I would like to begin by acknowledging the Whadjuk Noongar people, the traditional custodians of this land, and pay tribute to the unique role the W

Example

I would like to begin by acknowledging the Whadjuk Noongar people, the traditional custodians of this land, and pay tribute to the unique role the Whadjuk people play in this region in continuing such a vibrant and rich culture. I pay my respects to Elders past, present, and emerging, for they hold the beauty, knowledge, and traditions of this country (boodja).

Brokerage, as defined by Juli Coffin (2007), involves two-way communication where both parties are equally informed and equally important in the discussion (p. 23). Regarding Coffins paper, brokerage is seen as a tool that allows movement between the various levels of cultural security. Applying this to a healthcare context, engaging in conversation, and working with First Nations peoples could be the difference between understanding cultural differences or providing individually catered care and implementing these changes on a wider scale, otherwise known as providing culturally secure care (Coffin, 2007). To come together fairly, brokerage often occurs in a third space where respect and good communication are treasured, and no one system of belief is favoured (Coffin, 2007). Although I had never explicitly heard the word brokerage used until this unit, I recognised the concept as feeling hauntingly simple because it involves treating people with respect and dignity.

Even before the unit began, and despite understanding that learning about Aboriginal and Torres Strait Islander peoples barriers to health was important, I couldnt help but feel a sense of dread. However, looking back on my emotions with the privilege of hindsight, I think the uncomfortable feeling I was experiencing was fear. Although not malicious in intent, my cultural upbringing in a conventional Portuguese household taught me that I inherently knew less because I was a child. With time I began to pull away from my own culture, as I didnt feel that my voice was being heard, and this meant that discussing culture was a fearful subject for me. Upon attending my first class, I was met with an environment of safety, where it was understood that people would have varying degrees of knowledge, but that this didnt excuse us from taking accountability for our learning. Without initially realising it, the class environment was my introduction to the concept of creating a third space. Instead of being spoken down upon by my tutors, the entire class was challenged to work together and combine our various cultural experiences to move forward in our learning. Although it felt unnerving to be responsible for fostering this environment, I gradually began to understand that coming together in this way allowed me to hear voices and stories that I wouldnt have heard otherwise.

One resource that helped further my understanding of the importance of brokerage was a Ted talk delivered by Judy Atkinson, where she recalls a time when a doctor asked her to assist a female First Nations patient (TEDx, 2017). The woman was seated frozen still, so Atkinson bent down to her feet, asked a simple question, and then listened intently when the woman revealed her own story. When the woman had finished, she wiped a tear from Atkinsons cheek and thanked her for listening. In placing herself on the same level as her patient, Atkinson is cultivating a third space, providing an area to properly address her patients emotional well-being. Instead of attempting to solve her patients problem, Atkinson takes steps to open communication so that treatment can be a collaborative process. This story demonstrates that health is subjective and may look different for many people. As a future health professional, I must ensure that my care reflects this belief, as culture greatly impacts the definition of health. Therefore, engaging in brokerage is a fundamental process because it not only allows for the acknowledgement that treatment should be diverse but cements that it should be created in partnership with those who receive it.

In my expected future profession as a medical scientist, room for interaction with the public may be limited as my job will involve preparing laboratory specimens and conducting diagnostic testing (Australian Institute of Medical and Clinical Scientists, n.d.). However, I understand that this doesnt exempt me from applying any of the knowledge Ive gained. My experiences in this unit have fundamentally changed how I view my interactions with other people by demonstrating to me how comforting and validating a third space can feel. Before undertaking this unit, I had a more logical view of what helping other people should look like, and I didnt understand the differences between helping an individual and creating standards that protect an entire community (Coffin, 2007). Through learning about the idea of brokerage, Ive come to understand that being open to collaboration is an essential first step in cultivating culturally secure care. In my future practice, I aim to include my patients in the care I provide by taking a strength-based approach and emphasising what individuals and their support system already do best to minimise negative health outcomes (Gottlieb, 2014). After this communication, I will seek to employ protocols that respect my patients wishes. This may include providing separate areas for mens and womens business, acknowledging that healthcare may have different implications based on gender, or involving a ngangkari to facilitate spiritual healing (Fredericks et al., 2018; Hanifie, 2018). In conclusion, my time in this unit has allowed me to better appreciate the transformative effects of open discourse, defined in First Nations cultures as brokerage. Simultaneously, by creating a space where I felt secure, my peers and tutors helped me discover the positive effects of establishing a third space, instilling in me a feeling that I wish to provide to all my future patients.

Word count: 877

References

Australian Institute of Medical and Clinical Scientists. (n.d.). About medical science. https://www.aims.org.au/about/about-medical-science#:~:text=WHAT%20IS%20A%20MEDICAL%20SCIENTIST

Coffin, J. (2007). Rising to the challenge in Aboriginal health by creating cultural security. Aboriginal and Islander Health Worker Journal, 31(3), pp. 22-24.

Fredericks B., Daniels C., Judd, J., Bainbridge, R., Clapham, K., Longbottom, M., Adams, M., Bessarab, D., Collard, L., Andersen, C., Duthie, D. & Ball, R. (2017). Gendered Indigenous health and wellbeing within the Australian health system: A review of the literature. CQUniversity. https://healthinfonet.ecu.edu.au/healthinfonet/getContent.php?linkid=575665&title=Gendered+Indigenous+health+and+wellbeing+within+the+Australian+health+system%3A+a+review+of+the+literature

Gottlieb, L. N. (2014). Strengths-based nursing.AJN, American Journal of Nursing,114(8), 2432. https://doi.org/10.1097/01.naj.0000453039.70629.e2

Hanifie, S. (2018, March 28). Aboriginal healers complementary medicine finds a place in hospitals.ABC News. https://www.abc.net.au/news/2018-03-28/aboriginal-healers-complementary-medicine-finds-its-place/9586972

TEDx. (2017, August 2).The value of deep listening - The Aboriginal gift to the nation | Judy Atkinson | TEDxSydney [Video]. YouTube. http://www.youtube.com/watch?v=L6wiBKClHqY