Podcast: Yarning with Lesley Salem, the first Aboriginal Nurse Practitioner

Episode: 41
Guest: Lesley Salem and special guest co-host Tessa Moriarty
Duration: 32:16
Tags: Aboriginal and Torres Strait Islander, NAIDOC week, racism, Cultural Safety, mentoring
Soundcloud: Listen to Episode 41
 

Wonnarua woman Lesley Salem was the first Aboriginal Nurse Practitioner. She has dedicated her career to improving care for people experiencing chronic illness in rural and remote communities. She joined us on the podcast to share her story and the insights earned from her experiences, including her passion for diverse forms of education and the importance of mentoring the next generation of First Nations healthcare workers. 

Lesley tells us: 

“It starts with the growth of our students as undergraduates. It's the growth that [comes from] believing in what you can do. I thank God that I did Oral Vivas, because I've got mild adult dyslexia, and I can't write for crap. Any book I've published, you'll see another name there with me. It's usually my best friend, Barb Harvey, who takes me through every paragraph and says, "What are you trying to say here?" 

But we need encouragement. As long as our universities or Western models were oral ... I could have given 50,000 words without a problem. I could have had my notes in front of me and referenced any talk that I give along the way. I don't know what it is, but I can't get it from my head to paper. There's no consideration for anyone with learning difficulties or anything. So a lot of our good nurses, who don't have that ability to write, feel that they're left out and leave. New ways of learning, bringing back Oral Vivas, letting somebody talk or show what they can do. 

A lot of our Aboriginal nurses will feel left out, particularly from our rural and remote areas, because universities do nothing to embrace a different way of learning. I was lucky in country hospitals, there was an Oral Viva for everything. I barely passed any written thing, but we were so lucky, every PTS stage, everything up, we had to do an Oral Viva. Thank God, because I could talk.”

Thank you Lesley for joining us and sharing your knowledge. If you’d like to keep up with Lesley or look at her beautiful artwork, you can check out her website. 

This podcast is part of our special NAIDOC week newsletter, Edition 21 — Supporting Aboriginal and Torres Strait Islander nurses and midwives. The newsletter also features podcasts with CATSINaM CEO Dr Ali Drummond and Aunty Gina Bundle and Alexandrea Burton of the Baggarrook midwifery program. 

If you’re struggling and need to talk, Nurse & Midwife Support is here to support you: 1800 667 877 or by email.
 

Lesley Salem is a descendant of the Wonnarua Nation in New South Wales. She is an aboriginal artist, author, and Australia’s first Indigenous Nurse Practitioner.

Lesley currently works in private practice as a generalist and chronic disease Nurse Practitioner (NP). Her nursing is dedicated to improving the health of those with chronic disease, particularly in rural and remote Australian communities. At the centre of what Lesley does is a strong dedication to improving the health and wellbeing of Aboriginal and Torres Strait Island people and those with socioeconomic disadvantages. She enjoys mentoring and believes that sharing knowledge is the key to reducing barriers and making healthcare and education accessible for all.

On 13 June 2022, Lesley was awarded the Member of the Order of Australia (AM) for her significant service to nursing and to Indigenous health.

Elle Brown [0:10] Welcome to the Nurse & Midwife Support podcast: Your Health Matters. My name is Elle Brown, the podcast co-host today with Tessa Moriarty. I'm a Stakeholder Engagement Coordinator with Nurse & Midwife Support, and I'm a registered nurse. Nurse & Midwife Support is the national support service for nurses, midwives and students. It is anonymous, confidential and free. You can call anytime you need support on 1800-667-877, or contact us via the website, nmsupport.org.au. 

I would like to begin by acknowledging the traditional custodians of the land on which each of us are listening on. I pay my respects to First Nations elders, past and present. I extend that respect to Aboriginal and Torres Strait Islander people both contributing and listening today. Sovereignty was never ceded.

Today, Tessa and I will be yarning with Lesley Salem. We'll be talking about supporting Aboriginal and Torres Strait Islander nurses, midwives and students. Lesley Salem, 20 years ago, became the first Aboriginal and Torres Strait Islander nurse practitioner. Leslie currently works for Gidgee Healing in Far North Queensland and Mornington Island. In 2022, she was awarded a member of the Order of Australia for her significant service to nursing and Indigenous health. She is also an accomplished artist and writer.

Tessa Moriarty will be familiar to our audience, as she has co-hosted podcasts and written blogs for the website. She's an experienced Mental Health Nurse, clinician, and an open water swimmer.

Tessa Moriarty [2:08] Okay, fire away!

Lesley Salem [2:09] Hi, my name is Lesley Salem. I'm a nurse practitioner and I've been one for about 20 years, a little over now. I now devote my work to the health of Aboriginal people in Australia, particularly remote and rural, and to the nurses I work with. I'm Wonnarua, I'm a nurse practitioner with a deep passion for art, for the iconography and symbolism, which is a language that's being lost within our art.

Tessa Moriarty [2:36] Thank you very much for that, Lesley. Our first question to you is: tell us a bit more about your background and your career as a nurse and a nurse practitioner?

Lesley Salem [2:50] I became a nurse by accident. I wanted to be an electrician like my father, I idolised my father since I could ever remember. He was an electrician and an artist, and I just wanted to be an electrician. 

Before even the end of Year 12, I had done two electronics courses at TAFE and I was rewinding motors to make a quid in the shed. I wanted to make some money before I went to university because I got in to do Electrical Engineering. My best friend said to me, "Hey, just pretend you want to be a nurse!" All Denise ever wanted was to be a nurse. She said, "Just tell Matron that you really want to be a nurse." So I did, I was hired, and I started on the Monday. And that was the end of it, that's where I fell in love with nursing. 

I had a death on the first day, but it was a planned and lovely death. That in itself was something I'd never witnessed. Then [on] the second day we had a cardiac arrest and got the man back. Then a few days later, there was a noise ... the sister was sitting at her desk reading The Women's Weekly, like you did in those days. We all ran around and there was a car tooting outside, and she said, "Go and stop that noise!" I ran out and opened the back door, as was indicated by the husband screaming and yelling getting out of the car, and caught a baby as it came out of this woman. 

I went home and my image is of me at three in the morning in a cold shed, sitting by myself, rewinding motors and that ... I said, "This is the most exciting profession on the planet of the Earth." 

My training in a country hospital just solidified it, every day I worked, I loved it. I was proud of what I did, and I loved it, and I loved my nurse colleagues. I guess in a country hospital we got to do more than was usual in urban hospitals, because there were no helicopters or retrieving people quickly. You'd call a doctor on a Saturday night and he would come in, not straight away. So by third year we were intubating and cannulating, we were suturing, we were doing everything. I just knew the power of nursing straightaway then. Just knew it.

Tessa Moriarty [4:57] Wow! By the way, what country hospital was it?

Lesley Salem [5:02] Cessnock District Hospital. It was an amazing place, maternity services in those days, everything. So training was really well-rounded, but nursing was a powerhouse. There were no interns, residents and registrars, or anything. People were really well looked after and you saw somebody completely get well in those days. 

I feel for our new students, they never get to see anybody well. They get to see somebody well enough to go home, to 'home hospital,' so they never get to see the incredible work that they do in there reach fruition. That's a really sad thing for a lot of our nurses. How do you get satisfied when you're not seeing the end result of your work? 

I also realised that we're the healers. When a doctor comes in, barely glances at something and puts a stroke of genius on a medication chart for six minutes. We're the ones who give it, we monitor it, we see if it works or doesn't work. We see how it'll affect the patient in cost, or can they actually get the script? We look at all that. I could see from the very start that we were the true healers. It wasn't medicine healing people, it was us. They can operate on somebody, but we're the ones who did the rehab, looked after people and made them better. Educated them, made them aware, made them feel safe, and made them feel like they could come back. 

So I was gifted with this beautiful education to start with. Then I went to a larger urban setting down at Newcastle because I wanted to learn more, I just wanted to learn a lot more. I was really lucky to land in renal, where the nephrologist there actually did the postgraduate course. The nephrologists all taught it themselves. They gave us the capacity through protocols that we could initiate our own bloods, interpret it and respond to that. For many years, I went to every meeting I could about advanced practice. When I said I was going to be a Nurse Practitioner that ['s why] I was doing all this, I was sent to registrar training school in Sydney one day, every month, for 10 years. I was the only one who ever graduated. But that was the belief that these specialists had in us. 

As soon as we were able to apply, I applied. 19 had failed before me, and I was lucky I got through, but I loved my work. I like knowing a lot and I had the Head of Pharmacology from Sydney Uni and Medicine, and the questions they asked were not about patient care but 'how many Daltons does this drug break down into? How would you remove it if they poison themselves?" Weird and wonderful things. I actually like reading that, so I got through. I was number 13.

Tessa Moriarty [7:45] You were really on a trajectory of a highly specialised nursing career from right in your training days, weren't you? Probably more so than nurses that were trained in non-remote and city areas. 

Lesley Salem [8:00] Absolutely. We had fierce champions at Cessnock Hospital, fierce champions of nurses who knew their worth, and knew they did the work and who believed in themselves. That founding, well, that doesn't leave you. Then to come into a nephrology service, after a few stints in other places, but where even the cleaner had to come to the meeting because the head Nephrologist, Ranjit Nanra, believed that we were all part of a picture that made that complete circle around the patient. There was never a hierarchy, and he made sure every registrar and resident knew it. There was no hierarchy in there. We had to attend the full rounds, the senior nurse and any other nurse that was able. We would be asked questions of equal value of everyone, and testing all the time. So for the first 30 years of my career, we were equal. Simple as that. 

Elle Brown [8:53] Lesley, many who have honoured you have said "Because of her, we can." I would just like to know from you, what is it like to lead the way?

Lesley Salem [9:03] I don't think of myself as leading the way. I hope that I'm just influencing people to be what they can, for nurses to be leaders. We are the greatest workforce, and we're the healers. We still have to have a legislated collaborative agreement; no other professional has this. So what I hope I'm doing is not leading people, but influencing them, absolutely influencing them. 

As far as mentoring goes, you bring anybody to me, I will mentor because these are the people who will look after me as I get older. And so I want to teach every single nurse to be empowered to look after me like I would like to be looked after. To be a voice, to not be a handmaid. Not to be a profession in hospitals where we're now broken into tasks that somebody will come in and wash for you. You can be run off your feet doing these things. Well, that's wrong. When we do a shower, we can see that they can actually do it themselves, and if there's any deficit in their movements, and if they're continent or incontinent. 

So if I do anything, I'm not leading, I'm influencing. I just hope I'm one of those modern influencers. I just want every nurse in this country to realise we're the powerhouse, we're the big numbers, we're the healers. Every simple task we do is not simple, because in the holistic way nurses look at everything, we are judging everything.

Tessa Moriarty [10:23] In terms of mentoring and increasing the number of Aboriginal and Torres Strait Islander Nurse Practitioners in particular, the numbers in comparison to the country as a whole are quite low. In fact--whether this is indicative of the true number at this point in time--there's approximately about 15 Aboriginal and Torres Strait Islander Nurse Practitioners. That's a number that's on CATSINaM's website. 

Lesley Salem [10:52] Yeah. 

Tessa Moriarty [10:53] How do we get more Aboriginal and Torres Strait Islander Nurse Practitioners? 

Lesley Salem [10:56] It starts with the growth of our students as undergraduates. It's the growth that [comes from] believing in what you can do. I thank God that I did Oral Vivas, because I've got mild adult dyslexia, and I can't write for crap. Any book I've published, you'll see another name there with me. It's usually my best friend, Barb Harvey, who takes me through every paragraph and says, "What are you trying to say here?" 

But we need encouragement. As long as our universities or Western models were oral ... I could have given 50,000 words without a problem. I could have had my notes in front of me and referenced any talk that I give along the way. I don't know what it is, but I can't get it from my head to paper. There's no consideration for anyone with learning difficulties or anything. So a lot of our good nurses, who don't have that ability to write, feel that they're left out and leave. New ways of learning, bringing back Oral Vivas, letting somebody talk or show what they can do. 

A lot of our Aboriginal nurses will feel left out, particularly from our rural and remote areas, because universities do nothing to embrace a different way of learning. I was lucky in country hospitals, there was an Oral Viva for everything. I barely passed any written thing, but we were so lucky, every PTS stage, everything up, we had to do an Oral Viva. Thank God, because I could talk. It's just about being flexible in the way that people do learn, but it's not so much that. People, a lot of Aboriginal nurses will soak it up in the classroom, but it's about reflecting back. How do you get it reflected back, through what exam technique? Through what way do we actually spread it back?

Thanks, Lesley. In the article in the ANMJ in October 2021: 'Let's talk about racism,' you talked of not ticking the box on your Aboriginal identity when applying for jobs. You also talked about the racist comments of colleagues on the achievement of your qualifications, and the discriminatory treatment of the darker skinned Aboriginal nurses and staff who overlooked the treatment and care of Indigenous patients.

Yeah, and it is still alive and well. When we're at our CATSINaM meetings, we all relate [to] the things that come out. It's that consideration that if an Aboriginal person gets something, you've ticked the box, they've obviously filled the quota. That's constantly the thing, that you've filled a quota, and I knew that was alive and well. So I never tick, I deliberately didn't tick it for over, I don't know, 10 or more years, because I was on a path. 

Plus, when I left Cessnock Hospital in the early 80s, I found that when people knew, I would be asked to go to every ward, everywhere, and it still continued even though I didn't tick the box. But all of a sudden, every Aboriginal person--before we had CLOs in the hospitals--it was, "Get Lesley." No idea! Like, that mob isn't my mob. I've got no idea. Well, you do. You have a better way of just understanding their fears and different things. 

But instead of people trying hard themselves to understand, it was automatically your problem. Nobody let you off your own workload. And then whoever you were seeing, they then have an expectation that you are going to make everything flow properly. If not, you've got payback. It's just normal bitterness with people, people do pay back all the time, whether you're Aboriginal or not. If something goes wrong, they're going to sue, they hate you, they'll argue with nurses, nurses cop crap all the time. 

Payback, it's alive and well in every culture. But now you've taken on more. This mob think that you're going to look after them because you've been asked to go out there, or the NUM would ask you to go somewhere, and all of a sudden you've got this added cultural responsibility. And that's just racist, that people don't think that they can handle it, or try it themselves, or question a person, or do anything. 

I've heard so many reports ... "Oh, Bed One is this lovely 87 year old, she had a fistula, and her daughter stayed with her last night. She's really lovely. We've had to give her a few things for pain, but she's okay. Bed Two is an Aboriginal man who was in jail 10 years ago for drug use, who hasn't done a thing wrong for 10 years." Always the race card comes up, every single time. "He's been asking for more pain relief, I think he's only after drugs ..." 

In this one particular case, I heard that statement, that man had bled into his arm and they hadn't gone into him all night. All night, they had pressed the button on the automatic blood pressure machine in the room, and hadn't even gone into review. Just assumed that he was in jail 10 years ago, so he's only after drugs. You don't hear, "Oh this person is Scottish, Japanese heritage in Bed One. The fact that you're saying it, not even in a way that's appropriate. If this man's an Awabakal man, this is his Country, he has relatives here ... no.

Tessa Moriarty [16:12] Earlier you talked about, if I can actually put it [this way], the tardiness, or perhaps the laziness that some of the nursing profession can have, more than we're happy to say, putting the responsibility on nurses like yourselves and others who are Aboriginal or Torres Strait Islander to know, to inform, to educate, rather than actually do that ourselves. 

Lesley Salem [16:42] We have a double workload and a hidden workload all the time. The more people call on you, your workload is double that of anybody else. There's just so much institutional and on the ground racism, which people don't reflect on. When you act on a bias, it becomes racist. So you don't act on your bias. You've got to be able to say, I've got a bias here. Why did I say that? Or, what am I saying that could be interpreted wrong? 

And the institutional racism, well, that's so alive. We get all these things, this patient failed for the second time to turn up to the specialist appointment, they have been removed from that. Now they know that's standard across the board. It does them no harm to leave them on the specialist list. Have they got any idea, when the age of death is between 49 and 55 between Doomadgee and Mornington, how many children's funerals they go to a week and they are related to them? They are related to the people, and they're fearful of going out, and the work we try and do to get on [the list], and they're kicked off because they don't have shoes or anything? 

Yet this institutional racism ... even though they go, "Why did they bother referring them, they won't turn up?" They will, eventually. They will get sick enough, they will reflect enough, they'll be supported enough that we'll get them there. Less than a quarter of people in Doomadgee and Mornington get Centrelink payments. So [this attitude of] "Let's send them out to a town with no money, no shoes, no support, to go to a specialist appointment that they can't understand ..." And then we wonder why it takes us a while to get them out there. So there's just this institutional racism absolutely everywhere. They know a trend of something and yet they failed to act upon it.

Tessa Moriarty [18:32] Yes. Have there been improvements? Have there been any inroads? Is it still the same as it was when you were training? Have we made any inroads? Have there been any improvements whatsoever? 

Lesley Salem [18:46] Well, they're not put out on the verandah anymore or anything like that. Where my father couldn't get a loan as a young fellow to start his own business, things have improved like that. But when you're looking at the treatment our patients get when they present to larger cities, it is a bother. 

My niece is looking at some research at the moment. Our mob are kicked out ...well, they're discharged appropriately from acute mental institutions. But what is done about their social and emotional wellbeing? There's still nothing about social or emotional wellbeing. Do you have somewhere to go home to? Are you couchsurfing? The value markers are, are they hearing voices, the speed of their speech, it's not social or emotional. That's a huge thing, to send people back to remote rural areas, particularly Aboriginal people who will poorly articulate that because they've been used to it. I'm sorry, but that's just a form of racism. "Just get them out of here. Send them back on a plane. They can be taken care of back there." Knowing the circumstances are far worse. Yeah, it bugs me. 

Tessa Moriarty [19:56] So what do we need to do still, as a collective? 

Lesley Salem [20:00] If you gave me all the money in the world, I'd spend it on the schools. Education. When you're educated, you make better choices, you preserve culture better. At this point, what we have in ... and I've worked in white, poor socio-economic areas as well, up on Coledale and Tamworth. It's this circular way people live, they live in a constant circle of a rich past and the current, only in the current, and it's what you can eat, feel, see, hear, taste, your senses. It's 'what can I do today to make myself feel better?' 

There's nothing 'future' in anything in poorer communities and the old missions. Except for a few, many have broken out, and I've worked in some beautiful places, [inaudible] Hollow, where future became embedded in it. When you're looking at health, that's future-orientated. Everything about your health is future-orientated. When you look at school, that's future-orientated. Why bother to go to school, if you're not thinking about a future? Saving money is future-orientated. 

If you were to tell me how you change everything, how you learn a language of being non-discriminatory, and everything else, it starts with school. I think we should just embed everything and try and get more than 40% of kids to school in remote areas. We teach cultural respect for all cultures, age, culture, religion, race, we teach respect for culture and make it understood. Teach people how, when they're kids, to reflect on how you're feeling and what can be done, but education is the first thing into a future. That becomes really important. 

So like I said, investing in your health, how it affects you today, all the treatments, how will make you feel better today, and then start education on future things. I would put all money into school with kids. I think education is the most important thing on the planet of the Earth. My father was a lifelong learner. Even at 69, his last major course was a Fine Arts degree, but he had so many courses up his sleeve all of his life, because learning was everything. And I think he's right.

Tessa Moriarty [22:20] You're talking about education that's wider than the professions of Nursing and Midwifery, you're taking that right back to the education of everybody.

Lesley Salem [22:32] Everybody, because that's where our nurses will come from, and our doctors, and our allied health, and our health workers, and everything. It will come from the schools, and it's about us moulding into one, a smooth transition from one to another. 

We've gotten so many kids out to the private schools from the remote areas now, well, public schools but with housing, and we're getting more and more, which is phenomenal. Quite a few are coming back and starting tiny little things up because home is home. You may lose some, but they will influence others. I think it has to be that smooth transition between school, TAFES, unis. It's one thing you're going through on smooth [inaudible]. When I talk to people, a lot of the young girls up at Doomadgee and Mornington, it's overwhelming for them to think about applying for something to get in. I just think education is the key to absolutely everything, but it's how we educate and how we test knowledge. 

Elle Brown [23:41] This year there'll be a referendum on an Aboriginal and Torres Strait Islander voice to Parliament.

Lesley Salem [23:46] Shouldn't be there.

Elle Brown [23:47] Involving a change to the Constitution.

Lesley Salem [23:50] Why did you have to vote to count me as human when I was seven? Why did people have to vote to take me off the flora and fauna? Why did that have to come about? Why did we have to vote that gay people can get married? They're not referendums. It should just be done. It is right or it is wrong. Yes, of course it would be a yes vote from me. But why did this have to be done? Why did all the white people in this country have to vote me at seven years old so that I wouldn't be counted as flora or fauna? In this country? For God's sakes? Why did we have to vote for people to love each other and be married? Now why do we have to ask that First Nations people of a country be allowed a voice? 

Tessa Moriarty [24:39] Absolutely.

Lesley Salem [24:41] I'm sorry, but this shouldn't be a referendum. This should simply just be. I can go through many referendums, but I'm sorry. One point becomes humanity, an obligation to humanity. But yes, how grateful am I that my dad and nan weren't counted as animals anymore.

Tessa Moriarty [25:03] [We should] never have had to come [down] this path, we should never have had to do this at all. And we are. In this year of the referendum, as a collective we've got a huge profession, nurses and midwives are big across the country. What do we need to do for Aboriginal and Torres Strait Islander people, but also for nurses and midwives?

Lesley Salem [25:28] Look, I do understand that a referendum allows you to change legislation, I understand that. But at times, it just is very frustrating that that legislation was ever put there, or that there was no recognition to start with. But it's just simply a yes. It's an absolute yes, and the details of it will be sorted out later. 

We need voices from rural, remote, urban, we need voices of people who live very traditionally, and those who don't. But you're not wrong if you're an Aboriginal person living in a city, it's just your perspective is different. The issues, the responsibilities in your life, and the problems you face, it's just different. That's why we need all perspectives. So it's just a yes for me, and I do understand that a referendum is needed to change legislation. But I just think it's sad that we ever had to get to a point where that you count people as human, that you allow gay marriage, that you allow the Aboriginal people of this country to have a voice in its own government.

Elle Brown [26:28] How can we support the wellbeing of our Aboriginal and Torres Strait Islander nurses and midwives?

Lesley Salem [26:40] Recognizing that they're facing many more issues than you realise. I've got such quiet health workers that find it hard to articulate things, it's empowering some of them. I've got a health worker that is just shining at the moment, we've empowered her. We've looked at her work, we've empowered her to triage our patients, and she is now finding more issues with patients than what they're presenting with. So it's empowering. It's not making them feel threatened by the current system, but empowering and looking at, 'how can we best support you?' 

It may not be in a big yarning circle where there's a lot of shame in admitting that you're suffering. It might be one on one. It's finding common ground with people, all people, and then exploring issues through that common ground. Whether it's a patient coming in and asking them how their fishing has been going, or the footy, or how are the kids, it's exploring then what's bringing you in. "You look a bit tired," or leaving doors open for people to have conversations. I think that's an art form that is missing with a lot of people, that art of conversation to open people up.

Tessa Moriarty [27:49] Yes, yes.

Elle Brown [27:51] We could talk for hours.

Lesley Salem [27:53] You mean I could go on for hours!

Tessa Moriarty [28:00] Any further advice and words of wisdom that you have for us?

Lesley Salem [28:07] Education. Education for our young kids, education for our nurses, be a lifelong learner, being an empowerer. Mentor, mentor everyone, because I learned so much through mentoring. I just love it. If I don't know a question, and they don't know the answer, and I don't know the answer, then we explore it together. People should never shy away from mentoring, because this is the group that will look after us when we're old. But empower nurses to believe that we are the true healers. We are the greatest workforce. Never let anyone break us down into tasks, because what we do is about the whole person. We don't do tasks, we're judging, we're critically thinking, we're seeing how they swallow the tablet, we're seeing how they do everything. So never let us be broken down into tasks ever, ever. 

One more thing. The only tiny thing I think is lost in our unis is our psychological skills. I was going to go with this Assistant in Nursing when I was training. I was made to go with this Assistant in Nursing and there was a man who was dying. I was in third year and I was so cocky, I knew everything. Anyway, I was really disgusted that I had to be below this Assistant in Nursing, and it took me several days to figure it out. She could be in a room with people when they were struggling with somebody dying. She could be in that room when they asked a question, included the person who was unconscious in the conversation. She displayed not only sympathy, but empathy. She displayed kindness. She displayed courage when it was time to make people listen or do things and when I finally went out to one of the most wonderful sisters that I work with, Sister [inaudible], I said, "I think I get it. You got to use your powers in your head, too." And she went: [inaudible]. 

I now make nearly everybody I mentor give me 500 words or 200 words on how you saw a psychological skill used to achieve a treatment, to get a history out, to do anything. Because there's so many psychological skills, you aren't born with sympathy or empathy or kindness. You aren't born with the ability to educate to a lot of people, or be commanding. You're not born with those skills and these psychological skills are the only thing I think are missing because they are part of our repertoire for treatment. There becomes a point when empathy becomes dangerous, where all of those things become wrong. It's knowing and learning when to use the skill when it's appropriate, and when it's not welcomed, and when it's everything. If I could say anything, please look at your psychological skills and know when to use them.

Elle Brown [31:06] Thank you again, Lesley. Really enjoyed the chat today.

Lesley Salem [31:10] No worries!

Elle Brown [31:11] I want to acknowledge the impressive work over 25 years that the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives have done to support and advocate for Aboriginal and Torres Strait Islander nurses and midwives.

Lesley Salem [31:28] Yeah. They've empowered me. It feels like you're home when you go to the meetings. We talk the same issues. We come up with solutions. Yeah. They're wonderful.

Elle Brown [31:39] They are. That's all for today's podcast. Please remember, support is available whenever you need it on Nurse & Midwife Support, 1800-667-877. The service is anonymous, confidential and free, and you can call 24/7. You can also connect via the website, nmsupport.org.au. Your Health Matters. Thank you.