Monica Lawrence’s passion for Indigenous health and wellbeing has led to a career devoted to the development of culturally safe patient care and research methodologies that reflect and embrace the values of Aboriginal and Torres Strait Islander people.
On her very first day as a Graduate Nurse Monica (BNg ’99, GradDipNg ’01, MNg ’08, MPH ’15) observed culturally unsafe practices and disparities in cardiac care for Aboriginal people admitted to hospital for cardiac surgery as a result of rheumatic heart disease.
‘It was the experiences I observed in caring for my very first patient from a remote Aboriginal community in the Northern Territory which ignited the fire in my belly 19 years ago – which still burns to this day,’ says Monica.
Monica’s research methods include being in the community with the community to establish friendships and most importantly ongoing long-term partnerships for reciprocal relationships to occur. She says, ‘Sitting side by side with community people, sharing stories, yarning about shared experiences, along with feeling comfortable in the silence, respecting the silence and being with the community member in the silence, were all very important considerations.’
Monica’s latest research project, led by the Poche Centre for Indigenous Health at the University of Sydney, is focused on a portable and effective point of care testing technology that local health workers could use to screen for atrial fibrillation to help reduce rates of stroke and other cardiovascular diseases in Aboriginal people.
Atrial fibrillation is an established antecedent for stroke and other forms of cardiovascular disease, the main cause of mortality among Aboriginal and Torres Strait Islander people in Australia. The iECG screening device — an electrocardiogram (ECG) attached to a mobile phone – has been used effectively in clinical and community settings such as dental vans, pharmacies and in general practice.
The study found that the iECG device has the potential to reduce the incidence of strokes experienced at a younger age, reduce the higher rates of stroke experienced by Aboriginal people, and to contribute to improving both the health and health literacy of Aboriginal people.
The research has been documented in an article co-authored with fellow Flinders University graduate, Associate Professor Kerry Taylor (MPHC ’00, PhD(Ng/Midwif) ’11) and researchers from Aboriginal communities and other Poche Centres around Australia. The article, ‘Feasibility and acceptability of opportunistic screening to detect atrial fibrillation in Aboriginal adults’ was recently published in the Australian and New Zealand Journal of Public Health.
‘The senior women have invited me to return to teach them about cardiac health specific to their community requirements,’ says Monica. ‘I saw this as an opportunity to work with the senior women to teach them to use iECG technology to detect for prevalence of atrial fibrillation and to develop research skills in terms of data collection.’
Monica is currently undertaking a PhD in Aboriginal cardiac health and working as a casual academic teaching Indigenous Health for Midwives and Indigenous Health for Nurses for first and third year students at Flinders.