Moving Forward Together in Aboriginal Women's Health: - Theses ...

Moving Forward TogetherJanet Kellyhad a very lively two-way conversation that involved me sharing mynursing/sexual health knowledge and her sharing her and her friend’sexperiences. At the end of the consult she thanked me for the time Ispent with her. On reflection, we had both shared information and hadbenefited from our time together (Reflective journal 6 March 2005)This interaction demonstrates how the client and I were able to share ourknowledges and find ways to work collaboratively to ensure her personal andcultural needs were met. Using the Ganma metaphor, I was a ‘white’community health nurse (salt water) who brought to the consultationknowledge about sexual health and contraception. The client was a youngAboriginal woman (fresh water) who brought to the consultation knowledgeabout her cultural and personal priorities and that of her family and Elders.Together we created new knowledge (foam) as the options swirled andintertwined throughout our discussion. The encounter was positive andtransformative for us both. In order to work in this way, I needed to have thefreedom and organisational support to recognise and respond to the youngwoman’s needs. Working within a comprehensive primary health care modelthat valued both practitioner and client knowledge, and the ways that theseknowledges came together, enabled me to provide culturally safe care. Thisraises questions about what is considered valid knowledge in health careencounters.Evidence based practice –revisiting what constitutes knowledgeQuality health care is based on evidence based practice. Evidence is oftenconsidered synonymous with scientific. However, Canadian researchersKirkham et al (2007) question the ways in which unmodified and unquestionedWestern scientific evidence based practice is used in health care, arguing that itcan limit a health professionals’ ability to meet individual clients needs,particularly the needs of Aboriginal peoples with ongoing health disparities.While recognising that technical evidence based practice plays an importantrole in improving efficient and effective health care (biomedical model), ifused unquestioningly and unmodified, it can promote a (colonising) set recipeapproach that does not take into account the deep rooted social, economic andhistorical factors that underlay health disparities.106