Pre-Commencement Orientation TCHHS-P&C-HR … · Effective from: 7 September 2017 Version: 6.0...

Effective from: 7 September 2017 Version: 6.0

Pre–Commencement Orientation TCHHS-P&C-HR-HBOOK-0106

Table of Contents Acknowledgements ............................................................................................................................................... 3 Welcome ................................................................................................................................................................. 4 Torres and Cape Hospital and Health Service (TCHHS) .................................................................................... 4

Our Vision .............................................................................................................................................................. 5 Our Purpose .......................................................................................................................................................... 5 Two-way Learning ................................................................................................................................................. 5 Geographical Landscape ....................................................................................................................................... 5

Cape York ............................................................................................................................................................... 7 Deed of Grant in Trust (or DOGIT) Communities .................................................................................................. 7 Meeting Challenges, Making Choices (MCMC) Communities .............................................................................. 7 Discrete Indigenous Communities ......................................................................................................................... 7 Welfare Reform (WR) Communities ...................................................................................................................... 7 Remote Service Delivery (RSD) ............................................................................................................................ 7

Torres Strait and Northern Peninsula Area......................................................................................................... 8 Papua New Guinea – The Torres Strait Treaty ..................................................................................................... 8

Cultural Considerations ........................................................................................................................................ 9 Many cultures, common ground, your first day ..................................................................................................... 9 Expectations of You ............................................................................................................................................... 9 Get to know the Community ................................................................................................................................ 10

Other Resources toward Safe Cultural Practice .............................................................................................. 15 Approval ............................................................................................................................................................... 16 Effective Dates ..................................................................................................................................................... 16 Version Control .................................................................................................................................................... 16

2 TCHHS Pre-Commencement Orientation | TCHHS-P&C-HR-HBOOK-0106 Version 6.0

Acknowledgements This resource has been adapted from a number of sources. Thank you to the following contributors:

• Remote Area Health Corps (RAHC) • Rural and Remote Orientation & Training • Judith Austin - Charles Darwin University for NT Health • Chief Health Officer - Queensland Health • Department of Health

TCHHS Pre-Commencement Orientation | TCHHS-P&C-HR-HBOOK-0106 Version 6.0 3

Welcome Welcome to the Torres and Cape Hospital and Health Service (TCHHS). We are glad you have taken this opportunity to join the team and work with us in this unique and beautiful part of Australia. With diverse geographical locations and cultures, we deliver health services to rural and remote environments. The TCHHS offers excellent opportunities for new personal and professional experiences. This orientation booklet provides essential information to help you settle into your new position. Additional support and information will be provided as part of your site specific induction once you arrive at your location.

Torres and Cape Hospital and Health Service (TCHHS) The Torres and Cape Hospital and Health Service (TCHHS) is the most northerly of Queensland’s Hospital and Health Services and covers over 158,000km2 across 13 local government areas. TCHHS is one of Australia’s largest providers of health services to Aboriginal and Torres Strait Islander peoples. The TCHHS provides health care to a resident population of more than 25,000 people of which 63.7% identify as Aboriginal and/or Torres Strait Islander. The northern boundary is adjacent to Papua New Guinea. TCHHS comprises 31 primary health care centres, 2 hospitals (Thursday Island and Bamaga), a multi-purpose health service (Cooktown) and an integrated health service (Weipa). The TCHHS has approximately 800 employees and supports a wide range of healthcare providers including outreach teams and visiting specialist services from other health services and non-government providers. As a Hospital and Health Service employee you are eligible to salary sacrifice or package some of your pre-tax salary and use it to pay for benefits such as rent or mortgage repayments, insurance or motor vehicle operating expenses. For further information visit the website: http://www.health.qld.gov.au/services/torres-cape/


http://www.health.qld.gov.au/services/torres-cape/

Our Vision

“Healthy people and communities in the Torres Strait, Northern Peninsula Area and across Cape York.”

Our Purpose

To improve the health and wellbeing of people in the Torres Strait, Northern Peninsula Area and Cape York areas by partnering with communities. Our Objectives The TCHHS objectives align with the Queensland Governments’ objectives through the delivery of quality frontline services, building safe, caring and connected communities and creating jobs and a diverse economy.

1. Excellence in health care. 2. Advancing health through strong partnerships. 3. A safe, engaged, valued, skilled and culturally diverse workforce. 4. A well-governed organisation.

Two-way Learning

The TCHHS adopts a two-way learning culture where the culture of an individual, team, unit, organisation, family and community guides what and how we learn. A two-way learning culture acknowledges and respects formal and informal learning between the organisation and the community and between internal and external individuals to TCHHS. Having a two-way learning culture assists the TCHHS in providing culturally capable healthcare that meets the needs and expectations of our culturally diverse population.

Geographical Landscape

The Torres and Cape HHS is noted for the strong, rich culture of the Aboriginal and Torres Strait Islander people. Vibrant and diverse, this region offers opportunities to absorb and connect with the ancient rhythms of this ancient land and people.


Cape York Aboriginal history in the Cape dates back tens of thousands of years and, at the time of European settlement, the region consisted of forty-three tribal nations, each with its own language and traditional practices. Though many of the languages have now been lost, an estimated ten languages and possibly hundreds of dialects are still spoken in the Cape today. William Jansz, who captained the ship Duyfken, became the first known European to have seen Australia in 1606. He sailed down the west coast of the Cape as far as Cape Keerweer, where the first encounter between Europeans and Aborigines was a hostile one. Later the same year, the Spaniard Torres, sailed through and named what is now known as the Torres Strait. In 1770 James Cook sailed up the east coast of Australia in the Endeavour. The ship struck a reef near present day Cooktown, and Cook and his crew found refuge on the bank of a river, now known as the Endeavour River while they repaired the ship. This was the first white settlement on the east coast of Australia, and it lasted for nearly two months. Cook named Cape York, and landed on Possession Island and ‘took possession’ of the whole east coast of Australia for England, before passing though Torres Strait via Booby Island. Today, Aboriginal communities with diverse histories, cultures and languages are dotted all over the Peninsula, Most of the Western Cape communities are a Deed of Grant in Trust (DOGIT), Meeting Challenges, Making Choices (MCMC), a Discrete Aboriginal community or under a mining lease. Pastoral leases occupy the central and eastern areas of the Cape.

Deed of Grant in Trust (or DOGIT) Communities

DOGIT is the name for a system of community-level land trust established in Queensland to administer former reserves and missions. They came about through the enactment by the Queensland Government of the Community Services (Torres Strait) Act and Community Services (Aborigines) Act in 1984 by the Queensland Government, allowing community councils to be created to own and administer former reserves or missions under a Deed of Grant in Trust (DOGIT). The trusts are governed by local representatives who are elected every three years to councils called Incorporated Aboriginal Councils.

Meeting Challenges, Making Choices (MCMC) Communities

MCMC is the Queensland State Government's policy response to the Fitzgerald Cape York Justice Study which was published in 2001. It involves the Queensland Government and Indigenous communities working together to tackle a range of Aboriginal and Torres Strait Islander issues. The annual reporting to Queensland Cabinet by agencies detailing their progress towards the Partnerships’ goals relate only to the 19 MCMC Communities covered by the strategy.

Discrete Indigenous Communities

A “discrete” Indigenous community refers to a geographic location, bounded by physical or cadastral (legal) boundaries, and inhabited or intended to be inhabited by predominantly Indigenous people, with housing or infrastructure that is either owned or managed by the Queensland Government.

Welfare Reform (WR) Communities

Wellbeing Centres (WBC) are the product of Cape York Welfare Reforms where a magistrate and community commissioners from the Family Responsibility Commission examine justice and welfare cases in four communities and have the power to manage welfare payments and refer clients to services in the four WBCs.

Remote Service Delivery (RSD)

RSD sites are part of a Council of Australian Governments (COAG) National Partnership Agreement to establish an integrated local response which will include high-level agreement between governments, based on principles associated with the effective distribution of resources, detailed planning and service delivery agreements and community development initiatives which will build the capacities of individuals, families and their communities.


Torres Strait and Northern Peninsula Area The Torres Strait is the body of water between Australia and Papua New Guinea where the Pacific and Indian Oceans meet. The Strait is comprised of 133 islands, sandy cays and rocky outcrops, 38 of which are inhabited. The Torres Strait islands are grouped into five distinct clusters, which exhibit differences of geology, formation and cultures. These clusters are: Eastern Islands

• Mer (Murray Island) • Erub (Darnley Island) • Ugar (Stephen or Stephens Island)

Central Islands • Iama (Yam or Turtle-backed Island) • Masig (Yorke Island) • Warraber (Sue Island) • Puruma (or Poruma) (Coconut Island)

Western Islands • Badu (Mulgrave Island) • Moa (Banks Island) • Mabuiag (Jervis Island)

Inner Islands • Waiben (or Wayben) (Thursday Island) • Kiriri (Hammond Island) • Nurupai (or Ngurupai) (Horn Island) • Muralag (Prince of Wales Island)

Top Western Islands • Saibai (Saibai Island) • Boigu (Talbot Island) • Dauan (Mt. Cornwallis Island)

Three dialects are spoken: Kala Kawaw Ya (Top Western), Kala Lagau Ya (Central and Western) and Meriam Mir (Eastern). ‘Creole’ is the predominate language that emerged after the arrival of the missionaries. The communities in the Torres Strait are predominately Torres Strait Islander and Aboriginal descendants; however the Torres Strait is very much a multicultural society with a mixture of people from all family backgrounds. Most aspects of the Torres Strait culture are still practiced today through song, dance and traditional practices. The township of Bamaga, which is on the mainland, also includes four smaller surrounding communities which are:

• Seisia • Injinoo • New Mapoon • Umagico

Papua New Guinea – The Torres Strait Treaty

The Torres Strait Treaty was signed and entered into force in February 1985. It defines the border between Australia and Papua New Guinea and provides a framework for the management of the common border area. Torres Strait and PNG Treaty - http://www.austlii.edu.au/au/other/dfat/treaties/1985/4.html


Cultural Considerations

Many cultures, common ground, your first day

Aboriginal and Torres Strait Islander cultures are distinct and uniquely different. There is no one Aboriginal culture nor one Torres Strait Islander culture; in the same way there is no one Australian culture. Remember: there are no hard and fast rules. Every cultural group and community is different. The key to being culturally competent, and being able to deliver a culturally appropriate health service in Aboriginal and Torres Strait Islander communities, is to:

• Be respectful • Be observant and willing to learn • Ask for advice

Even other Aboriginal and Torres Strait Islander people who travel to different regions have to be aware of the cultural protocols that apply to the particular community they are in. Your first days within an Aboriginal and Torres Strait Islander community as a health professional are important, as this is where first impressions are made. These first impressions can determine your satisfaction in your role and placement, as well as the satisfaction of the community or communities you are working with.

Expectations of You

The reality of health professionals going into the Torres Strait and Cape York communities means you, like many before you, have come to work in the community with knowledge and a set of skills that will supplement the knowledge and skills already in the community. TCHHS employees are encouraged to learn more about the culture of the place/s they are working and living in by actively interacting with community members. Acknowledging the uniqueness of a community and endeavouring to understand its history and culture will assist in building meaningful and respectful relationships. The following principles will assist you in settling in and understanding what the community expects of you. 1. Stand back, look and listen This is probably the most important principle and will be the key to your success in a TCHHS community. You are a guest of this community, so you must be prepared to stand back, listen, hear and wait. Your interpretation of what you see and hear will be influenced by your own history, culture, values and beliefs – be aware of this and remain open minded. Scenario - Consider this scenario; you invite a guest into your home, someone you have only just met. Your guest immediately and very loudly, in an opinionated manner, advises you on everything that is wrong with your home and how you are managing your life. The guest then leaves saying they do not want to visit you anymore. How do you react?

• Ignore the guest • Tell the guest to, “Go away” • Take pity on the guest’s ignorance and insensitivity • Argue with the guest even though the guest is fixed in their opinion

Remember: you will be a guest in TCHHS communities, so be aware of how to avoid becoming insensitive and unwelcome. 2. Be open minded

If you are open minded it means you will be making an effort to understand and learnabout the community which will result in community members being open and honest in return. Be careful not to judge what you hear or comment on social and cultural beliefs or norms. Be patient; information will come to you. If you force the issue you may push the community away so let the community take the lead.


http://www.austlii.edu.au/au/other/dfat/treaties/1985/4.html

3. Assume nothing Assume nothing; experience working in one Aboriginal and Torres Strait Islander community does not make you an expert about all Aboriginal and Torres Strait Islander communities. In fact, it can result in culturally unsafe practice as your assumptions may stop you from looking, listening and learning. Remember, each community is unique and must be approached as such. Being in the community is a learning experience in itself. 4. Be aware of behaviour We need to be aware of how our culture, values and beliefs may impact on our behaviour and ensure we are mindful of this. Our behaviour may also be influenced by peers, media, fear or ignorance. Sometimes we stereotype or engage in paternalistic or patronising behaviour: for example, assuming a higher level of knowledge or skill than the people we are working with. 5. Clothing The community may have certain expectations about the way you should dress. As a health professional, they may reasonably expect you will dress in a way that reflects this role. Excessive untidiness or exposure of flesh (particularly upper legs, cleavage and midriffs) can cause offence in local communities. With certain occupations there can be an expectation of higher standards of dress. Be conscious of these expectations and sensitivities about respectful behaviour towards others in the community. Dress comfortably and attend to hygiene and the expected dress standards of your occupation and employer. The climate will also predict that sensible, comfortable clothing is required. Natural fabrics that protect from sunburn will help in the heat. It is also advisable to wear comfortable, covered-in footwear that provides protection from the environment.

Get to know the Community

Upon arrival at the community of your employment, you will participate in an induction to site process that should include a Community Cultural Orientation, preferably by one of the local Indigenous staff who works for TCHHS.

Community Cultural Orientation: The purpose of the community cultural orientation is to provide you with an insight into the cultural beliefs and practices of Aboriginal and Torres Strait Islander people living in that community.

Community Cultural Orientation ensures that service delivery processes and practices address respect and responsiveness to consumer diversity by being inclusive, flexible and culturally safe. Raising employee awareness of the cultural beliefs and practices ensures that service delivery and engagement is respectful of the needs of our clients. TCHHS’s intent to developing a two-way learning culture, acknowledges the importance of respecting and supporting the cultural diversity within TCHHS communities and within our workforce. In creating a culturally capable organisation for cultural groups, such as Aboriginal and Torres Strait Islander peoples, individuals are able to participate in lifelong learning which has been defined as the ongoing, voluntary and self-motivated pursuit of knowledge for professional or personal reasons. The Community Cultural Orientation is an informal process which is an important component of effective cross-cultural learning and will continue throughout the duration of your employment. Informal learning includes learning through conversation, observation and interaction. The complexity of the informal learning process in Aboriginal and Torres Strait Islander communities is amplified through non-verbal communication, silence, circular time rich processes, factionalism and politics, and the kinship system. The Community Cultural Orientation will also provide and identify appropriate links to community, such as links to the traditional owners of the community (country), the elders, key people and other organisations that work within the community including who to approach in particular situations, and the appropriate way to approach them. Show an interest in finding out about the history and language. Accept and appreciate information as it is offered to you and do not be judgmental. If you maintain an open mind, you will learn. In a word, it is all about being ‘adaptable’. Adaptation does not mean giving up your own culture, but rather being willing to accommodate new and different circumstances, reflecting on your journey and learning from it. To respect cultural appropriateness, the community cultural orientation is conducted by a TCHHS Aboriginal


and/or Torres Strait Islander Health Worker attached to the site or a community member. The following topics are likely to be discussed in-depth with you. 1. Understanding the importance of working effectively with Aboriginal and/or Torres Strait Islander

Health Workers Always seek the advice of Aboriginal and/or Torres Strait Islander Health Workers employed at your site. It is important to remember that you are there to do a particular job, not to become a member of the community. You may encounter situations where you wish to intervene; change or control matters, or take particular actions as you would normally do in usual practice in non-Aboriginal and Torres Strait Islander environments. It is important that you step back and consider the factors of the situation that are directly related to Aboriginal and Torres Strait Islander cultural beliefs and protocols, and the implications your actions may have on the community as a whole. Aboriginal and Torres Strait Islander people prefer to be cared for by other Aboriginal and Torres Strait Islander people. However, given the shortages of Aboriginal and Torres Strait Islander doctors and nurses, the role of the Aboriginal and/or Torres Strait Islander Health Worker is very critical. The essential role of the Aboriginal and/or Torres Strait Islander Health Worker is twofold:

1. Provide basic health care to Aboriginal and Torres Strait Islander clients 2. To act as a bridge between Aboriginal and Torres Strait Islander clients / communities and the health

professional / health system. As Aboriginal and Torres Strait Islander people, Aboriginal and/or Torres Strait Islander Health Workers have particular kinship relationships and obligations to members of their community. This can result in Aboriginal and/or Torres Strait Islander Health Workers:

• Feeling obligated to work out of hours if they are part of their community or kinship group • Feeling obligated to share their resources with family members • Perceiving clients in a holistic way (without many of the functional boundaries of western culture) • Being unable to assist certain community members due to avoidance relationships and factionalism • Being exposed to high levels of stress resulting from the fact that potentially all the clients seen by the

service who may be experiencing very distressing situations are well-known, if not related or closely connected to them

• Being under immense pressure as a result of community expectations, which in certain situations may be impossible to deliver on

• Being the target for blame if something goes wrong with the treatment of an aboriginal and torres strait islander client

• Needing to be away from the clinic to attend funerals and other culturally significant events (which can’t always be explained to non-family members due to cultural reasons). Attending funerals is a cultural expectation, and failure to do so results in cultural repercussions. Special leave entitlements are in place for all TCHHS employees (at the discretion of the chief executive) and cultural leave falls within these parameters

Remember that Aboriginal and/or Torres Strait Islander Health Workers have to regularly compromise their professional and cultural ethics due to the family and kinship dynamics within their culture. 2. Engaging with Community Engaging appropriately and successfully with your host community involves taking the time to learn how to present and conduct yourself. Further details can be sought from your colleagues in the community, particularly Aboriginal and/or Torres Strait Islander Health Workers who are a great source of knowledge. Respect should be an inherent part of your interaction with everybody within the community otherwise you may be perceived as ignorant. Refer to the following documents for assistance in engaging with the community:

• TCHHS Consumer and Community Engagement Strategy - https://www.health.qld.gov.au/torres-cape/docs/cons-engage-strat.pdf

• Protocols for Consultation & Negotiation with Aboriginal People - https://www.datsip.qld.gov.au/resources/datsima/people-communities/protocols-aboriginal/aboriginal-protocols-for-consultation.pdf


• Mina Mir Lo Ailan Mun Proper Communication with Torres Strait Islander People -

https://www.datsip.qld.gov.au/resources/datsima/people-communities/protocols-torres/tsi-protocols-for-consultation.pdf

3. Understanding the Kinship System You need to gain an understanding of the kinship system within the community, and how you can work effectively and culturally appropriately within these networks. Having a basic understanding of the kinship network and the roles and responsibilities of people within this network can help you greatly in your own role as a health professional within the Aboriginal and Torres Strait Islander community. All people in all cultures have some form of kinship system which governs their lives. It is the changing world and exposure to other cultures and world views that influences people and therefore changes our own understanding of family and how we connect to each other. Aboriginal and Torres Strait Islander society emphasises membership of a group and the obligations and responsibilities of individuals to meet the expectations of others. For many Aboriginal and Torres Strait Islander people, family and community are of central significance, and group interests and needs are a fundamental part of an individual’s identity and self-fulfillment. Kinship relationships go beyond the extended family and include unions without blood or marital ties. The kinship system has continued to evolve and adapt as part of Aboriginal and Torres Strait Islander culture, with Aboriginal and Torres Strait Islander families in urban, rural and remote areas still exhibiting kinship structures that provide psychological and physical support and security. There are many aspects to the kinship network: who can be spoken to, who has to be avoided, who has specific responsibilities and obligations, who guides and who teaches. Within the kinship network there are also avoidance relationships between people which are life-long. Some of these are public knowledge, and some are private. You need to be aware that such relationships exist, and may explain why some Aboriginal and/or Torres Strait Islander Health Workers are unable to work with certain clients, or why particular people are unable to attend the same meeting together. 4. Communication - Language It may be noticeable that, while many Aboriginal and Torres Strait Islander people speak English, it is often ‘Kriol’ or a dialect rather than a standard form of English. English may be a second or third language of consumers accessing the service and of Aboriginal and/or Torres Strait Islander Health Workers. Even when the language is known, tonal differences, colloquialisms and other factors may obscure the meaning, which can block access to important cues for responding appropriately. An important factor to remember is that Aboriginal and Torres Strait Islander people may have difficulty understanding you and conveying the message they are trying to communicate. There is no simple solution to this. It requires your willingness to make the situation as comfortable as possible for your Aboriginal and Torres Strait Islander clients and taking the time to learn to interpret such cues by clarifying through non-intrusive questions. Make use of the Aboriginal and/or Torres Strait Islander Health Worker, Interpreter Services (both face-to-face and telephone), speak in simple language and take the time to explain. 5. Communication - Non-verbal The unspoken messages given and received in Aboriginal and Torres Strait Islander cultures probably have the greatest impact on communication and the potential for rapport between health professionals and clients. You will find that Aboriginal and/or Torres Strait Islander Health Workers are particularly adept at interpreting non-verbal messages from Aboriginal and Torres Strait Islander clients. The ability to recognise and interpret these non-verbal cues is not difficult to learn, but it does require time. 6. Communication – Silence

For many Aboriginal and Torres Strait Islander people silence is used as part of communication styles and varies depending upon which community you are in. For example, silence can be used as a form of respect, contemplation, disagreement, or to allow time to reflect and consider. Be aware that silence in response to a


http://paweb.sth.health.qld.gov.au/clinicalsupport/atsi/documents/prot_consult_torres_st_is.pdf

question may mean that the person does not understand the question, does not know the answer, or may know but is lacking the confidence to reply. Give the client sufficient time to respond and if this is not successful in encouraging a response, in the first instance, seek assistance from the Aboriginal and/or Torres Strait Islander Health Worker. If they’re unavailable, try reframing the question in a different, specific or simpler way. 7. Avoidance Relationships - “poison relationships” Within the kinship network there are avoidance relationships between people which are life-long. Some of these are public knowledge, and some are private. Franks and Curr (1996) describe public knowledge avoidance relationships as relationships which “are about respecting your family and are not about disrespect. The term ‘poison’ is also used to describe avoidance; this term is meant with respect” (p.68). Be aware that such relationships exist and understand the impacts these have on service delivery. This may explain why Aboriginal and/or Torres Strait Islander Health Workers are unable to work with certain clients, or why particular people are unable to attend the same meeting together. 8. Respect Sacred Sites On your arrival in the community, gain advice on areas that are considered Sacred Sites. These areas are vital places which link Aboriginal and Torres Strait Islander people to their cultural traditions and to the land. These Sites provide a crucial component to Aboriginal and Torres Strait Islander spiritual beliefs and ceremonial activity, such as men’s and women’s business. The locals are generally happy to show respectful and interested visitors places of cultural significance or areas which may be restricted for certain people, e.g. a birthing site that only women are allowed to see. Ensure permission is sought before visiting a place you suspect might be special, and be aware that there may be places you will not be able to visit at all. Accidentally or intentionally entering such areas will offend Aboriginal and Torres Strait Islander people in the area, and may result in your immediate removal from the community. Please respect the wishes of the traditional owners by avoiding and respecting these areas. 9. Journey of Life Birth - today, while many Aboriginal and Torres Strait Islander births occur in hospital, traditionally, birth occurred at a specific birthing place, attended by women only. Aboriginal and Torres Strait Islander women should be attended by female midwives. A male health professional should offer assistance and then wait until asked for help. Traditionally, men are never present at the birth of a child. This may still be the practice in the community you are working with. Seek advice from a female Aboriginal and/or Torres Strait Islander Health Worker or an Elder for guidance regarding birth and pregnancy protocols specific to that community, particularly if you are a male health professional. Further advice should also be sought from the female client themselves, and their sisters, grandmother, cousins or aunts. Childhood - a child is a gift to the entire kinship network and is highly valued. Children are given constant affection and child-rearing is shared by all those who have a responsibility to the child within the kinship network. Each of these people has a specific role essential to healthy child-rearing. Gaining a basic understanding of these roles can help you in your clinical practice. Therefore, you should consider other members of the child’s extended family to be as involved and influential as the mother and father would be. Dying - giving a diagnosis of a serious, terminal illness can be difficult in situations involving Aboriginal and Torres Strait Islander clients and their families. The final stage of life is a very sensitive and significant time for patients and their loved ones. For Aboriginal and Torres Strait Islander people, the time before death, of death and following death are subject to a number of customary practices. These customary practices have meanings that are sacred to Aboriginal and Torres Strait Islander people. For example, Aboriginal and/or Torres Strait Islander Health Workers may find it difficult to speak with a client about the fact that they are dying. As the non-Aboriginal health professional, you need to speak honestly with the client and their family about what is happening and ensure the information is understood. This also includes information about the side effects of treatment. Death - when a death occurs in the Aboriginal and Torres Strait Islander community, the person is generally referred to as having passed away. The first name of the deceased can no longer be used. The name can be written down but not spoken. To refer to the deceased person to other family members you could say ‘your


father’, ‘your brother’, ‘your uncle’, or whatever the relationship may be. It is important that the family of the deceased person is consulted with in regards to; collecting the body and bringing it back to the community. It is important that health professionals understand this and enable this to happen. In both coronial and non-coronial cases, the post-mortem needs to be discussed sensitively with the family members of the deceased, providing as much information as possible and taking the time to ensure everything is understood. In regards to post-mortems, it is appropriate to respect Aboriginal and Torres Strait Islander culture, however still treat people as individuals by offering the family of the deceased the same range of choices as anyone else. Family and friends may gather in the house of the person closest to the one who died. Sad News, Sorry Business - customary practices following death differ between Aboriginal and Torres Strait Islander people. Sad News is the terminology used to refer to the time of mourning following the death of a Torres Strait Islander person. Sorry Business is the time of mourning following the death of an Aboriginal person. The term Sorry Business is frequently connected to a death in the Aboriginal and Torres Strait Islander community but is also used to describe other events such as the forcible removal of Aboriginal and Torres Strait Islander children from their families and communities. In some communities, the name of the deceased is never mentioned again. In others, it is not mentioned for a certain period of time. This may also extend to others living in the community who share the same name. Images of the deceased may also no longer be shown. This is why it important to include a disclaimer of ‘there maybe images of deceased people’ in promotional material used within the HHS. There may also be other ceremonies after a person has died. For example, a further ceremony may involve a smoking ceremony and the distribution of clothes. Consult with the Aboriginal and Torres Strait Islander Hospital Liaison Officer / Health Worker or family representative to manage the mourning period in the facility. Sometimes in Aboriginal and Torres Strait Islander cultures, the day before the burial, the family arrives at the morgue to dress the deceased person. If the deceased family member is female, only females will be allowed inside and vice versa. Traumatic or sudden death - slow deterioration of health and expected deaths are more readily accepted by Aboriginal and Torres Strait Islander families and communities than sudden deaths. Sudden death in Aboriginal and Torres Strait Islander cultures may be associated with sorcery and blame, which can lead to payback directed at the individual(s) or entity perceived to have caused the death. These issues are essential to understand, especially for TCHHS staff working in remote and regional areas. Sorcery is believed to be a contributing factor in many sudden deaths. It is as real to many Aboriginal and Torres Strait Islander people as a blocked artery or a diabetic ulcer and should not be dismissed as mere superstition. Blame is also a serious issue. It is not confined to Aboriginal and Torres Strait Islander people; everyone is at risk of being blamed, inclusive of people outside of the patient’s culture. 10. Traditional healers A traditional healer is generally a person who has a recognised skill of healing. This skill is often recognised at birth or during childhood and is developed by an older healer in the community. The role is honoured and respected by community members. There is no condition spiritual, emotional, mental or physical that cannot be referred to a traditional healer. The healing power of the traditional healer should not be underestimated in the treatment of an Aboriginal and Torres Strait Islander client. The Aboriginal and/or Torres Strait Islander Health Worker will be aware of the traditional healers associated with the community. It is encouraged to use the services of these traditional healers to complement conventional treatment wherever possible. This approach will give the client comprehensive treatment which uses contemporary medical expertise and traditional knowledge. This can in turn, bring spiritual wholeness and healing, which consequently validates functional contemporary Aboriginal life. 11. Alcohol policy reminder Seven Cape York communities and five NPA communities with Alcohol Management Plans restrict the possession and consumption of alcohol to improve the health and well-being of all people living in these communities. The restrictions apply to the entire area controlled by the local shire council. These communities are: Aurukun, Kowanyama, Mapoon, Napranum, Hope Vale, Lockhart River, Pormpuraaw


and all NPA communities. Staff working or visiting these communities are reminded that they are expected to respect and abide by the alcohol restrictions. Conditions vary according to community and can be checked at https://www.datsip.qld.gov.au/programs-initiatives/community-alcohol-limits These restrictions ban or limit the amount and type of alcohol you can take into the community. In some communities, alcohol is completely banned.

The restrictions are applicable both in the workplace and outside the workplace. Homes are included in the restricted areas. Beaches, wharves and riverbeds may also be included in the restricted area.

In accordance with the Public Service Act 2008 and the Code of Conduct for the Queensland Public Service, employees are reminded that it is your responsibility to comply with the laws of the Queensland Government and the local governments. Employees found to have contravened their responsibility in this regard may face disciplinary action in addition to the heavy fines imposed. See https://www.qld.gov.au/atsi/health-staying-active/fines-penalties

Other Resources toward Safe Cultural Practice The following are Aboriginal and Torres Strait Islander Health resources that may enhance your cultural journey in the TCHHS:

• Queensland Health Aboriginal & Torres Strait Islander Cultural Capability Framework 2010 – 2033 https://www.health.qld.gov.au/atsihealth/documents/cultural_capability.pdf

• Queensland Health Making Tracks Policy & Accountability Framework http://www.health.qld.gov.au/atsihealth/documents/makingtracks/making_tracks_pol.pdf

• Queensland Health Making Tracks Implementation Plan 2009-10 to 2011-12 https://www.health.qld.gov.au/atsihealth/documents/making_tracks_plan.pdf

• Queensland Health Statement of Commitment to Reconciliation 2010 https://www.health.qld.gov.au/__data/assets/pdf_file/0030/633873/atsi-reconciliation-statement.pdfProtocols - Welcome to Country and Acknowledgement of Traditional Owners, Custodians & Elders http://www.qld.gov.au/atsi/cultural-awareness-heritage-arts/welcome-to-country/index.html

• Protocols for Consultation & Negotiation with Aboriginal People - https://www.datsip.qld.gov.au/resources/datsima/people-communities/protocols-aboriginal/aboriginal-protocols-for-consultation.pdfMina Mir Lo Ailan Mun Proper Communication with Torres Strait Islander People - https://www.datsip.qld.gov.au/resources/datsima/people-communities/protocols-torres/tsi-protocols-for-consultation.pdf

• Sad News - Sorry Business Guidelines for Caring for Aboriginal & Torres Strait Islander people through death & dying http://www.health.qld.gov.au/atsihealth/documents/sorry_business.pdf

• Appropriate use of terminology http://www.flinders.edu.au/equal-opportunity_files/documents/cdip/folio_5.pdf

• Aboriginal and Torres Strait Islander Wellbeing page http://www.qld.gov.au/health/atsi/index.html • Closing the Gap in Queensland https://www.health.qld.gov.au/atsihealth/close_gap.asp

We trust you will find your time with us a rewarding and enjoyable experience which will stay with you

for the rest of your life.


http://qheps.health.qld.gov.au/atsihb/docs/atsiccf.pdf

http://www.health.qld.gov.au/atsihealth/documents/makingtracks/making_tracks_pol.pdf

http://qheps.health.qld.gov.au/atsihb/docs/making_tracks_plan.pdf

http://qheps.health.qld.gov.au/atsihb/docs/successfulinitiative.pdf

http://www.health.qld.gov.au/atsihealth/documents/reconciliation.pdf

http://www.health.qld.gov.au/atsihealth/documents/sorry_business.pdf

http://www.flinders.edu.au/equal-opportunity_files/documents/cdip/folio_5.pdf

http://www.flinders.edu.au/equal-opportunity_files/documents/cdip/folio_5.pdf

http://qheps.health.qld.gov.au/staffwellness/html/aboriginal.htm

http://qheps.health.qld.gov.au/indigenous_staff/docs/close_the_gap_dg_2010.pdf

http://qheps.health.qld.gov.au/indigenous_staff/docs/close_the_gap_pm.pdf

Approval

Policy Officer: Principal Learning and Development Advisor, People and Culture, TCHHS Policy Custodian: Executive Director of Corporate Services, TCHHS Endorsing Committee or Position: Learning and Development Leaders Group Approving Officer: Andy Marshall, Executive Director of Corporate Services, TCHHS

Effective Dates

Approval date: 7 September 2017 Effective from: 7 September 2017

Next Date of Review: 7 September 2018

Supersedes: Version 5.0

Version Control

Version Date Prepared by Comments 1.0 19 January 2015 Melissa Dalzell First release of document 4.0 03 November 2015 Danni Brown Brand update 5.0 08 August 2016 L&D Leaders

Group, Leanne Ferguson

Review of document

6.0 7 September L&D Leaders Group

Review of document


Pre-commencement Orientation Self-Declaration

Privacy disclaimer: Personal information collected by Queensland Health is handled in accordance with the Information Privacy Act 2009. The information provided by you will be securely stored and will be made available to appropriate authorised officers of Queensland Health or agents employed by Queensland Health. Personal information recorded on this form will not be disclosed to other parties without your consent unless required by law.

This form is to be used by all staff to acknowledge they have read the Pre-Commencement Orientation Booklet. Please return this form to [email protected]

Employee Details

Person ID Personnel assignment number Please indicate here if you work in more than one position in QLD Health

Family name First name/s

Position title Area code Contact telephone number

Organisation unit

Date Completed

Date

Employee’s Signature

Employee’s signature Date

Supervisor’s Signature

Supervisor’s signature Date Area code Supervisor’s contact number

Supervisor’s full name (please print) Supervisor’s position title

Pre-commencement Orientation Self Declaration For Review February 2016

mailto:[email protected]

Pre-Commencement Orientation TCHHS-P&C-HR … · Effective from: 7 September 2017 Version: 6.0...

Documents

Transcript of Pre-Commencement Orientation TCHHS-P&C-HR … · Effective from: 7 September 2017 Version: 6.0...