I participated in a 32-hour simulation block as a first-year student of Master of Nursing Practice. It was structured to develop a variety of nursin

Description

I participated in a 32-hour simulation block as a first-year student of Master of Nursing Practice. It was structured to develop a variety of nursing and clinical skills for students. Each day started with a briefing session from our facilitators who introduced us to nursing skills like A-E assessment, ISBAR framework, Care Plans, medication administration, and documentation on day one. We got to practice handover scenarios, wound management, pressure injury prevention, and removing sutures and staples of patients on day two. On the third day, we learned to monitor vital signs, assess pain, bed making, urinary and continence management, and personal hygiene. We also had a session on death and dying on the last day.

As student nurses, we rotated through different patient cases (Reginald Bean with a CVA, Kym Smith with heart failure, Peter W with COPD, and Ida Green with a fall) with different partners as allocated by the facilitator. On the second day we did Formative SIM Block Interim Student Self Evaluation" as part of the ANSAT (Nursing and Midwifery Board of Australia's Registered Nurse Standards for Practice Assessment Tool). The sim block final assessment was done by our facilitator on the last day of the simulation block with constructive feedback on our performance.

Feeling and thoughts

As this was my first simulation block, I was very nervous, unsure, and worried about making mistakes. I doubted my ability to think critically, prioritize actions, and communicate well. I was also excited and prepared for fast-paced real-type scenarios in the lab.

The debriefing sessions helped me to prepare my thoughts constructively as I would know in advance about what I was going to do in the lab. In the beginning, I was anxious and uncertain, but I ended with a sense of accomplishment, growth, and confidence. Besides learning clinical skills, I stepped out of my comfort zone, developed flexibility, and improved communication and interpersonal skills required for nursing practice. The constructive feedback allowed me to learn my strengths and weaknesses which will help me perform better in my clinical placement.

I had a mix of feelings while we were doing the death and dying session- sadness, a sense of responsibility, a desire to provide compassionate care, and awareness about how one life can impact so many people around. I was struck by the emotional toll that end-of-life care can take on healthcare providers while dealing with such a situation.

Evaluation

The simulation block allowed me to apply my theoretical knowledge in realistic clinical situations. I could narrow the gap in my thinking, knowledge, and skills. It was a safe environment under close supervision to develop my clinical skills, critical thinking, and communication abilities. The scenarios were close to real-life patient care that required us to demonstrate our knowledge of pathophysiology, pharmacology, and nursing interventions. I was encouraged to ask questions without feeling stupid. The facilitator challenged us to analyze our decision-making process, consider alternative approaches, and identify strategies for improvement.

The death and dying session highlighted the importance of skills such as active listening, empathetic communication, cultural awareness, ethical decision-making, and the ability to provide emotional support.

However, the simulation block could not cover the complications and uncertainty that may arise in unplanned real-life situations which highlights the importance of clinical placement for nursing students.

Analysis

The simulation block will always affect my professional nursing practice positively. Firstly, it made me realize that nursing is a continuous process of learning, unlearning, and relearning. All the given sessions exposed my gap in thinking, knowledge, skills, and understanding. As I was moved by the death and dying session it highlighted several key issues which can affect my nursing practice in the future:

Communication and Patient-centered care

The importance of clear empathetic communication in providing patient-centered care. It can help families make informed decisions for patients (Australian Commission on Safety and Quality in Health Care, 2023). According to the Nursing and Midwifery Board of Australia's (NMBA) Code of Conduct, poor communication can adversely affect the ecosystem of the healthcare setting.

Cultural sensitivity and respect

The willingness to learn, respect, and value the preferences of different cultures. As nurses, we should be culturally sensitive and responsive to provide equitable care to all patients. The NMBA Standard of Practice for Registered Nurses incorporates cultural sensitivity that demonstrates respect for individual cultures, preferences, and differences (Nursing and Midwifery Board of Australia, 2016). We must be mindful of cultural backgrounds, beliefs and rituals while handling patient death or dying situations.

Resilience and Self-care

Nursing can be emotionally demanding hence we should be resilient, flexible, and adaptable. They should be able to bounce back after a difficult situation (KIM and CHANG, 2022). They cannot hang on to stressful situations like the death and dying of their patients for too long. It is not good for their well-being as well as for the other patients around them.

Critical thinking and evidence-based practice

Critical thinking and clinical reasoning are fundamental in nursing practice. Nurses must keep them up to date with legislation policies and other ethical frameworks to make informed decisions and deliver high-quality evidence-based care (Nursing and Midwifery Board of Australia, 2016).

Post-mortem care and dignity

Nursing responsibility doesnt end after the death of their patients. They play a vital role in preparing the person's body by giving them personal care to preserve their appearance, condition, and dignity (Department of Health Victoria, 2015). Also, we should safely return any possession the patient is wearing. Additionally, if family and friends wish, they can participate in the process of preparing the body.

Ensure privacy and dignity of patients. Treat post-mortem care with respect. Nurses require attention to details like cleaning and preparing hospital rooms, removing medical equipment, and ensuring the room is ready for families to come in.

Documentation and Legal requirements

Proper, correct, and timely documentation is the key to nursing. It is the responsibility of the Registered nurse to check if the coroner needs to be involved or if any other authorities must be notified. Also, the NMBA Registered Nurse Standard of Practice states the importance of maintaining proper documentation.

Check documentation to confirm if patient wishes on organ and tissue donation. The Australian Organ and Tissue Authority's National Protocol for Donation after Cardiac Death elaborates on the role of nurses in identifying potential donors and initiating conversations with families.

Bereavement Support and End-of-Life Processes

Give information about the processes after death- like how to collect the death certificate. We should provide family time for acceptance and arrangement but at the same time, nurses should be mindful of healthcare setting policies after death. Providing emotional support and facilitating the grieving process for families is an essential aspect of compassionate nursing care.

From a theoretical perspective, the Kubler-Ross model of grief aligns with nursing practice that helps to understand and support families coping with death and dying (Tyrrell et al., 2023). Denial, anger, bargaining, depression, and acceptance are the five stages that people may experience as outlined in his model. This holistic approach helps to understand the emotional journey of death and dying.

Patients referred to palliative care services on time have been found to manage symptoms better and reduce the burden on health workers (National Palliative Care Standards - Palliative Care Australia, n.d.). In addition, culturally appropriate palliative care is crucial to ensure respectful end-of-life care, particularly for Aboriginal and Torres Strait Islander communities (Australian Institute of Health and Welfare, 2023). World health organizations also emphasize the importance of people-centered and culturally sensitive healthcare (WHO, 2015). Since the patient population is becoming increasingly diverse the need for culturally sensitive care becoming challenging at global, national, regional, and local levels.

As we finished the death and dying session in the lab, our facilitator gave us some time to collect our emotions. I realized the importance of self-care and emotional support are required by the health care worker as well while dealing with end-of-life. Studies have shown that nurses working with terminally ill patients have a high risk of burnout, fatigue, and moral distress (Higashibata et al., 2023). It is important to integrate self-care in the day to day-to-day life of nurses. The death and dying session showed me how versatile the role of a nurse can be with patients and families. Access to counseling, debriefing sessions, ongoing education, resources, and peer support programs in the healthcare setting can help nurses overcome the challenge to some extent.

Conclusion

For me simulation block was a valuable learning experience with exposure to almost real-like scenarios. Along with building confidence in me for the clinical placement; I have improved my clinical skills, critical thinking, and communication abilities. It was an opportunity to apply nursing principles, professional standards, and theoretical frameworks into practice. The constructive feedback from the facilitator will help me to improve, and perform better to provide safe, effective, and compassionate nursing care in the future.

The basic of doing better in nursing is through continuous learning and skill development. Effective communication and teamwork are the keys to performing better in any healthcare setting. Nurses must be able to think critically and adapt to different situations or challenges with resilience. In addition, evidence-based practice and clinical reasoning are important in nursing practice.

The death and dying scenario allowed me to understand the importance of compassionate and patient-centered care. Along with communication, it is equally important to be comprehensive, culturally sensitive, and respect autonomy while making ethical decisions. Additionally, the session emphasized the importance of self-care and emotional support for healthcare providers in challenging situations like death and dying.

Action Plan

To enhance the knowledge and skills I gained throughout my simulation block about the death and dying session, I plan the following:

Continuous Learning and Professional Development

Always seek learning as an opportunity. Active participation in workshops, seminars, interprofessional education or online learning modules regarding palliative and end-of-life care can enhance my skills in areas relevant to providing compassionate end-of-life care.

Keep updated with research and evidence-based practices to provide effective care to patients facing terminal illness.

Maintain strong awareness of my scope of practice, professional standards, and ethical principles I must uphold. The holistic understanding will help me develop my skills and expertise in all areas of nursing practice, including end-of-life care.

Communication and Reflective Practice

It is important to improve my communication skills based on feedback from my mentors, seniors, or colleagues. Another way of improving my communication skills is through active listening.

Journaling can be a key component to reflect on my improvement. The idea is to document my learning experiences, challenges, and strategies. It will improve my ability to analyze and think critically.

Self-Care and Resilience

Practicing self-care is equally important. I can achieve this by engaging in mindfulness practices and seeking counseling. This can help in maintaining resilience to face emotional challenges like those encountered in end-of-life care.

Cultural Responsiveness and Dignity in Care

Be aware of people's culture and spiritual needs through culturally responsive practice.

Prepare the patient's body with sensitivity, respect, and dignity. I must try to attend to the personal care within a few hours of the patient's death to preserve their appearance, condition, and dignity.

Ethical Decision-Making and Organ Donation

Educate myself about the process of organ donation and transplant. It can help fulfill the wishes of deceased patients and save another life. I need to demonstrate ethical communication and work within my nursing scope of practice.

Leveraging Clinical Placements

Get the most out of my clinical placement. Seek feedback from preceptors, mentors, and colleagues to identify strengths and areas of improvement. Active participation will help me recognize my progress and develop strategies for ongoing professional development. 1

Practice essential nursing skills within scope and guidance, such as patient assessment, medication administration, and emergency response, to build confidence and competence.

By implementing these strategies, I aim to continuously enhance my knowledge, skills, and professional practice in providing compassionate, culturally responsive, and evidence-based end-of-life care. This will enable me to better support patients, families, and the healthcare team in navigating the challenges of death and dying.

Reference

Australian Institute of Health and Welfare. (2023, July 7). Cultural safety in health care: monitoring framework, Summary - Australian Institute of Health and Welfare. Cultural Safety in Health Care for Indigenous Australians: Monitoring Framework; Australian Government. https://www.aihw.gov.au/reports/indigenous-australians/cultural-safety-health-care-framework/contents/summary

Australian Commission on Safety and Quality in health care (2023). Communicating with patients and colleagues. [online] Australian Commission on Safety and Quality in Health Care. Available at: https://c4sportal.safetyandquality.gov.au/communicating-with-patients-and-colleagues.

Best Practice Guideline for Donation after Circulatory Determination of Death in Australia. (n.d.). DonateLife. https://www.donatelife.gov.au/for-healthcare-workers/clinical-guidelines-and-protocols/national-guideline-donation-after-circulatory-death

Department of Health Victoria. (2015). Palliative care - grief and loss. Department of Health. https://www.health.vic.gov.au/patient-care/palliative-care-grief-and-loss

Higashibata, T., Hamano, J., Nagaoka, H., Sasahara, T., Fukumori, T., Arahata, T., Kazama, I., Maeno, T., & Kizawa, Y. (2023). Work environmental factors associated with compassion satisfaction and end-of-life care quality among nurses in general wards, palliative care units, and home care settings: A cross-sectional survey. International Journal of Nursing Studies, 143, 104521. https://doi.org/10.1016/j.ijnurstu.2023.104521

Nursing and Midwifery Board of Australia (2016). Registered nurse standards for practice. [online] Nursing and Midwifery Board Ahpra . Available at: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx.

Nursing and Midwifery Board of Australia. (2016). Continuing professional development. Nursing and Midwifery Board. https://www.nursingmidwiferyboard.gov.au/registration-standards/continuing-professional-development.aspx

KIM, E.Y. and CHANG, S.O. (2022). Exploring nurse perceptions and experiences of resilience: a meta-synthesis study. BMC Nursing, [online] 21(1). Available at: https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-021-00803-z.

Tyrrell, P., Harberger, S., Schoo, C., & Siddiqui, W. (2023, February 26). Kubler-Ross stages of dying and subsequent models of grief. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK507885/WHO. (2015). WHO global strategy on people-centred and integrated health services Interim Report. https://iris.who.int/bitstream/handle/10665/155002/WHO_HIS_SDS_2015.6_eng.pd

Proposal

The Wiradjuri Sexual Health Nurse Outreach Service - A mobile nursing service that provides sexual health screening, treatment, and education to Aboriginal and Torres Strait Islander communities in urban, regional, and remote areas.

Introduction

The Wiradjuri sexual health nurse outreach is a mobile nursing initiative to improve sexual health outcomes for Aboriginal and Torres Strait Islander communities. It will mainly focus on Wiradjuri; the second largest aboriginal group in Australia owing to the traditional land Peak Hill of Central West New South Wales (Wiradjuri Country, 2021). They are the people of the river (three Bila) and the country (nguram-bang). Different factors like colonization, socioeconomic status, and concern about privacy contribute to higher rates of STIs such as chlamydia, gonorrhea, and syphilis in Indigenous Australia (HIV, Hepatitis, and STIs in Australia, n.d.).

This mobile nursing service aims to reduce the proportion of Sexually transmitted infections (STIs) by strength-based improved access to culturally safe sexual health screening, treatment, and awareness among the Aboriginals of Wiradjuri. This proposal aims to examine the service of the National Schemes Aboriginal and Torres strait islander health and cultural safety strategy. Based on analysis and evidence, this holistic community-driven approach can reduce STI transmission by increasing testing and treatment rates along with preventing vertical transmission to its target population. The Wiradjuri sexual health nurse outreach service can help to close the gap in STI disparities experienced by Aboriginal and Torres strait islander people.

Service Description

The Wiradjuri Sexual Health Nurse Outreach Service aims to provide free to low-cost, confidential, and culturally safe sexual health services to Aboriginal and Torres Strait Islander communities across Wiradjuri. In collaboration with local Aboriginal Community Controlled Health Services (ACCHSs), community organizations and other health services the plan is to employ Registered nurses mainly of Aboriginal and Torres Strait Islanders who are willing to travel to various communities to provide sexual health screening, treatment, and education.

The target population is Wiradjuri aboriginal communities from age 16-30 prioritizing young adults, gay men, men, and other men who have sex with men, people who inject drugs and sex workers. The fund for this service is expected from multiple sources that might include government allocation, ongoing health program budgets, research grants or non-government contributions which is subject to explore further during the implementation and planning. The service aims to reduce rates of STI for the period 2023-2028 through the following key activities.

Education and Prevention

Delivering culturally appropriate sexual health education in schools, community settings, and education workshops (Ubrihien et al., 2021).

Collaboration with local aboriginal communities. Youth organizations and traditional healers to reach the target population, increase participation, and engagement and promote project activities.

Explore peer education programs by finding peer educators from the community who are trained and can encourage behavioral change among their peers.

Utilizing social media marketing similar to Snake condom Campaign and integrating other electronic media like text messaging to increase awareness (SNAKE Condom Social Marketing Campaign, n.d.).

Identifying community influencers and collaborating to provide appropriate sexual health education and risk reduction.

Awareness of STI prevention methods like Condoms, vaccination, and pre/post exposure prophylaxis.

Screening, treatment, and management

Offering confidential sexual health checkups that are respectful, culturally acceptable, and private.

Advice on contraception and family planning counseling.

Offering free contraception, STI testing, HPV vaccination along with contraception.

Providing on-site treatment of STIs with referrals to other health providers if needed.

Increasing workforce capacity through ongoing training and resources.

Service Analysis

Compliance with the National Scheme's Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy

The Wiradjuri service aims to align with several key actions outlined in the national strategy. It employs Aboriginal and Torres Strait Islander nurses to promote cultural safety and respect for indigenous health practices. The mobile and outreach nature improves accessibility to the communities facing barriers as well. In addition, it also has the following plan in place to strengthen this compliance.

Cultural safety

Provide staff training on the historical and ongoing impact of colonization and social determinants on Aboriginal and Torres strait islander health.

Implementing a cultural safety framework to ensure service is free of racism and discrimination through clear policies and complaint processes.

Introducing policies and procedures that protect the rights, safety, and dignity of Aboriginal and Torres Strait Islander staff.

Implement feedback mechanisms for ongoing reflection and to improve and deliver culturally safe services.

Increased participation

Actively involve Aboriginal and Torres Strait Islander community people to develop a community-based advisory group to plan, implement, and evaluate the service.

Encourage Aboriginal workforce participation by employing them by limiting job requirement criteria.

Greater Access

Collect comprehensive data on services provided and their impacts for further monitoring, experience, health outcome, and future research.

Partnering with Aboriginal community-controlled health services to support integrated, culturally safe services.

Provide and plan tailored customized activities to priority groups.

Open to address and educate concern about maintaining privacy and confidentiality.

Influence

Ensure service leadership demonstrates visible commitment to cultural safety through actions like championing cultural safety training, supporting Aboriginal and Torres Strait Islander workforce participation, and advocating for the service's cultural safety initiatives.

Empowering clients to make informed self-determinant choices through education and awareness.

Align with all government rules, laws, legislation, and standards. Following a proper code of ethics throughout the practice and staying within the scope of practice

Advocating for adequate resources and funding to support the service smoothly.

Promotion of a Strengths-based model of care

The Wiradjuri sexual health nurse outreach service seeks to adopt a strength-based approach and focus on empowering communities through education, prevention, screening, treatment to management in a culturally safe way (Measures, n.d.). This outreach health service acknowledges the strengths present within the Aboriginal and Torres Strait Islander community It is more likely that the prevalence of STIs is more common among young people living in poverty, uneducated, isolated, and financially poor (Ward et al., 2020).

On the other hand, the deficit model would refer to problems, risk factors, common stigma, cultural barriers, geographic isolation, and socio-economic disadvantages in vulnerable indigenous people requiring external intervention (Fogarty et al., 2018). While the service acknowledges these barriers, it prioritizes a strengths-based approach that recognizes the strengths and resourcefulness of the communities it serves. Here are the key aspects of the services strengths-based model:

Providing a service that includes knowledge of traditional health and practices where needed in culturally safe and respectful ways.

Encouraging self-determination about sexual health through education and collaboration which helps in making informed decisions.

Creating awareness about protective behaviors and seeking medical treatment by building community knowledge, skills, and confidence (Silver et al., 2015).

Partnering with local Aboriginal organizations and community people to participate in delivering personalized community-led sexual health projects that utilize the maximum of available resources.

Identifying Aboriginal and Torres strait islander peoples and communities' ability to address sexual health issues while providing all necessary tools and assistance.

The service considers Aboriginal and Torres Islander people of Wiradjuri as the key partners rather than beneficiaries of the service. The aim is to improve sexual health outcomes by supporting self-determination and maximum utilization of available resources by understanding the behaviors, knowledge, beliefs, and practices of the target population.

Support of Traditional Health-related Knowledge and Practices

In context to the current scenario, the Wiradjuri sexual health nurse outreach service is limited to formal support that incorporates traditional Aboriginal and Torres strait islander health knowledge and practices, particularly regarding sexual health. Although the service aims to employ Aboriginal and Torres Strait Islander nurses who might incorporate cultural aspects and traditional perspectives into service, it does not establish a formal channel to collaborate with traditional healers, and elders who hold knowledge. However, to support traditional health-related knowledge and practices the service aims to take the following steps:

Establish formal collaboration with local traditional healers, elders, and aboriginal knowledge holders to figure out appropriate and respectful approaches to initiate conversation regarding sexual health, practices, and treatment.

Collaborate with local aboriginal communities to listen to their viewpoints on incorporating applicable traditional practices into sexual health education, counseling, and treatment as requested.

Provide appropriate training to staff to understand local aboriginal sexual health traditions, beliefs, and customs to deliver care that aligns with those practices.

Organize advisory structures such as community reference groups to incorporate traditional knowledge through input and guidance that comes from the Aboriginal community.

Collaboratively work with elders and traditional practitioners to create informative resources and engagement activities that blend modern and traditional sexual health knowledge.

The Wiradjuri sexual health nurse outreach service aims beyond simply employing staff members from the Aboriginal and Torres Strait communities. The key is to actively involve local communities seeking their feedback, integrating useful traditional techniques, and implementing them in a culturally respectful manner. Along with following proper guidelines, it will require developing dedication, cultural knowledge, and open communication. trust within the community (AHPRA, 2018). This can be achieved through collaboration with communities and knowledge holders.

Recommendations

Based on the analysis, there are a few recommendations proposed to enhance the Wiradjuri sexual health nurse outreach services ability to serve and support the sexual health needs of its targeted populations.

Strengthen compliance with National strategy.

Plan comprehensive staff training based on the impact of colonization, racism, and other social determinants of Aboriginal and Torres Strait Islander sexual health.

Develop a cultural safety framework that requires staff reflections on biases to ensure culturally safe service without racism.

Establish a community advisory group of elderly aboriginal, youth, and health professionals to guide the service plan, method of delivery, and participatory decision-making.

Develop policies and procedures to protect the rights, dignity, and cultural safety of Aboriginal and Torres Strait Islander staff, beneficiaries as well as communities (Ubrihien et al., 2021).

Explore strategies to expand its access to difficult-to-reach target populations such as highly mobile populations, out-of-school populations, and people who are into drugs.

Practice leadership committed to cultural safety through different activities like training, advocacy, workshops, and other participatory programs.

Enhance Strength-Based Approach

Research to understand the risk of practices, knowledge, and attitudes of Aboriginal and Torres Strait Islanders in Wiraduri regarding sexually transmitted infection.

Explore ways to partner with traditional healers and elder generations to integrate traditional sexual health knowledge and practices in an appropriate culturally acceptable way.

Develop community engagement activities and peer education to empower individuals, families, and communities to make informed sexual health decisions.

Initiate reducing stigma and discrimination with proper access to sexual health services mainly for a priority group like youth, LGBTQI+ people, and sex workers (Ward et al., 2020).

Expand Reach for Priority Group

Develop customized sexual health education and services for priority groups like youth, MSM, sex workers, and people in custody through community partnerships.

Easy and increased accessibility to preventive measures like condoms, pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP) across all prioritized community settings including remote areas (Bell et al., 2020).

Collaborate with related services to outreach priority groups such as youth services, peer organizations, and mental health support.

Advocate for sustainable funding and adequate resources throughout the service period to expand culturally safe sexual health services across urban, regional, and remote areas.

Implement, monitor, track, and evaluate progress and impact in addressing priority group needs and service impact.

Disseminate information about service outcome, challenges and success to other medical services, education provider and interested parties that can benefit from.

Hence, the main objectives are to develop cultural safety and community governance that promote a strengths-based approach with tailored programs mainly for priority groups with easy access to preventive measures, treatment and counseling, and adequate resources.

Conclusion

The Wiradjuri Sexual Health Nurse Outreach Service can play a major role in reducing sexually transmitted infections mainly among the targeted population of Wiradjuri. This service aligns with the National Schemes Aboriginal and Torres Strait Islander Health and Cultural safety strategy, and strength-based approach, and fully supports traditional health knowledge related to STIs. It is recommended to strengthen cultural safety through trained staff, a community of advisory groups, and proper policies in place. Furthermore, by exploring partnerships with traditional healers it plans to strengthen its service approach. Its key recommendations include plans to create customized activities for priority groups while extending their access and advocating for adequate funds. The service with existing strengths, ongoing development, and improvisation can surely contribute to improved sexual health outcomes for Indigenous Australians.

The Wiradjuri Sexual Health Nurse Outreach Service can create an impact in the community of Aboriginal and Torres Strait Islanders through evidence-based recommendations and genuine feedback from the staff and clients who are part of the service in one way or another. Also, the focus should be on continuous improvement, development, and growth which will lead to better sexual health outcomes for Indigenous Australians living in Wiradjuri.

Reference

AHPRA. (2018). Nursing and Midwifery Board of Australia - Guidelines. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-Guidelines.aspx

Bell, S., Ward, J., Aggleton, P., Murray, W., Silver, B., Lockyer, A., Ferguson, T., Fairley, C. K., Whiley, D., Ryder, N., Donovan, B., Guy, R., Kaldor, J., & Maher, L. (2020). Young Aboriginal people's sexual health risk reduction strategies: A qualitative study in remote Australia. Sexual Health, 17(4), 303-310. https://doi.org/10.1071/SH19204

Fogarty, W., Bulloch, H., McDonnell, S., & Davis, M. (2018). Deficit discourse and Indigenous health: How narrative framings of Aboriginal and Torres Strait Islander people are reproduced in policy. https://www.lowitja.org.au/wp-content/uploads/2023/05/deficit-discourse.pdf

HIV, hepatitis and STIs in Australia. (n.d.). Kirby Institute. https://www.data.kirby.unsw.edu.au

Measures. (n.d.). AIHW Indigenous HPF. https://www.indigenoushpf.gov.au/measures

National Health and Medical Research Council. (2018). Keeping research on track II: A companion document to ethical conduct in research with Aboriginal and Torres Strait Islander peoples and communities: Guidelines for researchers and stakeholders. Commonwealth of Australia. https://www.nhmrc.gov.au/file/14196

Silver, B. J., Guy, R., Wand, H., Ward, J., Rumbold, A., Fairley, C., Donovan, B., Maher, L., Dyda, A., Garton, L., Hengel, B., Knox, J., McGregor, S., Taylor-Thomson, D., & Kaldor, J. (2015). Incidence of curable sexually transmissible infections among adolescents and young adults in remote Australian Aboriginal communities: Analysis of longitudinal clinical service data. Sexually Transmitted Infections, 91(2), 135-141. https://doi.org/10.1136/sextrans-2014-051617

SNAKE Condom Social Marketing Campaign. (n.d.). The Communication Initiative Network. https://www.comminit.com/hiv-aids/content/snake-condom-social-marketing-campaign

Ubrihien, A., Gwynne, K., & Lewis, D. A. (2021). Enabling culturally safe sexual health services in western Sydney: A protocol to improve STI treatment outcomes for Aboriginal young people. Pilot and Feasibility Studies, 7(1), Article 123. https://doi.org/10.1186/s40814-021-00847-7

Ward, J. S., Hengel, B., Ah Chee, D., Havnen, O., & Boffa, J. D. (2020). Setting the record straight: Sexually transmissible infections and sexual abuse in Aboriginal and Torres Strait Islander communities. Medical Journal of Australia, 212(5), 205-209. https://doi.org/10.5694/mja2.50492

Wiradjuri and First Nations Community. (n.d.). Wagga Wagga City Council. https://wagga.nsw.gov.au/_data/assets/pdf_file/0010/65917/WWCC_WFNC_CulturalProtocols_WEB.pdf

Wiradjuri Country. (2021, November 1). National Library of Australia. https://www.nla.gov.au/stories/national-library-publishing/book-title/wiradjuri-country