In this issue we look at some of the issues and challenges for CALD nurses, midwives and students, and suggest how non-CALD nurses and midwives can get involved and support them.

We recognise that Aboriginal and Torres Strait Islander nurses and midwives are not part of the CALD community. In a future newsletter we will focus on support for, and the challenges experienced by Aboriginal and Torres Strait Islander nurses and midwives.

This newsletter explores complex topics including racism that may be sensitive or triggering for many people. If this newsletter raises any issues for you, please reach out. If you’re experiencing racism and want to do something about it, we can support you.

Nurse & Midwife Support is available 24/7 Australia-wide. Call us on 1800 667 877 for anonymous, confidential, and free support.

Culturally and linguistically diverse (CALD) describes the many Australians (and people living in Australia) who originate from different countries with diverse languages, ethnic backgrounds, nationalities, traditions, society structures and religions. This may also include people born and raised in Australia whose families maintain cultural practices or identities from abroad.

One in four Australians were born overseas and one in two have a parent born overseas. Australians claim more than 250 ancestries and speak more than 350 languages at home. We are also home to the world’s oldest continuous culture, Aboriginal and Torres Strait Islanders. Our First Nations peoples have lived on and cared for our country for over 65,000 years.

Our community benefits from the wealth of experience people of diverse backgrounds bring to our nation. Many of us celebrate the strength this diversity offers.

Our nurses and midwives come from a wide range of backgrounds. A culturally diverse healthcare workforce means better communication, cultural understanding, and representation for CALD people in our care. CALD nurses, midwives and students make an important contribution, and we celebrate everything your knowledge and culture brings to the professions.

But we hear from many nurses, midwives, and students that they experience racism not only from patients and relatives but from fellow staff members. They often don’t feel safe to report their experiences. To be heard and get the support you need call Nurse & Midwife Support on 1800 667 877.

Since 2018 all registered nurses and midwives have been required to support cultural safety in their workplace. Our Code of Conduct states that we must:

• understand how our own culture, values, attitudes, assumptions and beliefs influence our interactions with others
• provide care that is free of bias and racism
• challenge beliefs that are based on assumption
• support an inclusive environment for the safety and security of all
• help create a positive, culturally safe work environment.

You can expect your workplace to:

• promote diversity and inclusion
• talk about racism and discrimination
• adopt practices that respect diversity, avoid bias, discrimination and racism
• offer cultural safety and diversity and inclusion training
• treat racism and discrimination as a workplace hazard.

Ask your organisation if it offers cultural safety training to staff and find out if its diversity and inclusion policies support cultural safety. If you need support to do this please get in touch [email protected] or visit the Australian Human Rights Commission: Cultural diversity in the workplace

In researching this newsletter, I came across an important initiative by the New South Wales Nurse & Midwives Association (NSWNMA). They seek to understand, elevate and support the experience of CALD nurses, midwives and students in our workplaces. In 2019 the NSWNMA released the Cultural Safety Gap report. It was based on a survey of the experiences of nurses and midwives from more than 100 different cultural backgrounds and found that just under 10% of nurses and midwives experienced racial discrimination daily. It is essential reading for all nurses, midwives and students and their managers to better understand the experiences of CALD peers, and how everyone can support cultural diversity in our workplaces.

The NSWNMA established a CALD reference group in response to the report findings. And that group recommends that all nurses and midwives take cultural safety training. 

Blog: Black nurses report experiences of discrimination in rural workplaces

It’s only the skin colour, otherwise we are all people: This research study was published in the Mar-May 2021 issue of the Australian Journal of Advanced Nursing (AJAN). The study reveals that Black sub-Saharan African nurses report incidents of discrimination and disadvantages based on their race and skin colour in rural workplaces, not only from patients but from their colleagues.

Robert Fedele examines the revelations of the study in this piece that first appeared in the ANMJ: Black African nurses battle racism in rural Australian workplaces, study finds. We thank the ANMJ for allowing us to republish this informative piece.

Blog: Racism is an occupational safety issue

Employers and workers need to take racism seriously as an OH&S issue. Experiences of racism can cause depression, anxiety, low self-esteem, chronic health conditions and suicidal ideation.

NSWNMA CALD reference group coordinators Helen Macukewicz and Catherine Ivanfy urge leaders and managers to do more to acknowledge the reality of racism, treat it as a workplace hazard that has effects that extend into workers daily lives, and implement measures to protect workers.

To combat racism and ensure that nurses and midwives feel valued, safe and equal at work we first need to understand their experiences. Read Catherine and Helen’s blog about the need to seek information and gather data about racism in healthcare settings: Missing data obscures the hazard of racism in nursing & midwifery.

Podcasts: Nurses and midwives talk about how to improve cultural safety in our workplaces

Hear six passionate nurses talk about their commitment to supporting CALD nurses and midwives. We worked with the NSWNMA to offer you two podcasts:

Episode 36: Addressing the Cultural Safety Gap with Catherine Ivanfy and Helen Macukewicz

Catherine and Helen discuss how the report findings led to the formation of the CALD reference group. Find out how you can advocate for improved cultural safety in your organisation. Listen to the episode.

Episode 37: Calling Racism Out with Bukwa Madzinga, Julie Ngwabi, Merilyn Homes, and Marty Williams

Four members of the NSWNMA CALD reference group – Julie, Merilyn, Bukwa and Marty share their lived experiences and motivations for tackling discrimination and the importance of calling racism out. They discuss candidly the harmful effects of racism, the benefits of being part of the CALD reference group and their reasons for raising their voices to spotlight discrimination. Listen to the episode.

Join the Campaign: Racism. It Stops With Me (RISWM)

The Australian Human Rights Commission encourages us to join Racism: It Stops With Me, a national campaign that urges Australians to reflect on racism and take action against it. It comes with the Workplace Cultural Diversity Tool, a free, confidential self-assessment tool for organisations seeking to strengthen their approach to cultural diversity and anti-racism in the workplace.

The purpose of the RISWM campaign is to:

• Increase awareness and understanding of racism at the interpersonal, institutional, and systemic level across Australia
• Equip more Australians with the tools to engage in active anti-racism
• Create safer and more inclusive workplaces for First Nations people and people from culturally and linguistically diverse communities

NSWNMA webinars: Promoting Diversity and Inclusion for CALD Nurses and Midwives

All nurses and midwives should expect cultural safety at work. This series explains how we can all work towards more diversity, inclusion and safety in our workplaces. Topics include Working in Multicultural Teams, Bystander Action, How Culture Influences Work and more. Contributors include representatives of the Australian Human Rights Commission, African Women Australia, the Multicultural Communities Council of Illawarra, and other clinicians and researchers. I was lucky enough to participate as a NMSUPPORT representative.

The webinar series was made in response to The Cultural Safety Gap report (2019).

Check out Webinars: Promoting Diversity and Inclusion for CALD Nurses and Midwives.

Racism has no place in nursing and midwifery. Nurse & Midwife Support is joining CATSINaM, NSWNMA, ANMF, NMBA and many other organisations to spotlight racism, its harmful effects, and work to eradicate it from our professions.

If you or your workplace are working to raise awareness of racism and celebrating cultural diversity, we would like to hear from you. If you experience racism in the workplace and don’t feel people are doing enough, we’d also like to hear from you. Please get in touch: [email protected].

The team at NMS are here to support you. Please get in touch on 1800 667 877 or by email.

Let’s work together to include and support everyone. 

Your health matters. Your workplace safety matters.

Racism is when a person, people or institution from the dominant group use their power in ways — direct or indirect, intentional or unintentional — that harm a person or people from a racially marginalised group.

According to the Australian Human Rights Commission (AHRC):

“In 1975 the Racial Discrimination Act came into force, making discrimination illegal.

In 1995, the Act was extended to make public acts of racial hatred against the law. Today, the Act continues to send a strong message about our common commitment to racial equality and the importance of a fair go for all.

Despite this legal protection, too many people in Australia continue to experience prejudice and unfair treatment because of how they look or where they come from.”

Discrimination can often be invisible to people from the dominant culture. If that’s you, it’s important to listen to your CALD co-workers when they speak on issues of racism and discrimination, because they often have the context and experience to see what you may not be able to.

The process of racism takes many forms:

• overtly racial insults and jokes.
• Implicitly racial comments or microaggressions, such as asking someone “Where are you really from?” or asking someone of African descent if you can touch their hair.
• Stereotypes and vilification of people from a particular racial or ethnic background, such as the racism and Sinophobia many Asian-Australians experienced in relation to the COVID-19 pandemic.
• Barriers to professional recruitment or advancement to people who are culturally or racially marginalised.
• Failure to acknowledge harmful or traumatic events, such as minimising the impact of the Stolen Generation on Aboriginal and Torres Strait Islander communities.
• Failure to acknowledge or diminishing the achievements or a person or people of colour — see the #OscarsSoWhite campaign in response to a lack of diversity among Academy Award nominations.
• Consciously or unconsciously neglecting the needs of marginalised people, for example failing to provide examples of how skin conditions appear on people with darker skin in dermatology textbooks.
• Laws or policies that intentionally or unintentionally discriminate against members of a marginalised group — check out the AHRC’s timeline of racist laws and policies in Australian history.
• Violent attacks (verbal and physical).

Not all acts of racism are on the same scale, but all are harmful and are often experienced cumulatively by the target.

We thank the ANMJ and the NSW Nurses and Midwives Association (NSWNMA) CALD Reference Group for their contributions to this issue, their insights and advice, and their ongoing work to advocate for CALD Australians.

If you have an experience you’d like to share or there’s a topic you think we need to address in a future newsletter, drop me an email: [email protected].

Workplace safety matters.

Mark Aitken RN
Stakeholder Engagement Manager
Nurse & Midwife Support