and Indigenous women were made to leave their communities and families to give birth in hospitals in larger regional locations. The chapter guides readers through providing culturally safe care to pregnant Aboriginal and Torres Strait Islander women, before looking at the shift to reopening birthing centres in remote locations to allow Indigenous women to once again safely give birth on Country.

This chapter explores the care of Elders and older Aboriginal and Torres Strait Islander peoples. It discusses the shorter lifespan and earlier prevalence of chronic conditions, including dementia, in Indigenous Australians. The chapter calls for a human rights approach to caring for older Aboriginals and Torres Strait Islander people and promotes patient-centred care that considers the rights of Indigenous peoples. It explores the current health policies and strategies implemented within Australia, which provide guidance on caring for older Indigenous Australians. The importance of nurses providing culturally safe aged care and palliative care is discussed.

This chapter discusses the role of community controlled health services in the Australian healthcare system and their contribution to improving health outcomes for Aboriginal and Torres Strait Islander peoples. It begins by exploring the establishment of community controlled health services in Brisbane in response to the different health needs of Indigenous people at the time. The chapter then discusses the concept of community control, defining it as being by the community, for the community. Aboriginal community controlled health organisations (ACCHOs) are led by, based in and governed by Indigenous communities. The chapter discusses the experience of working in a community controlled clinic as part of a multidisciplinary team. Key health services, including the National Aboriginal Community Controlled Health Organisation (NACCHO) and the Queensland Aboriginal and Islander Health Council (QAIHC), and their contribution to culturally safe care, are discussed in detail. The chapter concludes by considering recent changes to the Australian healthcare sector and future opportunities for ACCHOs.

This chapter discusses midwifery practices in relation to Aboriginal and Torres Strait Islander women in urban and regional areas. It begins by considering the challenges Indigenous women face when they experience maternity care in mainstream healthcare settings, and the importance of providing and receiving culturally safe maternity care. Traditional birthing practices used by Aboriginal and Torres Strait Islander women prior to colonisation are discussed. The chapter provides an overview of maternal and neonatal health today by considering statistics related to the health of Indigenous mothers and infants, fertility rates and gestational issues Aboriginal and Torres Strait Islander women may face, along with recent improvements in antenatal care and infant health outcomes. Current birthing practices are discussed, before Indigenous-led models of care are presented as ways to provide culturally safe care to pregnant Aboriginal and Torres Strait Islander women. The chapter considers the role of Indigenous nurses and midwives in contributing to better maternal outcomes for Indigenous women and their babies, and provides concrete ways in which all nurses and midwives can provide culturally safe care.

This chapter considers cultural safety within the context of Australian nursing and midwifery practice, using Irihapeti Ramsden’s definition of cultural safety as a framework. The chapter begins by considering the effects of colonisation on the health of Aboriginal and Torres Strait Islander peoples, and how nurses must be aware of their patients’ cultures (which extend beyond ethnicity) in order to effectively treat them. The chapter discusses the journey practitioners take from cultural awareness through cultural sensitivity to achieve cultural safety. The chapter suggests that nurses must use self-reflection as a tool to understand their own beliefs, values and attitudes and how these may impact the healthcare they provide. This chapter is a call to all nurses and midwives to understand the differences between themselves and their patients, and to provide culturally safe care to all patients.

This edition of Yatdjuligin was written in 2020, the Year of the Nurse and Midwife. It was also written during the first global pandemic for more than 100 years – COVID-19. In this year, while the professions of nursing and midwifery were celebrated, the reality was that nurses and midwives were working in unprecedented times on the front line across the globe.