Although it may seem quite daunting for some to leave the comforts of city life to work as a locum pharmacist in regional or remote communities, the potential rewards, professional experience and knowledge gained can be life changing. Pharmacists working in regional and remote areas have an opportunity to help address the problems of access to health services, which are experienced by up to 7 million Australians, including many who are First Nations.
Earlier this month at PSA22, new guidelines were launched to help pharmacists support Aboriginal and Torres Strait Islander peoples with medicines management. The guidelines aim to support pharmacists in engaging with Aboriginal and Torres Strait Islander peoples, families, health services and communities with medicine management, to deliver positive health outcomes across the health system.
In Aboriginal language the term ‘deadly’ means awesome or great. So how do pharmacists strive to become a ‘deadly pharmacist’? To be a ‘deadly pharmacist’ involves – engaging with the individual, the community and two-way knowledge sharing.
Some of the following points are important to consider when providing medicines management to Aboriginal or Torres Strait Islander communities:
- Pharmacists can ask a person if they identify as an Aboriginal or Torres Strait Islander person, however irrespective of the response it is never appropriate to ask an Aboriginal or Torres Strait Islander person to quantify their Indigeneity.
- Ensure you are aware of the appropriate name for people in the local region.
- Pharmacists should acknowledge and understand that some patients may choose to use traditional healing practices. The Western approach to medicines may fail to acknowledge the spiritual and social significance or health impact of traditional healing practices.
- Understand that for Aboriginal and Torres Strait Islander peoples, ‘good health’ is more than just the absence of disease.
- The word ‘medicines’ may be interpreted as only liquid medicines by some and therefore not include tablets, inhalers etc.
- Traditional bush medicines are often used as an immediate dose or taken to resolve symptoms. Patients who are familiar with these may be less familiar with the long-term use of medicines eg. Diabetic medicines.
- When providing written instructions on a label, knowledge is needed that different words used to describe times of day in one culture, such as ‘dinner’, can mean midday or evening mealtime in another culture.
- Some patients may benefit from symbols being added to the dispensing label to define dosage timings.
- When developing a medicines list for an Aboriginal or Torres Strait Islander patient it should be culturally responsive, locally appropriate and cater for individual factors (e.g. language and health literacy). NACCHO and NPS MedicineWise have produced a useful resource to assist with medicines lists for Aboriginal and Torres Strait Islander people called ‘Principles for producing the best possible medicines lists’.
- Continuously self-reflect on your interactions with peoples of different cultures, as it is important to recognise that providing culturally safe and responsive care is a lifelong learning process.
To complement the new guidelines the PSA and NACCHO have co-designed the ‘Deadly Pharmacists Foundation Course’.This interactive online course includes seven modules covering topics such as Aboriginal and Torres Strait Islander culture, communication skills including how to use clinical yarning in your practice and conditions of prevalence in some Aboriginal and Torres Strait Islander communities.
It is important that all pharmacists learn about, engage with and invest in the local culture where they live and work, to gain an understanding of the diverse and unique cultures of Aboriginal and Torres Strait Islander peoples. Cultural training programs and activities are only a starting point to learning about local culture. Proactively engaging with Aboriginal or Torres Strait Islander peoples and communities on an ongoing basis is required to customise and build on any knowledge that has already been acquired.