A Natural Pathway: Building the Indigenous Nursing Workforce in Remote Australia

Mrs Cathryn Josif1

1Kimberley Rural Health Alliance, Broome, Australia


The recruitment and retention of nurses to rural and remote areas is a global issue. Australia’s nursing and midwifery workforce is maldistributed and rural areas are underserved.  Only 1.1% of  this workforce identify as Aboriginal or Torres Strait Islander people. This is acknowledged as contributing to the poorer health outcomes of Indigenous Australians. Building a robust Indigenous nursing and midwifery  workforce is vital to achieving health equity for Aboriginal and Torres Strait Islander people.

The University of Notre Dame,  Broome is attempting to strengthen the Indigenous nursing workforce via a ‘natural pathway’ that takes Indigenous students from Vocational Education  and Training (VET) to Higher Education (HE).  The pathway begins with certificate courses in Health Support / Assistant Services and progresses to a Diploma of Nursing. Suitable VET students are identified and encouraged to undertake higher education studies.

This pathways concept is actively promoted in many ways:

  • To prospective students from initial enquiry
  • Interchange of VET and HE teaching staff to emphasise learning continuity
  • Promotion of increased opportunities for Aboriginal students who complete HE studies
  • Joint planning, delivery and close collaboration of VET and HE staff to ensure smooth transition and successful articulation processes
  • Provision of additional learning assistance as needed
  • Introduction of advanced academic learning skills to prepare students for transition to higher education.

This paper presents two case studies demonstrating the progress and experiences of two  Kimberley based Aboriginal nursing students.  The barriers and facilitators identified by the students as they traversed the pathway are highlighted. Our learnings and recommendations  to best support Indigenous students are provided.

An increase in the Indigenous nursing workforce  can help close the  gap by creating a more culturally safe health system which Aboriginal people are more likely to access.


Cath Josif RN, RM, CHN, PhD and Churchill Fellow has lived most of her life in rural and remote Australia. She has worked with Aboriginal communities in the Northern Territory and Western Australia as a RAN and researcher in community-based participatory action research projects across the lifespan. She was a researcher on the 1+1= A Healthy Start to Life project recognised in the NHMRC 10 of the Best Research projects 2014. She is now the Assistant Dean and Coordinator of  the Enrolled Nurse / Bachelor of Nursing Articulation Pathway, Kimberley Rural Health Alliance, Notre Dame, Broome.