The Australasian College for Emergency Medicine (the College) is the peak professional organisation responsible for training emergency specialists and the advancement of professional standards in emergency medicine in Australia and Aotearoa/New Zealand. In 2013 the College established a two-year project to develop education resources for emergency medicine doctors that are related to Indigenous1 health and culture.
The Indigenous Health and Cultural Competency Project was funded by the Australian Government as part of a suite of projects aimed at improving Australia’s emergency department (ED) medical workforce and in particular supporting international medical graduates. The limited literature that specifically explores Indigenous peoples’ experiences of emergency departments suggests that Indigenous patients can find emergency departments culturally unsafe.
This is due to a range of reasons, some specific to the emergency department and some a general reflection of non-Indigenous health care systems (e.g., Thomas, Anderson & Kelaher 2008; Einsiedel et al. 2013; Cunningham, Cass & Arnold 2005; Durey, Thompson & Wood 2012). The unique context of emergency departments creates significant challenges in delivering culturally safe care to Indigenous patients. Emergency department care is delivered in a high-pressured, timecritical environment and continuity of care is greatly disjointed. This means that establishing rapport and an effective therapeutic relationship, so crucial for culturally safe care with Indigenous patients, is difficult.
Due to its 24-hour a day, 7-day per week mode of operation, there is also restricted access to essential resources, such as Indigenous hospital liaison officers and interpreters, and difficulty in arranging appropriate follow-up with community services, such as Aboriginal Community Controlled Health Organisations.
These factors are problematic and can contribute to a care environment that supports the dominant cultural paradigm, often to the detriment of colonised peoples.