Issues Renee Fiolet and Leah East
Gender equity: what the COAG report means for Australian nurses and midwives The Council of Australian Governments (COAG) Reform Council’s recent report revealed that although women are living longer, some women are still experiencing health disparities compared to men. The report, Tracking equity: comparing outcomes for women and girls across Australia, examined whether Australian women and girls are benefiting from national reforms aimed at improving the lives of Australians and to track gender equity in the Australian context (COAG Reform Council, 2013). Key findings in the report highlighted several significant issues in which nurses and midwives need to consider in contemporary practice. Three pertinent issues that need to be addressed urgently are: • Over one third of women with a disability report they need more health services that address their needs. There are as many as two million women who experience disability in Australia, which signifies a significant number of these women are not receiving the care required to promote health and their positive wellbeing (COAG Reform Council, 2013). • Domestic/family violence significantly contributes to poor outcomes for women and is the most commonly cited reason for homelessness among women. However, due to the lack of national data and domestic violence often not being routinely assessed in health care settings, statistics may be grossly underestimated meaning that many women may still be suffering in silence, which equates to adverse health outcomes for these women (COAG Reform Council, 2013). • Women identify the cost of health care, remoteness and extended waiting times as significant barriers to service accessibility, which is another contributing factor to poor health outcomes for women (COAG Reform Council, 2013). So how can nurses and midwives working within Australia address these key issues that significantly impact the health outcomes for the country’s women and girls? We suggest that by drawing on our national competency standards (Nursing and Midwifery Board
of Australia 2006a; Nursing and Midwifery Board 2006b) particularly those relating to being informed, completing comprehensive assessments, utilising resources effectively, patient advocacy and working within interdisciplinary teams we can aim to address these health disparities. It is imperative for nurses and midwives to recognise the current issues facing Australian women in order to provide therapeutic care. It is the duty of the nurse/midwife to be aware of the social and environmental conditions that may be impacting the health of a woman (and all clients). In order to stay abreast of current issues professional development opportunities can be utilised. Professional growth is easier today than it has ever been with online and hardcopy access to journals such as the ANMJ as well as online education, webinars and online forums that are often freely available and can be utilised during breaks, handover or from home. Comprehensively assessing clients involves a holistic approach which includes recognition of the social and environmental context in which they live as well as acknowledging their ongoing needs. Through comprehensive assessment nurses and midwives are able to identify individual needs, suitable resources and if required referral for clients (Luxford 2012). To be able to recognise and refer clients to suitable services and associated resources, nurses and midwives need to know what is available for individuals within the local community. This requires consciously familiarising oneself with other health care professionals, services and organisations available within the neighbourhood and also through telephone networks and the internet. Additionally, prioritising and taking advantage of opportunities to be educated about local services can assist with gaining this knowledge which in turn can assist with promoting health outcomes for clients. One of the most important roles for nurses and midwives is patient advocacy (McPherson and Stakenberg 2012). By being active patient advocates, nurses and midwives can take a leading role in bringing women’s health issues and disparities to the forefront of both the public and political arenas in order to help address these issues and improve health outcomes for women. Furthermore,
by working within the interdisciplinary team health outcomes for clients can be improved (McPherson and Stakenberg 2012). Interdisciplinary team work requires effective communication skills and dedication to the sharing of knowledge. This begins with the ability to recognise the unique contribution other team members can make towards client care and validating the role of the client in the process of care coordination, which in turn promotes therapeutic care and positive wellbeing among clients (Nursing and Midwifery Board of Australia 2006a; Nursing and Midwifery Board of Australia 2006b). Nurses and midwives are in a prime position to promote wellbeing, provide therapeutic care and help minimise health disparities faced by some women. In taking an active stance to being informed, working within the interdisciplinary team, patient advocacy and conducting individual comprehensive assessments, we as a health care discipline can assist in reducing pertinent health issues faced by Australian women.
References:
Council of Australian Governments Reform Council. 2013. Tracking equity: Comparing outcomes for women and girls across Australia. Australia. www. coagreformcouncil.gov.au/reports/gender-equity/ tracking-equity-comparing-outcomes-women-andgirls-across-australia Accessed 1 December, 2013. Luxford, Y in Berman et al. 2012. Kozier and Erb’s Fundamentals of Nursing: Assessing. 2nd Edition. Australia: Pearson. McPherson, C and Stakenberg, S in Berman et al. 2012. Kozier and Erb’s Fundamentals of Nursing: Values, ethics and advocacy. 2nd Edition. Australia: Pearson. Nursing and Midwifery Board of Australia. 2006a. Registered nurse competency standards – rebranded. Australia. www.nursingmidwiferyboard.gov.au/ Codes-Guidelines-Statements/Codes-Guidelines.aspx# competencystandards Accessed 3 December, 2013. Nursing and Midwifery Board of Australia. 2006b. Midwifery competency standards – rebranded. Australia. www.nursingmidwiferyboard.gov.au/ Codes-Guidelines-Statements/Codes-Guidelines.aspx# competencystandards Accessed 3 December, 2013.
Renee Fiolet RN, BN (Hons), GCHE, PhD Candidate and Lecturer in Nursing & Midwifery, Deakin University Dr Leah East RN BN (Hons) PhD, Senior Lecturer in Nursing & Midwifery, Deakin University PAGE 39 March 2014 Volume 21, No. 8.