TRANSCULTURAL NURSING

"AUSTRALIA"

Compiled By :
1. Jein Pinkan Melda (9103022009)
2. Bernadette Masayu (9103022004)
3. Hilda Princess (9103022025)
4. Belgis Azzahra (9103022023)
5. Margaretha Dewi Yanti (9103022031)
6. Aryo Damar Panuluh (9103022036)
7. Fawnia Kartika (9103022019)
8. Ignasia Yunesti (9103022051)

NURSING STUDY PROGRAM

WIDYA MANDALA CATHOLIC UNIVERSITY SURABAYA

2023

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 LIST OF CONTENTS

COVER 1
LIST OF CONTENTS 3
CHAPTER 1 4
INTRODUCTION 4
1.1 Background 4
1.2 general purpose 5
1.3 Special purpose 5
1.4 Benefit 5
CHAPTER II 6
LITERATURE REVIEW 6
2.1 nortern Australia 6
2.1.1 history 6
2.1.2 Geography 7
2.1.3 Beliefs in medicine 8
2.1.4 Aboriginal people 9
2.2 south Australia 10
2.2.1 History 10
2.2.2 languages spoken by south Australia 11
2.2.3 Health belief systems in south Australia 11
2.3 Health-related beliefs in western Australia 11
2.3 western Australia 12
2.3.1 Geography 12
2.3.2 Western Australia's Culture 12
2.3.3 Health - related beliefs in aboriginal people 13
2.4 Eastern Australia 15
2.4.1 Geography 15
2.4.2 Section between east and west 15
CHAPTER III 17
nursing and nurse education in Australia 17
3.1 Advantages and disadvantages of nursing care in indonesia and australia17
3.2 nursing structure 18
3.3 nurse education in australia 19

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 3.4 nursing regulations and nurse education. 20
3.5 conceptualization of nursing and the health care system in australia. 22
3.6 practice standards analysis 22
3.7 does western australia have health insurance 25
3.8 Nursing in sydney 25
3.9 health belief systems in sydney 26
3.10 Health insurance in sydney 27
CONCLUSION 28
TABLE OF CONTENT 30

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 CHAPTER I

INTRODUCTION

1.1 Background

Transcultural keperaw atan is a nursing ministry that focuses on the analysis of

comparative studies of cultural differences ((Leininger, 1978) (Asmadi, 2008)).
Transcultural keperaw a tan is a humanist science and tips, which isfocused on individual
or group behavior, as well as the process of bringing together or improving healthy
behavior or physically and psychoculturally ill behavior according to cultural
background.

Multiculturalism as a term used to describe society. Multiculturalism tends to be

defined on a complexity of meanings and diverse perspectives. In Australia,
multiculturalism is used to describethe cultural diversity of the country. In Australia,
especially in Western Australia is one of the largest countries in Japanand Australia has
an area of 2.646 million. km2 In this country there are also approximately 7 recognized
religions including Protestantism (23.1%), Catholicism (22.6%), Orthodox Christianity
(2.3%), other Christians (4.2%), Islam (2.6%), Buddhism (2.4%), Hinduism (1.9%), and
there are several others that are not religious (30.1%).

The indigenous people of the Australian continent are aboriginal tribes and
Torres Islanders. Aboriginal people are indigenous Australians and have lived on the
continent formore than 50,000 years. Aboriginal tribes in Australia are categorized into
their own race, namely Australoid. Aboriginal people have brown skin color but tend to
be black due to exposure to sunlight. Originally, Aboriginal people lived on hunting and
fishing in rivers. Wild animals they hunt include kangaroos, which are typical animals of
the Australian continent. Aboriginal hunting equipment includes spears, arrows and
boomerangs.

Earlychildhood in Australia was heavily influenced by the British keperawatan

tradition which was characterised by the apprentice nurse education style. However,

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 this influence has been replaced by the transfer of all registered nursing education to
the higher education sector for registered nurses. A significant break with the past,
where nurses were often regarded as physician aides or devoted bodyguards in an
institution, provided opportunities for Australian nurses to develop nursing discipline in
an academic setting. Qualified nurses are now instrumental in academic life at
Australian universities, and therefore have seized the opportunity to advance their
discipline through scientific endeavours.

1.2 Problem Statement

Based on the background above, it can be formulated, the problem in this study
is what are the various cultures in Australia, especially in the field of nursing?

1.3 Purpose

With this article, readers are expected to be able to understand what cultures
exist in other countries, especially Australia. There are a wide variety of cultures that
may be implicated in the nursing process.

1.4 Benefits

Can increase knowledge and insight into what are the cultures in Australia,
especially in nursing, Can change the reader's perspective from various aspects,
especially in terms of health.

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 CHAPTER II

THEORY REVIEW

2.1 Northern Australia

2.1.1 geography
The Northern Territory (NT) is a federal territory of Australia located in the north
central part of Australia. It borders Western Australia to the west, South Australia to the
south, and Queensland to the east. To the north of the region are the Timor Sea,
Arafura Sea, and Gulf of Carpentaria. It has an area of 1,349,129 square kilometres
(520,902 sq mi), making it the third largest in Australia, but with a small population. The
population of the Northern Territory is only 243,700 (2014), so of Australia's eight major
states and territories, the Northern Territory is the least populated, less than half of
Tasmania's population.

The archaeological history of the Northern Territory began more than 40,000
years ago when Indigenous Australians settled in the region. Makassar fishermen began
trading sea cucumbers with the indigenous people of the Northern Region since at least
the 18th century. The coast of the region was first discovered by Europeans in the 17th
century. The British were the first Europeans to try to settle in coastal areas. After three
failed attempts (1824-1828, 1838-1849, and 1864-1866), they only succeeded in
establishing a settlement in 1869 in Darwin Harbour. Today its economy is based on
tourism, particularly Kakadu National Park in the Top End and Uluru-Kata Tjuta (Ayers
Rock) National Park in central Australia, and mining.

The capital and largest city is Darwin. The population is not concentrated in
coastal areas, but rather along the Stuart Highway. Other large residential areas are
(sorted by population) Palmerston, Alice Springs, Katherine, Nhulunbuy, and Tennant
Creek.

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2.1.2 Geography

Indigenous Australians have lived in what is now the Northern Territory for an
estimated 40,000 years and have established extensive seasonal trade relations with the
people of what is now Indonesia for at least five centuries. After the British arrived, they
made four attempts to settle in the harshness of the northern coastal environment, with
three of them failing and starving. The Northern Territory was part of colonial New South
Wales from 1825 to 1863, except for one brief period, from February to December 1846,
when the Northern Territory became part of Northern Australia, a colony that existed
for a short span of time. It was part of South Australia from 1863 to 1911. Under South
Australia's colonial rule, an above-ground telegraph network was built between 1870 and
1872.

A railway network was also built between Palmerston and Pine Creek between
1883 and 1889. The economic pattern of livestock and mining is well established. By
1911 there were 513,000 farms. Victoria River Downs was once a cattle station in the
world. Gold was discovered at Grove Hill in 1872 and in the Pine River, Brocks River,
Burrundi, and copper was found in the Daly River. On 1 January 1911, a decade after
federation, the Northern Territory was separated from South Australia and control was
transferred to the Commonwealth.

Late in 1912 there was a sentiment that the name "Northern Territory" was
unacceptable. The names "Kingsland" (based on King George V and adapted to
Queensland), "Centralia", and "Territoria" were proposed and Kingsland became the
preferred choice in 1913. However, the name was never used. For a short time between
1927 and 1931 the Northern Territory was divided into Northern Australia and Central
Australiaat 20 degrees south latitude. Soon after, parts of the Northern Territory were
considered in the Kimberley Plan as a possible location for the establishment of the
Jewish Homeland, which could understandably be considered "Unpromised Land".

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 During World War II, much of the Top End came under the control of a military
government. This is the only time since Federation of parts of an Australian state or
territory under military control. After the war, control of the entire region was handed
back to the Commonwealth. Indigenous Australians have fought for their right to fair
wages and land. An important event in this struggle was the strike and march carried
out by the Gurindji people at Wave Hill Cattle Station in 1966. The Australian
government, led by Prime Minister Gough Whitlam, established the Woodward Royal
Commission in February 1973 to investigate the acquisition of land rights in the
Northern Territory. The first report of Woodward Court in July 1973 recommended
establishing a Central Land Council and Northern Land Council to provide Aboriginal
views. In response to the Royal Commission's report, a Land Rights Bill was drafted, but
the Whitlam Government was dismissed before it was passed.

The Aboriginal Land Rights (Northern Territory) Act 1976 was finally passed by
the Fraser Government on 16 December 1976 and came into force the following Australia
Day (26 January 1977). In 1978 the Northern Territory was granted self-government,
with the Legislative Assembly headed by a Chief Minister. The Administrator of the
Northern Territory is an official who acts as the indirect representative of the Queen in
that region.

During 1995-1996 the Northern Territory was one of the few places in the world
to allow assisted suicide euthanasia, until the Federal Parliament abolished the
law. Before the abolition of the law went into effect, three people had used the law with
the help of Dr. Philip Nitschke.

2.1.3 Beliefs in medicine

In Northern Australia, there are a range of beliefs related to medicine that reflect the
diversity of local cultures, histories and experiences. Some of the beliefs related to
medicine that exist there include:
1. Traditional Aboriginal and Torres Strait Islander Medicine: Aboriginal and Torres Strait
Islander communities have traditional systems of medicine based on hereditary

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 knowledge, medicinal plant use, spiritual practices, and natural remedies that have been
passed down from generation to generation. This treatment is closely related to cultural
beliefs, spirituality, and understanding of the balance of nature.
2. Spiritual Awareness and Energy: Some people in Northern Australia believe in the
influence of energy and spirituality in health. Therapies such as Reiki, meditation, or
other energy remedies can be part of their wellness approach.
3. Complementary and Holistic Medicine: A holistic approach that treats the individual as
a whole, including physical, emotional, and spiritual aspects, is growing in popularity.
People choose alternative therapies such as acupuncture, yoga, chiropractic, or massage
therapy to strengthen their health holistically.
4. Use of Medicinal Plants and Herbal Supplements: The use of medicinal plants and
herbal supplements in alternative medicine is also common. Some communities may opt
for natural remedies to cure or treat various health conditions. While these beliefs are
diverse and respected, it is important to remember that conventional medical
approaches remain an important part of Northern Australia's health system.
Governments and health agencies encourage the judicious use of alternative medicines,
ensuring their safety, effectiveness, and proper understanding of their use. Consultation
with a skilled and knowledgeable healthcare professional is important before choosing or
using any treatment approach.

2.1.4 Aboriginal people

At first Australian Aborigines came from Asia who moved their residence to the islands of
Southeast Asia. Furthermore, the tribe settled on the Australian continent for
approximately 45,000 to 50,000 years. Some experts explain if the movement of modern
humans out of Africa towards West Asia to south to Southeast Asia. Before Europeans in
1788, Aboriginal people could adapt to various types of climate in Australia such as
temperate, tropical and desert. Aboriginal people long ago hunted for and gathered
food. In addition, agricultural practices have also been implemented by Aboriginal tribes.
In the process of collecting small meals to supplement needs, Aboriginal people will form
groups.

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 Australia is a continent and country that has a unique blend of indigenous
traditions and new influences. Australia's indigenous people are Aboriginal and Torres
Strait Islander people. Where the indigenous people of Australia are heirs to one of the
oldest cultural traditions that still exist. Their existence in Australia has been around for
over 40,000 or perhaps about 60,000 years.
The Australian continent has indigenous people. One of the indigenous people in
Australia is the Aboriginal tribe. It is estimated that Aboriginal people have occupied the
continent for approximately 50,000 years.
The total number of languages spoken by Aboriginal people is about 250
languages and 600 dialects and is widespread on the Australian continent. Please also
note if the existence of Aboriginal tribes in Australia is divided into two groups. The first
group was the Aboriginal tribes who had inhabited Australia after the British colonized
the island around 1788. And for the second group are the inhabitants who are on the
Torres Strait islands. In addition, these residents also live in Queensland, one of the
states of Australia and Papua New Guinea. Where they come from Melanesia which has a
different culture from the Aborigines on the main continent of Australia.
2.2 South Australia

2.2.1 History

South Australia (SA) is a state in the south central part of Australia that includes some of
the most arid parts of Australia. With a total area of 983,482 square kilometres (379,725
sq mi), it is Australia's fourth-largest state and territory by area, and fifth-largest by
population. It has a total population of 1.77 million[1] and its population is the second
most concentrated in Australia, after Western Australia, with over 77 per cent of South
Australians living in the capital city, Adelaide, or surrounding areas. Other population
centres in the state are relatively small — the town of Mount Gambier, the second
largest population centre, with a population of 28,684. South Australia borders all states
on the Australian mainland, as well as the Northern Territory. To the west it is bordered
by Western Australia, to the north by the Northern Territory, to the northeast by
Queensland, to the east by New South Wales, to the southeast by Victoria, and to the

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 south by the Great Australian Bight. [note 1] The state comprises less than 8 per cent of
Australia's population and ranks fifth in population among Australia's six states and two
territories. The majority of the population lives in the greater Adelaide Metropolitan
area. Most of the rest settled in fertile areas along the southeast coast and the Murray
River. The state's colonial origins are unique in Australia as a freely inhabited and
planned province of the United Kingdom,[4] rather than as a convict settlement. Colonial
rule began on December 28, 1836, when councillors were sworn in near The Old Gum
Tree. [5] Like the rest of the continent, the region has a long history of human occupation
by various tribes and languages. The South Australian Company established a temporary
settlement in Kingscote, Kangaroo Island, on 26 July 1836, five months before Adelaide
was founded. [6] The guiding principle behind the settlement was systematic
colonisation, a theory espoused by Edward Gibbon Wakefield which was later used by
the New Zealand Company. [7] The goal was to establish a province as a center of
civilization for free immigrants, promising civil liberties, and religious tolerance. Although
its history has been marked by economic hardship, South Australia remains politically
innovative and culturally vibrant. Today, it is known for its fine wines and various cultural
festivals. The state's economy is dominated by agriculture, manufacturing, and mining
industries.

2.2.2 Languages Spoken by South Australia

Adelaide is the largest metropolitan area in the state of South Australia.

As of March 2018, South Australia's population was 1,733,500. [1] The majority of the
state's population lives in the Greater Adelaide metropolitan area which had an
estimated population of 1,333,927 as of June 2017. [13] Other notable population
centres include Mount Gambier (29,505),[14] Victor Harbor–Goolwa (26,334),[14]
Whyalla (21,976),[14] Murray Bridge (18,452),[14] Port Lincoln (16,281),[14] Port Pirie
(14,267),[14] and Port Augusta (13,957).
In the 2016 census, 78.2% of the population only spoke English at home. Other
languages most commonly spoken at home are Italian (1.7%), Standard Chinese (1.7%),
Greek (1.4%), Vietnamese (1.1%), and Cantonese (0.6%).

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2.2.3 Health belief systems in South Australia

In South Australia, health belief systems are very diverse and include a wide range of
approaches and practices. The majority of South Australians rely on a conventional
healthcare system supported by the government, including healthcare provided by
doctors, hospitals and other health institutions.
However, alongside conventional medicine, there is also a growing interest in holistic and
alternative health approaches among a subset of the population. This approach includes
the use of alternative therapies such as acupuncture, kinesiology, homeopathy, and
various other forms of complementary medicine.
South Australians are also increasingly aware of the importance of healthy lifestyles,
including a balanced diet, regular exercise and other holistic health practices such as
yoga, meditation and mindfulness.
The South Australian government has also adopted a range of health policies focusing on
disease prevention, mental health promotion, as well as campaigns for public health
awareness.
Of course, as elsewhere in the world, health preferences and belief systems can vary
significantly from individual to individual in South Australia.
2.3 Western Australia

2.3.1 Geography

Western Australia is the largest state in Australia with an area of 2,646,000 km2.
Western Australia is the second largest subnational entity in the world after Sakha,
Russia. This Western Australian state occupies the most isolated part of the continent
from the major cultural centres of the east. Covering one-third of Australia's territory,
the state borders South Australia and the Northern Territory. Its capital is Perth.

Western Australia's landscape consists mostly of vast plateaus articulated by

several mountain ranges, to the east of which lies a vast desert. The Kimberley region in
the far north is a plateau that has many parts. The coastline is rugged and treacherous,

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 with strong currents and tidal ranges that can reach 39 feet (12 meters), while the hilly
hinterland is sparsely forested and overgrown with dense grass.

2.3.2 Western Australia's culture

Australian culture is essentially a westernized culture, originating in England but

also influenced by Aboriginal, Torres Strait Islander and other Australian groups. Among
them are some cultures in Australia , namely:

1. Aboriginal people
It is an indigenous Australian tribe that has inhabited the continent and
surrounding islands since 50,000 years ago. The tribe speaks more than 250
different languages and dialects.
2. Boomerang
It is a traditional weapon typical of the Aboriginal tribe, Australia that has been
invented since decades ago. This weapon is a throwing weapon commonly used
for hunting.
3. Tiwi Dance
Is a traditional Aboriginal dance. This dance is performed with strong
movements, where every change of movement must be done precisely
according to the stroke of the musical instrument.
4. Didgerido
Is a traditional musical instrument that has been thousands of years old. This
musical instrument has a long shape and is somewhat pursed. The didgeridoo
has a distinctive sound, depending on the skill of the blower.
5. Sunday Roast
Australia has the same traditional food as the British, namely Sunday Roast.
Sunday Roast is a dish that is usually served on Sundays, consisting of grilled
meat, potatoes, and served with vegetables or pudding.

2.3.3 Health-Related Beliefs in Aboriginal People

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 The health of Aboriginal people in Australia is poor and much worse compared to
non-Aboriginal peoples, and their life expectancy at birth is about 21 years lower for
men and 19 years lower for women. Among Aboriginal and Torres Strait Islander males
(6.8%) die in infancy, compared with 1% in the rest of the population. For women the
figures were (6.7%) and (0.8%). Most diseases are more common among Aboriginal
people. In Australia itself is common to use traditional medicine including:

1. Bush treatment
Bush medicine consists of traditional medicines used by indigenous Australians,
namely Aborigines. For the Anangu cultural block in the Western Desert,
practitioners of shrub medicine are known as ngangkari. They heal diseases
through healing rituals involving magic. Examples of this ritual are singing,
massaging, and sucking to remove foreign objects that enter the body, and
invoking the power of the god of war to heal soldiers' wounds caused by spears
and clubs.
2. Community Healers
In addition to using traditional medicine, they turn to community healers for
treatment aimed at providing physical and spiritual healing. Aboriginal people
believe that their healing "medical personnel" have special powers bestowed
upon them by their spiritual ancestors to heal, they act as general practitioners
and psychiatrists, healing the body and mind.
3. Mysterious Pill
The use of 20th century medicine was developed by Aboriginal peoples. This
drug made from soft cork wood trees, or Duboisia myoporoides, was used by the
allies in World War II to preventsea collapse when they sailed. The pill was flown
to Europe and developed in great secret by researchers and developed in the
production of tropane alkaloid drugs, scopolamine and hyoscyamine, which are
useful for eye surgery. And these pills are also commonly used to treat influenza,
colds and coughs, and as chewing gum (kino eucalyptus).
4. Shrub Medicine

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 In the 21st century Healing methods are increasingly widespread marked by the
emergence of Pampuni (touch healing), Mapampa (blowing), and Marali
(spiritual healing and shrub medicine) methods to complement general
medicine. And after going through various studies, the local community has
provided plant material including gumby-gumby and Alstonia constricta
(bitterbark) parts for supporting treatment.

2.4 EASTERN AUSTRALIA

2.4.1 Geography

The eastern state of Australia is a state bordering the coastline of the

eastern continent of Australia. These countries are the mainland states of
Victoria, New South Wales and Queensland, and the island state of Tasmania.
The Australian Capital Territory and Jervis Bay Area, although not a State, are
also included in this region. On several occasions, the State of South Australia
was also included in this grouping due to its economic relationship with the State
of Tmur.

Regardless of which definition is used, the eastern states cover most of

Australia's population. The cities contain the federal capital Canberra and
Australia's three largest cities, Sydney, Melbourne, and Brisbane (all capital cities
of their respective east coast states). Of the 19 Australian cities with populations
over 100,000 as of 2021, 16 are located in eastern states by limited definition (17
if including South Australia), which includes two non-capital cities with
populations over 500,000: God Coast, Queensland and Newcastle, New South
Wales. In terms of climate, this region is dominated by humid subtropical zones,
with several tropical climate zones (Queensland) and oceanic (Australian Capital
Territory, Victoria, New South Wales). In most situations, an eastern State is
defined as a State that uses Australian Eastern Standard Time (AEST), and that
definition will be adhered to.

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 The combined population of Queensland, New South Wales, Australian
Capital Territory, Victoria, Tasmania is 19,484,100, or 81% of Australia's
population. The five states of the territory cover 2,829,463 km, or 37%

2.4.2 SECTION BETWEEN EAST AND WEST

Since the 1980s, the government has proposed building high-speed

railways in Australia. However, this train will only pass through the eastern states
of Victoria, New South Wales and Queensland. Adelaide is often included in the
proposal, but Green Party leader Bob Brown said a rail link connecting Perth was
inevitable.

Politicians and presses from Western Australia often use the term to
emphasise their and our attitudes regarding the isolation of the country from the
rest of the country. For example, in 2016 WAtoday released a plan titled "Ten
reasons why Perth beat Australia's East Coast". In 2015, international visitors to
Australia spent $24.1 billion. The state and eastern territories generated $20.5
billion of that amount, or 85%. Similarly, the eastern States accounted for
8,588,000 (85%) individual visits to the State that year, rather than a possible
10,133,000.

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 CHAPTER III

NURSING AND SEAT ASSURANCE IN SYDNEY

3.1 Advantages and disadvantages of nursing care in Indonesia and Australia

Excess:

a. Accessibility: The nursing system in Indonesia tends to be more affordable and

accessible to the public, especially in terms of treatment costs and the location of
health facilities. Australians have broad access to quality health care, including
through a public health insurance system called Medicare
b. Kinship: The family nursing model common in Indonesia allows the role of the family
in the treatment process, so as to provide strong emotional and social support for
patients.
c. Cultural diversity: Indonesia has a rich cultural diversity, and the nursing system in
Indonesia strives to understand and respect the needs of patients from various
cultural backgrounds.
d. High quality of care: Australia has an internationally recognised healthcare system
with high standards. Modern healthcare facilities and advanced medical technology
are available throughout the country.
e. Trained medical personnel: Australia has trained medical personnel to a high
standard, including competent and experienced nurses.

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 Deficiency:

a. Limited resources: Sometimes, the nursing system in Indonesia faces limitations in

terms of resources, such as inadequate health facilities and a shortage of trained
medical personnel.
b. Regional inequality: Access and quality of health care may vary across different
regions of Indonesia. Some regions may face challenges in terms of adequate
infrastructure and health facilities. As in many other countries, there are inequalities
in access and quality of healthcare in remote or rural areas of Australia.
c. Regulations and standards: Although regulation of the nursing profession continues
to evolve, some challenges still exist in terms of consistent standards and oversight
across systems.
d. Cost of care: Although healthcare accessibility in Australia is relatively good, the cost
of care can be expensive, especially for care that is not fully covered by Medicare.
Additional health insurance is often needed to reduce costs.
e. Waiting time: Sometimes, especially for non-urgent care, there are long wait times
to get healthcare in Australia. This can be challenging for those who need immediate
treatment.

3.2 Nursing structure

In Australia, there are two levels of nurses, RN and EN. RN's nursing services are
considered 'person-centered and evidence-based' with preventive, curative, formative,
supportive, restorative, and palliative elements. RNs work in therapeutic and
professional relationships with individuals, as well as with families, groups, and
communities.' Their work involves a direct role in caring for patients, as well as in non-
clinical care involving management, administration, education, research, and consulting,
as well as regulatory and policy development (NMBA, 2016a). They have high
responsibility, accountability, and autonomy, and can delegate tasks to EN (Schwartz,
2019). In addition, RNs with significant advanced practice experience can continue their
studies to be endorsed as Nurse Practitioners (NPs) who have diagnosis and prescribing

18
 rights within the scope of their practice. EN is a second-level nurse who works under the
supervision of an RN, either directly or indirectly, with a focus on providing nursing
services directly to patients (NMBA, 2016b). It is generally well known that EN provides
nursing services to patients whose condition is stable and performs less complex basic
skills, while RN provides nursing services to patients whose condition is unstable or
deteriorating, and they can perform more complex clinical procedures (Endacott, et al.,
2017; Jacob, et al., 2016). ENs who have completed approved medical administration
education can list this qualification on their practice registration and add it to their
practice skills set. Of all nurses in Australia, about 80% are RNs and the remaining 20%
are ENs. (Schwartz, 2019).

3.3 Nurse Education in Australia

To be able to practice as an RN, it is required to complete at least a bachelor's

degree in nursing for three years in higher education. In recent years, pre-registration
master's degrees have emerged that provide pathways for graduates from other
disciplines to become RNs (Gerdtz, et al., 2021). These programs have resulted in the
evolution from a nursing shortage to a breakthrough from other programs into nursing.
The nursing program must be mapped in NMBA standards of practice and ANMAC
accreditation standards. Prospective learners must meet the requirements of the
program (ability, nature, skills, and behaviors to meet learning outcomes) and readiness
to practice (ANMAC, 2019), as well as meet the NMBA English language requirements.
Program selection is competitive and based on academic results from the final year of
secondary school through the Australian Tertiary Admissions Ranking (ATAR) or
equivalent. In addition, some universities have specific requirements for mathematics or
science (Ralph, et al., 2019). EN learners in Australia undertake a two-year Diploma
Program in Nursing at a vocational education provider. There is a pathway for EN
students to convert from a diploma to an undergraduate program in their second year
to become an RN, and receive an equalization year of courses/credits from previous
studies. Since the transfer of nursing education to the higher education sector, students
can immediately register as nurses after successfully completing an accredited program

19
 (Missen, et al., 2018), which is a three-year undergraduate program or a two-year
diploma program. Unlike Indonesia, there is no internship program in Australia. After
initial education, RNs are hired as recent graduate nurses (NGNs). Most recent
graduates do this through a Postgraduate Nursing Program (GNP) which is usually one
year long where they are provided with further support and education to ease the
transition. However, this employment program is not mandatory, but can facilitate the
transition to RN practice (such as performing patient care services and leading care
teams) through learning days, supernumerary, mentoring support and clinical rotations
(Missen, et al., 2016). There are several Postgraduate Nursing Programs available for EN.
There are many Australian research bodies describing these programs and nurses'
experiences in transitioning into professional practice after graduation.

3.4 Nursing Regulations and Nurse Education

In 2009, the Australian National Health Practitioner Regulation Act 2009 was
passed which established national registration and accreditation schemes for 15 health
professions including nursing and midwifery, pharmacy, dentistry, medicine,
physiotherapy, chiropractic, occupational therapy, optometry, podiatry, psychology,
paramedics, osteopathy, traditional Chinese medicine, medical radiation, and Aboriginal
and Torres Strait Islander health practices. The Act stipulates:
1. Registration of health workers
2. Student agreement
3. Regulation of Health practitioners
4. Study programs that provide qualifications
5. Clinical training in Health professions
Australian higher education providers (universities) are accredited by the
Tertiary Education Standards and Quality Agency (TEQSA) under the Tertiary Education
Standards and Quality Agency Act 2011 (the TEQSA Act). Vocational education providers
(TAFE institutions) are run by individual State and Territory governments and regulated
by the Australian Skills Quality Authority (ASQA) under the National Vocational
Education and Training Regulation Act 2011. Registered Nurse (RN) education providers

20
must be registered with TEQSA, and Trained Nurse (EN) education providers must be
registered with ASQA or state regulators as Australian Registered Training Organisations
(RTOs) (ANMAC, 2017). Nursing programs2 in Australia are accredited by the Nursing
and Midwifery Board of Australia (NMBA), following an assessment process and
recommendation from the Australian Nursing and Midwifery Accreditation Council
(ANMAC), under the Australian National Health Practitioner Regulation Act 2009.
Programs aimed at achieving initial enrollment are designed to prepare its students with
comprehensive nursing practice, in general or mental health nursing, and are mapped
according to the NMBA Registered Nurse (NMBA, 2016a) Registered Nurse (NMBA,
2016a) Registered Nurse Nursing Practice Standards (NMBA, 2016b) and must meet
ANMAC accreditation standards. Students rarely have the opportunity to gain practical
experience with a specialisation. Overall, the organisations that play a key role in
overseeing nursing and nurse education in Australia are:
• The Australian Nursing and Midwifery Council (NMBA), one of 15 national
health professional regulatory bodies, comprising the Australian Health Practitioner
Regulation Agency (AHPRA). The NMBA was formed in 2014 when state-based individual
registration was merged into a national registration approach. NMBA responsibilities
include enrolling nursing and midwifery practitioners and students, as well as
developing codes, standards, and guidelines for the nursing and midwifery profession.
AHPRA also arranges announcements, complaints, investigations and disciplinary
hearings for reported nurses and midwives. It also assesses trained overseas nurses and
midwives who wish to register to carry out nursing/midwifery services in Australia, and
approves accreditation standards and accredited courses for registration or attestation.
• Australian Nursing and Midwifery Accreditation Council (ANMAC), the external
accreditation body for NMBA-approved programs. Her responsibilities include
developing accreditation standards for nursing and midwifery registration or attestation
programs, as well as assessing courses and education providers offering them to
determine whether they conform to approved accreditation standards. After the
assessment, ANMAC makes recommendations to the NMBA regarding program

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 approval. ANMAC also has an independent role in assessing the skills of internationally
qualified nurses and midwives for migration purposes.
• The Australian Federation of Nursing and Midwifery (ANMF) is Australia's
largest union and a professional nursing and midwifery organisation. ANMF provides
professional, industry, and political advocacy and support for its members. ANMF also
provides professional protection insurance coverage for its members.
• Although it does not play a direct role in the program for registration, the
Australian College of Nursing (ACN) is a professional college with a strong policy focus
regarding nursing and nursing education. ACN also provides extensive graduate
certification programs and advanced professional development programs for nurses.

3.5 Conceptualisation of Nursing and the Health Care System in Australia

The conceptualisation of nursing in Australia has been influenced not only by

British traditions, but also by developments in North America. Like Virginia Henderson's
definition of nursing, it is often used to introduce nursing to beginning students. The
healthcare system in Australia is based on the principle of universal access to
healthcare. The Medicare levy provides funding for the reimbursement ofprivate
medical services such as general practitioners and specialist doctors. Therefore, the
healthcare system in Australia is largely managed by the government.

3.6 Standard Analysis of Practice

In both Indonesia and Australia, education providers are required to ensure that
their students meet the standards of practice set by the authorities before completing
their courses. This standard consists of standards of professional competence/practice
required by nurses of a certain level (first or second). This standard is used to assess
students' performance during clinical placement in their education program to ensure
that they are competent health practitioners.
Prior to 2010, nursing practice in Australia was regulated by individual states and
territories. Since 2010, professional regulation is implemented nationally by the NMBA,
AHPRA, enacting the National Law on Health Practitioner Regulation 2009 covering all

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professions, while the NMBA is responsible for the regulation and standards of practice
for nursing and midwifery. This includes the development of codes of ethics and
standards for all nurses with some similarities and differences in both countries.
Competency/practice standards describe the level and scope of practice for
nurses after graduation. Education providers in both countries require students to work
to a standard after completing their courses. In Australia, the standards of practice for
RNs and ENs are set by the NMBA which consist of:
- Registered Nurse Practice (RN) Standards
- Trained Nurse Practice Standards
- Nurse Code of Conduct
- Nurse Code of Ethics

Australian standards of practice are quite general and developed specifically for
Australia:

1. Think critically and analyze nursing practice

2. Engage in therapeutic and professional relationships
3. Maintain the ability to provide nursing practice services
4. Conduct a comprehensive assessment
5. Develop a nursing practice plan
6. Provide quality nursing practice services that are safe, appropriate, and responsive
7. Evaluate nursing practice outcomes

In addition, the Nurse Practice Standards define the requirements for practice in the
specialty. In Indonesia, the Decree of the Minister of Health of the Republic of Indonesia
No HK.01.07/Menkes/425/2020 outlines the standards of the nursing profession
consisting of core competency standards and professional codes of ethics. In addition,
this document also in detail outlines the topics of nursing specialties and skills needed
by professional nurses and vocational nurses. The framework aligns with the ASEAN
Nursing Core Competencies and is intended to provide mobility inthe ten countries

23
included, although the extent to which they facilitate is unclear. Its competency
domains include:

1. Practices based on ethical, legal and cultural sensitivities

2. Professional Nursing Practice

3. Leadership and Management

4. Education and Research

5. Development of Personal and Professional Qualities

However, it was identified in the interview that because the core competency standards
have not been formally implemented, their application varies greatly and depends on
the respective health facilities. The professional practice standards of the two countries
as a whole are very appropriate, with many of the same areas of emphasis:

- Holistic and person-centered nursing

- Legal and ethical considerations in the delivery of nursing services
- Bukti based treatment
- Patient safety and quality of care
- Professional relationships
- The need to support the education of others
- Continuous professional development (CPD)
- Health improvement
- Health resource allocation
- Care across the health continuum
- Culturally sensitive nursing service delivery
- Personal health and well-being

Standards in both countries use problem-solving approaches to nursing planning and

delivery using assessment, planning, problem identification, treatment implementation
and outcome evaluation. Indonesia has adopted a nursing diagnosis approach that is

24
 widely used internationally, especially in the United States. In this approach, there is a
predetermined and detailed list of nursing diagnoses. This approach was used in
Australia after the transfer of nursing education to the higher education sector in the
1980s, but has since evolved away from the allocation of specific nursing diagnoses to
problem identification. However, both approaches require nurses to implement
structured decision-making for care.

Both Indonesia and Australia use the International Nursing Code of Ethics (ICN). It
was identified inthis review that Indonesia is still using the updated 2016 version in 2021
in consideration of the global health situation. This difference may only be a matter of
time and updates to the latest version will appear in the future.

3.7 Does Western Australia Have Health Insurance

Australia has a government-funded healthcare system, with medical services

subsidised through the universal national health insurance scheme. In comparison,
Australia's health budget is USD 3,484 per capita, while Indonesia's is still around USD
100 per capita. Australia provides State insurance i.e. government-run Medicare
covering a wide range of primary health care services. Spending on 67% of Medicare as
State insurance and other health programs. Medicare provides healthcare to Australians
for free, or at a reduced cost. Paid from taxes paid by every Australian. Medicare covers
many essential treatments but not all of them. This includes things like medically
necessary hospital procedures in public hospitals, visits to the doctor and some
medications. It does not cover treatment in private hospitals, ambulance services and
extra services such as eyeglasses, dental care, and natural therapies. This is why many
Australians choose to have private health insurance.

3.8 Nursing in Sydney

Nursing care in Sydney follows high standards and focuses on providing holistic,
integrated and quality care to patients. Nurses in Sydney, as in the rest of Australia,

25
 have careful training and must be registered and adhere tostrict nursing standards.
Many hospitals and healthcare institutions in Sydney have teams of well-trained nurses
to provide care tailored to the individual needs of patients. Nursing care in Sydney
includes:

1. Patient Monitoring: The nurse is responsible for continuously monitoring the

patient's condition, measuring vital signs, understanding medical history, and noticing
any changes that may occur in the patient's condition.

2.Care Planning: Nurses are involved in specific care planning according to the
individual needs of each patient. They work closely with the medical team to determine
the best plan that includes drug treatment, wound care, physical therapy, and more.

3. Mentoring and Education: In addition to providing physical care, nurses in

Sydney also support patients emotionally and educate patients and their families about
health conditions, treatment and preventive measures.

4.Health Team Collaboration: Nurses in Sydney work in teams of various health

professionals such as doctors, therapists, nutritionists and others. This collaboration
helps ensure patients get comprehensive care.

5. Public Health Monitoring: Nurses are also involved in public health initiatives,
such as disease prevention campaigns, vaccination programs, and health advocacy.
Nursing care in Sydney emphasises the importance of a patient-centred approach,
respecting individual needs, and providing comprehensive and ongoing attention to
their patients.

3.9 Health Belief Systems in Sydney

In Sydney, as elsewhere in Australia, belief systems about health vary widely. The
majority of Sydneysiders tend to rely on conventional healthcare systems supported by
the government, such as healthcare provided by GPs, hospitals and other official health
institutions. However, there is also a growing interest in holistic and alternative health

26
 approaches among a subset of Sydneysiders. Some of them seek additional or
alternative treatments such as acupuncture, herbal therapy, chiropractic, osteopathy,
and other therapies that can complement conventional medicine or be their top choice.
Sydneysiders are also increasingly aware of the importance of a healthy lifestyle, such as
a balanced diet, regular exercise and stress management. Holistic health practices such
as yoga, meditation, and mindfulness are gaining popularity among people seeking
balance between body and mind. In addition, the Sydney government and public health
organizations are also involved in health awareness campaigns, healthy lifestyle
promotion, and disease prevention. Belief systems about health in Sydney vary greatly
from individual to individual. Some people lean towards conventional approaches while
others prefer holistic or alternative approaches. Most people combine elements of
these approaches to care for themselves and their families in a way that is best suited to
their individual beliefs and needs.

3.10 Health Insurance in Sydney

In Australia, including Sydney, the health insurance system is supported by a

universal health insurance program administered by the federal government, known as
Medicare. Medicare provides access to basic healthcare and supports the cost of
medical care for Australians.

Medicare is a public health care system that is entirely state-sponsored and

finances the majority of the health care costs of Australians and Permanent Residents
(except for those living on Norfolk Island). Medicare is operated by the government
authority namely Medicare Australia. They are the main financial backers of the health
care system in Australia.Residents are entitled to subsidies when undergoing treatment
from medical practitioners, midwives and legal nurses and health professionals who
have obtained a Medicare service provider number, and are also entitled to free care at
General Hospitals.The Medicare program covers most of the cost of visits to general
practitioners, specialists, and necessary hospital services, as well as most of the costs
for recognized prescription treatments. In addition, the program also provides mental

27
health services, nursing services in hospitals, and several other medical procedures.
Australian citizens and eligible visa holders can take advantage of Medicare services.
However, there is also private health insurance that can be purchased additionally to get
more benefits from health services that are not fully covered by Medicare, such as
faster access to certain specialists, hospital options, or additional coverage for dental,
eye, or alternative therapies. Many private health insurance companies offer different
policies with varying coverages and additional benefits. Most financially capable
Sydneysiders have private health insurance for added protection and wider access to
healthcare. Sydney's health insurance system provides broad access to basic health
services through Medicare, while private health insurance offers additional options for
wider coverage and flexibility in healthcare.

CONCLUSION

In Australia, practice standards for RNs and ENs are determined by the NMBA
consisting of: Registered Nurse (RN) Practice Standards, Trained Nurse (EN) Practice
Standards, Nurse Code of Conduct, Nurse Code of Ethics

Health-Related Beliefs in Aboriginal Communities The health of Aboriginal

people in Australia is poor and much worse than that of non-Aboriginal people, and their
life expectancy at birth is approximately 21 years lower for men and 19 years lower for
women. Overall, the organization plays a key role in overseeing nursing and nurse
education in Australia.

Nursing care in Sydney adheres to high standards and focuses on providing

holistic, integrated and quality care to patients. Residents are entitled to subsidies when
undergoing treatment from medical practitioners, midwives and registered nurses and
health professionals who have obtained a Medicare service provider number, and are also
entitled to free treatment at General Hospitals. Responsibilities include developing
accreditation standards for nursing and midwifery registration or licensure programs, as
well as assessing study programs and educational providers offering such study programs
to determine whether they comply with approved accreditation standards. Medicare is a
fully state-sponsored public health care system and finances the majority of the health

28
care costs of Australians and Permanent Residents (except for those based on Norfolk
Island). Nursing programs2 in Australia are accredited by the Nursing and Midwifery
Board of Australia (NMBA), following an assessment and recommendation process from
the Australian Nursing and Midwifery Accreditation Council (ANMAC), under the Act
National Australian Health Practitioner Regulations 2009.

Transcultural nursing is a humanist science and technique, which is focused on

individual or group behavior, as well as the process of reconciling or improving healthy
behavior or physical and psychocultural illness behavior according to cultural
background. Aboriginal people believe that their healing “medics” have special powers
bestowed on them by their spiritual ancestors to heal, they act as general practitioners and
psychiatrists, healing the body and mind.

However, there is also private health insurance that can be purchased

additionally to get more benefits from health services that are not fully covered by
Medicare, such as faster access to certain specialists, a choice of hospitals, or additional
coverage for dental, eye care, or alternative therapies. Regulations and standards:
Although regulation of the nursing profession continues to evolve, several challenges
remain in terms of consistent standards and oversight across the system.

Australia has a government-funded healthcare system, with medical services

subsidized through a universal national health insurance scheme. The family nursing
model that is common in Indonesia allows the family to play a role in the care process, so
that it can provide strong emotional and social support for patients.

Educationally qualified nurses now play a part in the academic life of Australian
universities, and have therefore seized the opportunity to advance their discipline through
scientific endeavour.

The majority of South Australians rely on a conventional, government-supported

healthcare system, including health services provided by doctors, hospitals and other
health agencies.

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Endacott, R., O'Connor, M., Williams, A., Wood, P., McKenna, L., Griffiths, D., Moss, C., Della, P., & Cross,
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Ralph, N., Graham, C., Beccaria, L., & Rogers, C. (2019) Entry requirements in nursing: Results from a
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Missen K, McKenna L, Beauchamp A. (2018) Are we there yet? Graduate readiness for practice,
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