What communication strategies can you employ to ensure the work environment is culturally safe?

This descriptor introduces students to verbal and non-verbal communication cues of Australia’s First Peoples. The topic has a progressive focus on building skills for students to be able to engage in respectful and culturally safe communication. Communication, and culturally safe communication, is the foundation for building positive relationships with Australia’s First Peoples.

Please use the following link from the Share Our Pride website for Respectful Relationships with Australia's First Peoples.

Learning Outcome

Upon the completion of this topic you should be able to identify the skills of culturally safe communication when interacting with Australia’s First Peoples.

Communication

Evidence has repeatedly shown that First Peoples are more likely to access health services that:

• communicate respectfully;
• have some understanding of culture, and
• build good relationships

Skills that assist in culturally safe communication with Australia’s First Peoples include, but are not limited to:

LANGUAGE

English may not be the first language spoken by the client. Different dialects such as Kriol or Aboriginal English may be used (revisit diversity from Module 1). Avoid using complex words and jargon, explain why you need to ask questions, use diagrams or images to explain instructions and terms as they will not always be familiar to patients.

Don’t equate a lack of English to be a lack of intelligence. Processing information in a second dialect is not a smooth process, so processing information in a second or third language is very complex, especially when you are not well.

If required, seek help from local First Peoples staff.

TIME

In Western culture, emphasis is placed on time to meet deadlines and schedules. Time is perceived differently by First Peoples cultures, as more value is placed on family responsibilities and community relationships.

SILENCE

Silent pauses should be acknowledged, and a need to fill these silent moments should be avoided as one could be gathering their thoughts. Silence during conversations is normal and should not be interpreted as a lack of understanding.

EYE-CONTACT

Some (not all) First Peoples may be uncomfortable with direct eye contact, especially if unfamiliar. Avoidance of eye contact is customarily a gesture of respect.

KINSHIP NETWORKS

Kinship is a fundamental characteristic of First Peoples social organisation and family relationships. Please view the following video (1 minute 8 seconds) from Reconciliation Australia:

LISTENING

Active listening is a crucial skill in communication. Avoid selective hearing, use paraphrasing to clarify the message you have received, reflect feeling and demonstrate empathy where appropriate and avoid talking over the client.

NON-VERBAL COMMUNICATION

Some non-verbal communication cues (hand gestures, facial expressions etc.) used by First Peoples can have different meanings in the Western context. Be mindful of your own non-verbal communication, body language and how it can be interpreted.

QUESTIONING

In First Peoples cultures, indirect questioning is the approach most preferred. Direct questioning may lead to misunderstandings, discourage participation and make it difficult to obtain important information.

DECISION MAKING

Due to family kinship structures, decisions often involve the input of other family members.

Further information

Queensland Health - Communicating effectively with Aboriginal and Torres Strait Islander Peoples

University of Sydney - Learn about Aboriginal Kinship systems

Let’s explore some specific strategies for communicating effectively with Australia’s First Peoples.

Watch the following video, it contains invaluable tips and strategies to help you engage respectfully with Australia’s First Peoples.

This is an additional video, hosted on YouTube.

A key message in this video is the importance of providing person-centred care to First Peoples. Recognise the diversity of First Peoples’ communities and treating each person as an individual. There is no ‘one-size-fits all’ for First Peoples. There are many different languages and cultures, so it’s safer to avoid making generalisations about clients.

Also keep the following points in mind as you develop relationships and provide person-centred care to First Peoples clients, families and communities.

Language

English may not be the first language spoken by the client, so be prepared for the possibility of language barriers. For example, different dialects, such as Kriol or Aboriginal English may be used. As with any client where English is not their first language, take care to avoid medical jargon. Where required, seek support from Aboriginal Health Workers, liaison officers and interpreters. Also keep in mind that communication with the client’s family member/s can be incredibly useful in overcoming communication barriers.

Remember, First Peoples are diverse. By deepening your cultural capabilities and improving your understanding, you will have the agility to embrace and respond effectively to this diversity. This directly relates to improved health outcomes for First Peoples clients.

Time

Did you know the concept of time may be perceived differently by some of Australia’s First Peoples? For example, a commitment to family responsibilities and community relationships is valued much more highly than the rapid turnover of delivery of services. When working with Australia’s First Peoples:

• consider allocating flexible consultation times
• be mindful not to rush your client and
• wherever possible, manage time according to their individual needs.

It’s all about having respect for values and beliefs that are different to yours.

Your non-verbal communication speaks far more than your verbal communication. Take your cues from the body language of the client. Also keep in mind, Aboriginal and Torres Strait Islanders may communicate less frequently with eye contact. Please note, this is not always the case and it’s a popular misconception that all First Peoples avoid making eye contact.

If the client is not making eye contact, it may be an indication of any number of things. For example:

• the client is experiencing pain
• you have not established enough rapport or
• there is limited understanding of what is being said.

Questioning

The way you ask your questions in the healthcare setting will determine the quality of the response. A single, open (or indirect) question will generally yield more comprehensive information than a closed question containing multiple components.

Multiple questions combined in the one inquiry can lead to the client agreeing to questions without having a true understanding of what is being asked. Choose your questions carefully and avoid an interrogation style approach if you are hoping to obtain a complete picture of what’s going on for the client.

Kinship networks

As discussed in Week 1, the Kinship network is a fundamental characteristic of Aboriginal and Torres Strait Islander people’s social organisation and family relationships. It is a complex system of social and familial roles, cultural responsibilities and obligations. Kinship is determined by blood lines and for more traditional First Peoples will dictate many social customs. For example, kinship will impact on who people marry, interactions between siblings and in-laws and funeral roles.

Decision making

Due to family kinship structures, decisions often involve the input of other family members. So keep in mind decisions are not always made immediately. Be patient and respect the client’s right to involve their own people when it comes to healthcare.

Your task

What other tips and strategies can you share with the rest of our group? We’d love to know what communication strategies have been working for you. Also feel free to share stories where the experience hasn’t gone so well. Let’s open up the conversation and learn from each other.