DANMM mentoring project: supporting Aboriginal and Torres Strait Islander nurses and midwives to remain in the workforce

Impact summary

A four-year collaboration with Murrumbidgee local health district (MLHD) provided an opportunity to evaluate a cultural mentoring program. The research sought to understand how a mentoring programme achieved its aims and anticipated outcomes that would ultimately inform future Aboriginal and Torres Strait Islander workforce support programmes. The research project used a hermeneutic phenomenological philosophical framework to conduct Aboriginal and Torres Strait Islander people’s methods of yarning, which engaged in conversation around key topics with participants, followed by the research team’s analysis of yarns. A qualitative study utilising purposive sampling to select participants. Participants were drawn from those who had undertaken the cultural mentoring programme and could have been either mentors or mentees. Interviews were conducted once the 12-month mentoring programme had ceased. The five main themes that were drawn from the data were cultural safety, motivations, relationships, learning and support. The evaluation of a pre pilot mentoring project designed to support Aboriginal and Torres Strait Islander nurses and midwives in a rural health district led to the up scale of the project and successful NSW Health translational grant

Research and engagement activities leading to impact

This work involved a pre-pilot evaluation that was funded by a Faculty of Science Seed Grant. The evaluation concluded that participant experiences indicate that mentoring can be an avenue for providing appropriate clinical and cultural support and a safe space for Aboriginal and Torres Strait Islander nurses and midwives. They also show that identified support roles and Aboriginal-led projects can have larger impacts, fostering organisational connections and broader feelings of cultural respect amongst Aboriginal and Torres Strait Islander staff beyond programme participation.

Findings of the pre- pilot were shared in a meeting with the NSW Chief Nurse, Senior executives of MLHD and Senior Executives in the MLHD Division of People and Culture. Following extensive consultation, it was decided to up scale the program through a NSW Translation grant. Extensive consultation was held with a cultural governance group that comprised of Senior Aboriginal Leaders and LHD's across NSW. Initial evaluation project led to further project with $360,000 grant project which kicked off in 2022 and expands the project across five LHDs and 25 Aboriginal Nations.

Research outputs associated with the impact

So far, the research was initiated due to ongoing retention concerns related to Aboriginal nurses and midwives. The pilot and up-scale sought to investigate the impact of a cultural mentoring program aimed at supporting and retaining Aboriginal nurses and midwives. The research has involved researchers across four universities and five local health districts. It is supported and sponsored by the Ministry of Health. The research has led to two peer reviewed journal articles, one internal grant (9874), one competitive grant (360,000), two media publications as well as community pieces: https://www.croakey.org/medical-radiation-sciences-addressing-workforce-pressures-cultural-safety-and-quality-of-care/

Researcher involvement

Jessica was the Chief Investigator for the pilot program and the Co- Chief Investigator for the successful NSW Translational grant. Jessica led the writing and leadership of the NSW translational grant.
Participants and co-researchers are listed as participants in the section below

Outcomes of research leading to impact

Participant experiences indicate that mentoring can be an avenue for providing appropriate clinical and cultural support and a safe space for Aboriginal and Torres Strait Islander nurses and midwives. They also show that identified support roles and Aboriginal-led projects can have larger impacts, fostering organisational connections and broader feelings of cultural respect amongst Aboriginal and Torres Strait Islander staff beyond programme participation.
As a result of the pilot the program has changed from face to face to a comprehensive online program that is accessible to rural, regional, and remote nurses working in the projects footprint. The program is offered across five local health districts and demonstrates improved access to the program for regional nurses and midwives.
The program has been well received by disciplines other than nursing. For example, investigators were invited to present the program to medical radiation scientists at the ASMIRT 2023 Conference in Sydney.

Beneficiaries of the impact

Nurses and Midwives across 5 local health districts
1.Sydney LHD,
2.Western Sydney,
3.Western NSW LHD
4.Mid-North coast LHD
5.Murrumbidgee LHD

The project footprint incorporates health services across the traditional lands of the Birpai, Dunghutti, Gumbaynggirr Nganyaywana, Darug, Gadigal, Wangal, Bidjigal, Wiradjuri, Wamba Wamba/Wemba Wemba, Perrepa Perrepa, Yorta Yorta, Nari Nari, Muthi Muth, Wailan, Wongaibon, Wailwan, Ngemba, Barindjl, Gunu, Murruwarri, Ngemba and Kamilaroi Nations.

We acknowledge Associate Professor Linda Deravin, Dr Claire Seaman and Ms Nikki Trudgett who were involved in the preliminary research.

Details of the impact achieved

NSW Translational grant- $360,000 commenced in 2022 and aims to assess the feasibility, acceptability, resource implications and early indicators of impact of implementing DANMM across 5 LHDs in NSW.

The project is designed to measure the feasibility and acceptability (as of the DANMM program) and through the early indicators of impact we are addressing the following questions:
•Is the DANMM program feasible to implement as planned?
•Is DANMM acceptable to nurses, midwives, and key leaders?
•What are the resource implications of administered DANMM across 5 LHD’s?
•Is participation in DANMM associated with changes in workforce satisfaction, retention, and experience of cultural safety?

The project is an Aboriginal designed and led program with an Aboriginal Steering Committee, Aboriginal team members who are leaders across 5 LHDs and are committed to using this program to support their workforce. The DANMM feasibility study, through quantitative and qualitative methodology will address research questions that will yield positive cultural capability impacts across nursing and midwifery workforce in the five participating LHD’s:

●The Nursing Workplace Satisfaction Questionnaire will assess whether a cultural mentoring program moves the level of satisfaction and retention of Aboriginal nurses and midwives
●Through the be Ganngaleh nga Yagaleh cultural safety assessment tool determines what constitutes as a culturally safe workplace for Aboriginal nurses and midwives.
●Understanding what program elements influence success (identification of what program aspects influenced success through participants and key stakeholder feedback (qualitative and quantitative).
●Through the Organisational Commitment and Health Professional Program Readiness Assessment Compass (OCHPPRAC) and pre/post qualitative interviews with LHD’s key leadership stakeholders will identify what organisational factors influence cultural capability in participating LHDs.

We know that improving cultural capacity leads to a more culturally safe health service for both employees and patients. We currently have no indicators on what is considered a culturally safe workplace for NSW Aboriginal nurses and midwives. DANMM will provide NSW health a footprint on what constitutes a culturally safe workplace.

With nurses and midwives comprising 57% of the overall health workforce, this project has the potential to impact the overall cultural capability of the nursing and midwifery workforce in the five LHDs. This project will impact patient care which in turn will impact Aboriginal and Torres Strait Islander populations.

Impact date	2019
Category of impact	Other Impact
Impact level	State