‘You need to be able to understand why they’re doing that’

as pharmacists. Please like rate and subscribe, so you never miss an episode, and we hope you enjoy the podcast. So is it okay to ask you just to introduce yourself to the audience?

Started working with some friends in Orange and yeah, loving life, doing so well, almost finished uni, so can't complain.

in a way is sort of lucky. I mean, my older sister was the first one in my whole family to go to uni, which was really, really, really cool. So she's a physio now and she's just opened her own business. I'm the second going to uni, for pharmacy obviously, and then my little sister has just started doing nursing. So we're all very healthcare advocating for First Nations people, loving all of that sort of side of healthcare and yeah, it's really good. We're all very passionate about it.

We've got beautiful grandparents who share so much culture and so much love, and as they age, especially from a pharmacy point of view, you can really see the ongoing health conditions that they can have, which can be from ageing, but also if you're aware, there's lots of different health conditions that you can get generationally and from colonisation and all of those things, which I'm sure we'll talk about. But yeah, I'm very passionate about it.

Very excited to jump into my early career pharmacy journey, advocating for Indigenous people and their healthcare and also education, very passionate about education and making sure people go into the right careers and know that there's options for them out there rather than just staying at home.

many, many years. I'm sure again talk about this later, but there's so many young Indigenous pharmacists at the moment who are doing some fantastic things in the space, which is very exciting, very exciting to be among those awesome people. So NAIDOC week this year, we're recognising all of our next gen, how we're going to push through the achievements of them and also just sharing our culture, acknowledging what's happened in the past and how we can use that to move

forward and be better. So a very good week of celebration. Definitely.

So in colonisation times you can see lots of displacement, lots of forced assimilation as seen with the stolen generations, which really saw a lot of loss of culture, which is really sad. And also, like I just said, identity was a big thing. So lots of people lost that and were disconnected from their families and again,

their lands and their culture. So yeah, that really has ongoing impacts in terms of their wellbeing, in terms of physical health, pretty self-explanatory I guess if you're aware of colonisation, what happened post colonisation, all the social determinants of health obviously were impacted and ongoingly impacted today. So housing was always an issue. I mean, we lived off the land, we got all of our medicine from the land, we've got our what we used to live everything from the land.

And when colonisation happened, we didn't have that. We lost pretty much all of our access to housing and we had to learn to live another way. And lots of sad things happened, obviously. And then going into today we've got transport issues, things that are big barriers to actually accessing healthcare are big ones, health literacy, which is very, very important and very common. I mean among so many other, for lack of a better term, suppressed cultures.

I guess I lots of, Australia's a very diverse country. I'm sure everyone's had some sort of complication like language barriers, understanding of medicines and health in different ways through different cultures. Not only First nations people, but our overseas refugees and people like that who we also really care about. So that's really important I think, to understand the history moving forward so we can better the healthcare for our patients here.

respiratory conditions. Again, these can come from so many different factors like smoking has been introduced from colonisation and is quite high rates among our Indigenous people, which is really disappointing. But we have lots of things to help combat that in our communities, which we'll talk about later. Another big one is diabetes.

So we really commonly see that among First Nations people, and you'll see a lot of pharmacists' role within the Aboriginal medical service sort of side of healthcare is rather than being a pharmacist in that setting, you are actually a diabetes (educator). So a lot of them will go in as a diabetes educator and do all that education sort of thing for the patients at

their Aboriginal medical service. And just because it's such an important field, especially in terms of educating our patients, things that we can do in the pharmacy, I think it's really important to know what sort of services are actually out there and subsidies and programmes that we can use to lessen the burden of, for example, costs of medications. So knowing our patients and knowing what they need.

So we can recommend, for example, the CTG closing the Gap PBS program, so making sure they're signed up to that. Being aware of the Indigenous dose administration age, so sort of like our Webster packs, they can get that for free, which was really, really good. But yeah, just being aware of who our patient population is, how we can help them, and how we can actually get funding and support from our governments and bodies to actually help us facilitate that in practise is really important.

Another thing that I think is important is acknowledging the difference in cultures. So as a pharmacist we might write, for example, on our Webster packs, we have morning lunch, dinner, bedtime. I think it's important to steer clear of that, especially among mob patients, and instead of having those specific times have an actual time. So for example, 8:00 AM 12:00 PM, 7:00 PM 8:00 PM I'm not sure, something like that.

Just so we can establish an actual time and avoid those medication issues at home because some mob might call their tea time like morning tea, or dinnertime could mean lunchtime, and then we're getting our doses at the wrong time of the day or we're missing

doses. I think that's very important just to steer clear of using those kind of languages in practise just so we can all be on the same page and those things just because we do have a lot of programs out there to support our First Nations people, so we need to use them to the best of our ability so we can really get the best out of our patients.

So we're often relied on as that first point of contact, and if we're having First Nations patients coming to us and actually actively taking that step to seek healthcare, we need to be equipped to help them in the best way we can and to make them feel safe and welcome when they do come into the pharmacy. And that goes beyond just pharmacists. I think the whole team needs to be educated and competent in that field.

There's just been a lot of distrust in the past and we'd hate for this to be ongoing, especially as pharmacist scope is expanding and we're having such a bigger impact on our community's health. I think it's very important to have the whole team trained.

You'll find if you open up in conversation with an Indigenous patient, if you are kind, caring, open and willing to understand, most of them will be very, very appreciative to share their culture and tell you about it. Especially me being an indigenous person. If I was to go and work in another state, for example, and I'm not familiar with the customs on that land, I would engage in conversation with the elders, with local people and just ask the questions, be upfront,

be inquisitive. They're always appreciative of people learning the culture, especially as it's starting to diminish a little bit with ageing population and all of those sorts of things. So it's very important to talk and gain that trust and build positive relationship with our patients is the most important thing. Another thing we can do is on a very, very, very simple level, just display local art. It's such a beautiful thing in our culture, in all cultures across Australia and all the mobs.

It is so special and everywhere you go you'll find a local First nations artist who would be more than happy to share their art. It is just so welcoming walking into a health service that isn't white and clinical and scary to most. It is lovely walking in and seeing your culture displayed and your culture acknowledged, and it really helps break that barrier between having the distrust between western medicine, bush medicine. Yeah, all those sorts of things.

And as a pharmacist, we're often dealing with ageing population, elderly patients, and we have to see them often as they need their medications reviewed, all of those sorts of things. They need our help and it's very important to understand, for example, the stolen generations was a very sad time, obviously, but those people are now in their sixties, I believe.

So they're people that we're seeing often and we need to acknowledge that the way they were treated is trauma and we need to work actively work to make that not happen when they come to the pharmacy. So something, like I said, the white clinical pharmacies can be quite scary, quite confronting sometimes speaking to a man who has a deep voice even can be quite confronting and traumatic for a lot of patients.

So very important to understand the history and that just in terms of what that looks like, it's talking and learning and understanding what's happened.

If you're sitting down with a patient, they're going to want to tell you about their kids, their partner, their nan and their their dog, which oddly enough we actually do lots of scripts for pets in rural pharmacies. So that is important to know who the dogs are. So just stuff like that and being able to communicate is just so important. And having care care is really the key. If you're a caring person, you'll succeed. I'm sure of it.

card. So it's really, really helpful to limit that burden of cost for medications with the PBS system. The maximum payment's somewhere around $30 anyway, but when you're on so many medications and like we mentioned earlier, lots of First Nations people have chronic conditions, it can add up. It becomes very expensive. So just having that system is very, very,

very helpful and supportive from a patient's point of view. We also, like I mentioned before, we have the Indigenous dose administration aids, so our Webster packs, so everyone can get a Webster pack or I'm not sure what everyone else calls them. I call them Webster packs. Everyone can get one.

But the really cool thing about the PPA program is that our Indigenous patients can get them free of charge, so they don't have to pay for their packing fee, they don't have to pay for the utensils we use to pack, they don't have to pay for their covers. Everything's covered by the pharmacy as such,

and then the pharmacy will get reimbursed. So that's really good because again, like I said, lots of First Nations people are on many medications, so having the ability to still have autonomy over their care at home, not having to go into a nursing home or into a hospital setting or have a carer come to their house to sort out their medications, it's such a big help having these things for free that they can take home, having the education around how to use them and then we're limiting those

medication error that happen quite often at home. So that's a very important one. And I think not a lot of pharmacies use it often. I know from experience we can sometimes forget about programs that can be beneficial to our patients. So as I mentioned before, just being over the top of that, being aware of what we can do to make our patients stay a lot easier, make their week easier, just those sort of things is really important.

There's also the remote area Aboriginal Health Service under our Section a hundred I think, of the National Act.

So I don't have a whole lot of experience with this because we don't have that much where I'm from, but it pretty much just allows our so Aboriginal Health Services to give out free medication to the patients without making them go back to the pharmacy, back to their prescribing doctor at the Aboriginal Health Service and just saving that travel time, especially in remote areas where we have not many pharmacies getting around and a lot of the community have to

travel upwards of 50 kilometres to get to a pharmacy. So this is a really good one. I do hope I can really learn more about that as I become an intern into my early career. But yeah, it's very important to have those sorts of things in place so patients don't have to have that burden of transport. And again, cost of transport and medications and those sorts of things. It's very, very important. This is fantastic. Can't wait to learn more about that one.

So I think taking out the pharmacy as the middleman and allowing pharmacists to do that for the patient at the pharmacy will be very, very handy. We see patients come into the pharmacy who should be on Closing the Gap, but unfortunately haven't been signed up or told about it and is still paying the PBS max price for their prescriptions, and then we are stuck having to deliver that bad news to the patient saying, I'm so sorry, but your prescription is not concessional price. You either have

a choice to pay or go back to the doctor. So like I said earlier, rural communities, it is so hard to see a doctor. I'm sure Metropolitan and city areas are similar, but definitely in rural settings you really struggle to see a doctor. So if they're having to go back to the doctor to resign up for the Closing the Gap program, it's actually limiting their access to the medicine itself.

So I really think that allowing the pharmacist to actually be able to sign the patient up at the pharmacy would be really helpful. Not sure if that will happen, but it would be great if it did. Another thing with the Closing the Gap programme, so I went to Canada earlier this year as part of the NACCHO Leadership Pharmacy leadership program, which was a really great experience.

Something I learned over there was they have sort of something similar to the Closing the Gap program, but they also allow some over the counter products to be prescribed by the pharmacist without a script. So I know here you can get some things on the PBS, but you have to have a script from your doctor. So in Canada they don't have to have that. So any over the counter products that can help with their chronic conditions, anything that will help,

especially with pain is really important. And vitamins, they're so expensive, but they have a whole program for over the counter products to be supplied to First Nations people free of charge, which is fantastic. I really would love to see that happen here if it happens. I don't know how it would look in terms of funding and PBS and government and all of those very important factors to consider, but I do think that will limit the

mortality rates to be honest. I know lots, like I mentioned earlier, first Nations people are more subject to having a premature death and employment rates are low, they're growing, but they're still low. Just money is a big thing in everyone's life at the moment, not just First Nations people that's affected, but in particular, we just need to look after our people. We really do, and I feel like this would be a really good step in the right direction to have

this included. Again, whether it is possible, I'm not sure whether it would work again, I'm not sure, but just something I learned while I was over there and it was very interesting. It worked very well. Just a little bit more paperwork for the pharmacies, which we hate sometimes, but it is what it is. We need to keep our patients happy and healthy, so happy to do it.

But this model just shows that, from my understanding, shows that pharmacists do have an important role in the indigenous health setting. We have the most knowledge on medicines that is literally who we are, medicine experts, and we can advocate for our patients. We can say to the doctors, this is the best medication, this is how it should be taken. All of those things there where we can actually impact the patient's life for

the better. And also having everybody there together is so important rather than, like I said earlier, travelling from your GP to your pharmacy back to your GP, back to the pharmacy, just so much easier having everyone there together. It also highlighted how important diabetes education is and how much more the patients improved with their health literacy and their knowledge around their condition of diabetes and how to use their medications.

Because with diabetes, there's so many things happening. Sometimes you've got injections, you've got to test your blood glucose levels, you've got normal medications like your tablets. There's so much happening. And on top of that, you've got all the comorbidities that come with diabetes. So it's very important. Diabetes education is very important, and that model really highlighted how important a pharmacist is in that role. I.

It's so important and I know there's limitations to it and extra training, and it's such, I guess a scary thing for a lot of pharmacists, especially ones that have been working a long time and haven't done those sorts of things before. But that's who we are. We look after our patients where the medication experts, like I said,

we are definitely equipped to do that. And in terms of a First Nation setting, speaking particularly in rural remote areas, sometimes you have to have consults with your GP via telehealth, which can be really difficult. If you could just go to your pharmacy and see the pharmacist that you see every day about every little issue that you have.

Sometimes you see them down the street or at the pub, you feel comfortable going to them and talking to them about things, and they also have the skills to help you and not have to send you away. I think that's something that we should really consider. And yeah, I think it's very important.

which is such a big help. I don't have to, luckily enough go too far for uni. So I am still with my family, with my grandparents, who I love so dearly. I'm still close to home, which is fantastic. And I use this money to help obviously with my transport textbooks, everything to do with uni, my HECS debt, all of those things, it's so important. But for other people living more, I'll just use an example, say Narromine or Dubbo or Nyngan,

for example. All of those very central West, getting out into our Western Australia area, not Western Australia, but you know what I mean, getting out into that area where these students will have to move away from home, they'll be disconnected from their culture, and on top of that, they're worried about money. This is just such a big help and I'm a testament to that. I have really, really good things to say about these. And the people that run it are beautiful.

So if there aren't any students wanting some help, please reach out to PPA. They're a fantastic organisation, their pharmacy assistant scheme, so that doesn't directly go to the pharmacy assistant student themself. So the trainee, just because they're getting paid, which makes sense, they've got a job, but it actually goes to the pharmacy themselves. So the pharmacy gets paid, I think $10,000 per annum, so per year for the student that's there doing their studies

just to help support the student. So give them an incentive to give that trainee the best experience, help them out, mentor them, let them go to conferences, let them go to things that's going to further their development in that career. And you don't have to be a pharmacist to make a difference in the First Nations space. They really, really love everyone, especially in a community pharmacy in small rural areas, that's sometimes their favourite place to go, sometimes their only interaction.

So it is really nice to have representation of us in healthcare. And further than that, not even just pharmacy, it would be great to see more First Nations nurses in the hospital setting or doctors or physios like my sister. It's really good. It's very good. And I love seeing organisations and groups support First Nations kids, and I love it. It's so good.

Culturally Safe Care, fantastic document. Every pharmacy I go to, well, I work at two, I've worked at two, but every pharmacy I go to for placement, anything like that, I'm always saying, read this document. It is so good. Have it on hand for everyone to read. It is fantastic. So she is amazing. Obviously I also have two really good friends who are pharmacy students as well, indigenous pharmacy students. I'm going to tell you some fun things they've done because they are awesome.

So Lachie Munns and Summah Holden, they're beautiful people. So something they've done together as well as the whole NAPSA Indigenous teams. So they've advocated to split the role of rural and Indigenous chair. So previously they've been together as a role on the NAPSA committee, but recently that's changed due to them advocating for rural to be separate and indigenous health to be separate because they are separate. The two don't go hand in hand. So it's really awesome to see that happen.

And they've also just this year they facilitated again with some other really awesome indigenous pharmacy students, our very first pharmacy leadership summit for our Deadly Future pharmacists. So that was really good. So we saw about 20, I think 20 students from across Australia come over to Melbourne, and it was really good. We learned so much, and it's so good to develop that network and we all can relate to things. We all have similar histories and similar stories in our own way.

It was fantastic. So they're doing some really awesome things. Summah has been going on some IHA high schools to Deadly Careers programme visits. So that's pretty much getting kids excited and keen to go into Allied health careers, which is very important. So she's been going around to different high schools and advocating for pharmacy and indigenous health and lots of other allied health careers like nursing and physio, ot, all of those cool careers,

and she's been influencing kids to do that. So she's a very inspiring person. Lachie is very passionate about policy, which we need those people. They're always great to have on our team. So he's doing lots of stuff in the space of First Nations education and health policy writing still as a student. So very impressive. He has a very long list of things. So another great person to talk to. If you know him, everyone please talk to him.

So lots and lots of students are doing really, really awesome things. It makes me very happy.

So they are very educated people in their field and they know what they're doing. They're very culturally safe. They're good people to talk to and learn from. They also, if you ask them, they will do team trainings for you guys. So if your team does want culturally safe care training in person face-to-face, reach out to your local Aboriginal health service because they will facilitate that. I'm sure of it. They will help you out, attend their community events.

They have some fantastic events, and I think showing your face in the community rather than just in the dispensary is so important to having those positive relationships. My local Aboriginal Medical Centre, we call it OMS. It is a fantastic service. It's so comprehensive. It goes right into mental health, cultural health, connecting to identity and land. We've got a whole Allied health area building. We've also got dentistry, and we've got our GPs obviously, and our nurses.

We've also got transport services and learning things. We've also got a quit smoking team. It's a very comprehensive medical centre, and we try to use them at the pharmacies. I work out. We do try to use them. We refer our patients to them. They're just a very good organisation, so reach out to them, get them to help you because they will help you.

So that's something a pharmacist could really help with. Unfortunately, a pharmacist isn't going to it that I know of, but it is just a space that we could connect with and collaborate with, and we could go there and run those information sessions around a very culturally responsive team and make those sessions even better. Some other things that they do are healthy ageing events. So in an ageing population, we have in orange lots and lots of elderly

people and they need connections. They're lonely, they need people to talk to also, they need to connect to culture. They need help with their medicine, they need help with their health. So they have lots of healthy ageing events. And again, it would be really fantastic to see a pharmacist involved in those things.

on the pharmacy team. So not as such in my area, but I know for example, in the Torres Straits or in far north Queensland, lots of communities will shut down when somebody passes away. So that's in relation to sorry business. So as a pharmacist, you need to know that, hey, this person that I see every day isn't here today and I haven't seen them for a week. What's happening? The community shut down. What's happening? You need to be able to understand why they're doing that.

You need to be able to understand how to help them through that and when they don't need help and when they need space. So things like that are very important to understand also from, for example, my point of view working here where that isn't really something that happens. I mean it is, but not to that extent. In my mob, in my area, we travel around a lot.

So we get people coming through town and leaving town, going to different towns around us, and sometimes we don't see them for a week or we don't see them for two weeks and we need to know, yeah, they're just travelling around. Or again, with the, sorry business stuff. Somebody might come into the pharmacy and say, I have to go to see my family five hours away for three weeks. I need my medication early. Can you dispense a couple of repeats for me?

You need to know that, yeah, something's happening. I can help you. We can do that and I'll support you. I think that's very important to understand. And also with men's and women's business, like I touched on earlier, it's good to know that that's a very traditional thing in culture and women's business.

So especially around topics of sexual health, for example, you'll get people coming into the pharmacy that won't talk to a certain pharmacist or won't talk to a certain tech or assistant, but that's not because they don't like you, it's because it goes against their culture. So knowing that and knowing when me as a woman can step in and help, or my colleague as a male can step in and help, I think that's really essential to understand that dynamic.

And again, read that document that Fay wrote, it has so much information in there and from a non-indigenous point of view as well. I think you just need to know that and that document really goes through it so well. And there's so much to read and so much to learn. So if you're not the talkative type, please read the document because you will learn so much.

And another one, I really think we need to jump into that Aboriginal medical service space because we can offer so many skills and we can really improve that. We really can. So we need to do that. Jump into it.

If I'm going out to remote communities, which I have been in the past, it's really interesting to see the dynamic that they have and the thoughts that they have around money, not being able to afford uni, leaving home, being scared to leave home. And it is scary as an 18-year-old leaving home when you finish school to go and pursue a career that you're so passionate about. So I think having a face that you can rely on, relate to and talk to about these things is really important.

So the high school visits are fantastic. Another thing is showing people where to find scholarships because I struggled so much and I didn't really learn it at school. Nobody showed me at school where to look for scholarships, and I was just lucky enough to have a really good boss at the pharmacy who helped me get my scholarship and showed me where to look. So I think about my little sister and other kids her age that have just left school and they don't know where to look.

They don't know how to find a scholarship. And then to them, that makes them feel I can't afford to go and I know the feelings. So it is just really important for them to know where to look, and there's so many resources out there. Another thing not to do with pharmacy, but just something to help build up those work rates is the I iPad program. I don't know if anybody's familiar with that, but it's another fantastic program that gets First Nations kids into policing.

So just another career path for people to go up because not everybody's wanting to go to university, and I understand that. So it's really important to let people know that there's so many other avenues and just supporting them, giving them somebody to talk to, somebody to rely on again, and someone to look up to. Just showing them that they can do it. They don't have to stay at home, they can't afford to go.

a profession. Until next time, take care and keep making a difference in healthcare.