Elaine Duffy

Horizontal violence: a conundrum for nursing

Abstract Horizontal violence is described as intergroup conflict and is manifested in overt and covert non-physical hostility such as sabotage, infighting, scapegoating and criticism. The notion of horizontal violence is frequently referred to amongst nurses, and is often explained in terms of behaviours associated with: women working together; personality traits; jealousy; ambition, and lack of respect for each other. It is rarely linked to politics in nursing and health care. Nursings subordinate position in the health care system is long established and well documented. The subordination of nurses, established early in the history of the nursing occupation, and the ideologies of women as nurses have been maintained and reinforced through primary socialisation, nursing education and professional socialisation. As a result, nurses perceive themselves as powerless to effect change and to challenge the status quo in nursing and health care. This paper explores critically the phenomenon of horizontal violence in nursing. The analysis rests on the premise that, structurally, nurses are an oppressed group. Oppression theory, therefore, provides the framework for analysis.

‘She knows how we feel’: Australian Aboriginal and Torres Strait Islander childbearing women's experience of Continuity of Care with an Australian Aboriginal and Torres Strait Islander midwifery student

BACKGROUND Marked differences exist between the maternal and neonatal outcomes of Australian Aboriginal and Torres Strait Islander women and their babies compared with the outcomes for other Australian women and their babies. Australian government policies underline the need to increase the number of practising Aboriginal and Torres Strait Islander midwives and nurses as a strategy for delivering culturally appropriate healthcare to improve health outcomes for Aboriginal and Torres Strait Islander families. Additional challenges are experienced by Aboriginal and/or Torres Strait Islander midwifery students providing Continuity of Care (COC) to Australian Aboriginal and/or Torres Strait Islander childbearing women. One such example is the challenge presented due to the close connections and relationships that exist within some Aboriginal and/or Torres Strait Islander cultures in terms of the maintenance of a professional relationship, in particular, the maintenance of professional boundaries. Whilst there is a growing body of evidence on the benefits to women of continuity of midwifery care models, little is known about the experiences of Aboriginal and Torres Strait Islander women who receive COC from Aboriginal and Torres Strait Islander midwifery students. AIM To explore the experiences of Australian Aboriginal and Torres Strait Islander childbearing women who participated in a Continuity of Care journey with an Aboriginal and/or Torres Strait Islander Bachelor of Midwifery student. METHODS Exploratory, descriptive study using semi-structured interviews informed by an Indigenous Research Methodology. FINDINGS Thematic analysis identified four major themes: (i) communicating our way, (ii) the role of relationships, (iii) support and assistance and (iv) challenges of the system. The findings illustrated the benefits Aboriginal women experience as a result of having Aboriginal and/or Torres Strait Islander midwifery students provide Continuity of Care. CONCLUSION Increasing the number of Australian Aboriginal and/or Torres Strait Islander midwives is essential to improving health outcomes for Australian Aboriginal and Torres Strait Islander childbearing women and their families. Caseload midwifery models with Aboriginal and Torres Strait Islander midwives across Australia are needed. Health services, in partnership with Universities and Aboriginal and Torres Strait Islander communities, have a vital role to play in the development and expansion of these models.

Educating Health Professionals

Health professionals who teach may be salaried health sector employees who are directly engaged by a higher education institution in adjunct or conjoint academic appointments. Many teaching health professionals also provide learning activities through good will and altruism. Another group consists of academics with health professional degrees for whom academia is the primary employment; these professionals may engage in professional clinical practice in only a limited capacity.University teachers are a heterogeneous group, reflective of the society from which they are drawn, but can be considered in three loose groupings. One group is made up of people who are primarily educators and who hold educational qualifications in support of their academic roles. Another group hold qualifications in a health profession such as nursing and forego their professional practice in order to become full-time university teachers.

Major current themes in health professional education

Reflecting on the current state of the art of health professional education evokes a mixture of conflicting thoughts and feelings, uncertainty and challenges on one hand and excitement and opportunity on the other. These sentiments have been expressed throughout this book by colleagues from a range of disciplines and contexts. The authors have shared with you their personal experiences, research and personal reflections on what it is to be a teacher/researcher in the academy.

Indigenous Issues in Health Professional Education

Furthermore, the Declaration advocates that Indigenous peoples have the right to the dignity and diversity of their cultures, traditions, histories and aspirations, which shall be appropriately reflected in education. Through Indigenous leadership and academic pursuits, countries such as Australia, the USA, Canada and New Zealand have explored and continue to explore ways of dealing with the effects of colonisation by actively pursuing decolonising strategies in both education and research.