Working with refugee families: exploring community health nurses’ experience in Australia

Abstract

Background: Primary healthcare services have been developed to meet the complex healthcare needs of refugees arriving in Australia. Refugees often require immediate health care, having suffered physical and emotional trauma in their country of origin in addition to the sub-optimal health care available in temporary camps. Aspects such as social isolation, mental health concerns, and settlement experience into the Australian culture further contribute to their health disparities. Community health nurses as the first point of contact are well-positioned to work with refugee families to identify risks to health outcomes from the impact of Social Determinants of Health (SDoH).

Purpose: Whilst there is a growing body of literature related to the refugee experience of negotiating care in complex health systems, there is limited literature exploring the role of nurses working with refugee families. This study aims to increase the understanding of community health nurses’ experience and use of an assessment framework when working with refugee families.

Method: Using a qualitative approach, personal interviews were conducted with 14 Registered Nurses working in Queensland public health refugee services. A preliminary thematic analysis has been completed.

Findings: The registered nurses identified their key roles include triage, completion of comprehensive health assessments, coordination of care and referrals for newly-arrived families. Early analysis of the interview data reveals a sense of being overwhelmed by the refugee family’s journey. Participants described using a wellness model of care to guide family interaction and deliver culturally safe care, but felt this lacked sufficient framework to assess complex family needs.

Conclusion: Whilst the nurses’ role is pivotal in working with families, care provision is not always embedded in family-centred models of care, which could help to reduce social isolation issues. Identifying and addressing SDoH is fundamental to improving health outcomes and reducing long term disparities in access to health care.