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Understand aboriginal health: What all nurses need to know
Transcript of Understand aboriginal health: What all nurses need to know
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© Canadian Nurses Association, 2012
Understand aboriginal health: What all nurses need to know
CNA Webinar Series: Progress in Practice
Fjola Hart Wasekeesikaw Executive Director, Aboriginal Nurses Association of Canada
Lisa Perley-Dutcher
Director, Aboriginal Health Resources Initiative, University of New Brunswick
June 18, 2013
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Fjola Hart Wasekeesikaw, RN, MN Executive Director
Aboriginal Nurses Association of Canada
Debbie Grisdale BNSc, MHSc Policy Advisor
Policy and Leadership Canadian Nurses Association
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Aboriginal Nurses Association of Canada working to improve the health of Aboriginal people
• Officially established in 1975 when a group of
nurses of Aboriginal ancestry from across Canada met to share their knowledge, cultural heritage & experiences.
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• Continues to engage in activities related to
recruitment & retention, member support, consultation, research and education to improve the health of Aboriginal people
• Promotes the development & practice of Aboriginal Health Nursing.
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• Since 2008, A.N.A.C. has collaborated on a set of projects - cultural competence and cultural safety in First Nations, Inuit and Métis Nursing Education: – Literature review, development of a framework,
research on the use of cultural competence and dissemination of research results and publication of an article in a refereed journal.
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• A.N.A.C. National Forum, “Honouring the Nursing Spirit at the Heart of Aboriginal Healing”
November 9 & 10, 2013 Marriot Vancouver Airport Hotel in Richmond B.C.
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Lisa Perley-Dutcher, RN, MN Director
Aboriginal Health Human Resources Initiative University of New Brunswick
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Cultural Competency & Safety: Working with
Aboriginal Peoples in Canada
Lisa Perley-Dutcher, RN, MN
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Objectives:
• Provide participants with a brief introduction and context of the presenter
• Provide an overview of the present health status and challenges faced by Aboriginal peoples accessing the health-care system
• Discuss some of the impacts of colonization on the health status of Aboriginal peoples
• Discuss briefly the concepts of cultural competence and cultural safety
• Provide some alternative approaches for nursing practice
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My Context: Tobique First Nation (Wolastoqiyik People)
Seven Sacred Teachings: Respect, Truth, Honesty, Humility, Wisdom, Courage and Love
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Lisa Perley-Dutcher June 10, 2009
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• Connection to the land • Language • Cultural practices • Relationships • Spirituality/ceremony • Elders’ teachings/stories • Balance in life (i.e., medicine wheel teachings)
Lisa Perley-Dutcher 2013
Some Common Core Aboriginal Values:
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General Health Status of First Nations and Inuit Peoples in Canada • Tuberculosis: 8-10x higher • Diabetes estimates: 2-5x higher • Cardiovascular disease: 3x higher (Reading, 2009) • Suicide/self-inflicted injury: Inuit rates 6-11x higher Aboriginal youth aged 10 to 29 are 5-6x higher
(Canadian Mental Health Association, 2013)
)
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Stella’s Story
Consider Colonization as a Social Determinant of Health
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Some of the major impacts of Colonization on Aboriginal Peoples:
• Suppression of language, ceremonies, culture and “spiritual way of life”
• Destruction of family systems (residential
schools creating multi-generational trauma) • Loss of land and relationship to the land • Traditional food - change in diet • Identity crisis/diminished self-worth (racism & stereotyping) Smylie, J. (2000)
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Health-care Encounters Common Themes Experiences for Aboriginal Peoples
• Don’t feel safe • Don’t trust • Feel judged • Assumptions made • Miscommunication • Misunderstood • Stereotypes and racist behaviors (lead to
negative attitudes)
Lisa Perley-Dutcher 2013
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Embracing Diversity
• There is a need to unlearn the notion that culture
and difference is negative or problematic. • This involves asking the question: How do we learn that our view is a perspective and not the perspective? (RNAO, 2007)
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Recommendations for Health-care Providers
1) Learn appropriate names of Aboriginal peoples in Canada
2) Understand current socio-demographics of Aboriginal People in Canada
3) Learn traditional geographic territories & language groups
4) Impact of colonization on health status
5) Understand that socio-demographics have an impact on health
6) Recognize need to provide services close to home
7) Understanding of government’s obligations and policies
8) Support the process of self-determination
(Smylie, 2000)
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Cultural Competence:
“Cultural competence is a continuous process of effectively developing the ability to work within the
cultural context of community, family and individuals from a diverse cultural and ethnic
background.” (RNAO, 2007)
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Camphina–Bacote (2002) Framework for Cultural Competency
Five Constructs: • Awareness - self and others • Skills - assessment and communication • Knowledge - about cultural similarities and
differences • Encounter - exposure to different cultures • Desire - the will to be culturally competent
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Cultural Safety:
“a process of reflection on his or her own
cultural identity and will recognize the impact that his or her personal culture has on his or her professional practice . . . .
Unsafe cultural practice compromises any action which diminishes, demeans or disempowers the cultural identity and wellbeing of an individual.”
Te Kaunihera Tapuhi o Aotearoa - Nursing Council
of New Zealand (p.7) & Ramesden, 2002
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Cultural Safety as a Paradigm Shift Requires:
Challenging existing power within the nurse/client relationship: Success as defined by the recipient Client as powerful player in relationship Client defines culturally safe care
(Brascoupe & Waters, 2009; Ramesden, 2002)
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Cultural Safety as an Outcome
“How safe did the service recipient experience a service encounter in terms of being respected and assisted in having their cultural location, values, and preferences taken into account in the service encounter?”
(Brascoupe & Waters, 2009)
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Alternative Approachs:
• Develop cultural competency • Practice cultural safety • Strength-based approach (CANAC, 2013)
• Acknowledging Indigenous knowledge (CANAC, 2013)
• Promote self-determination (Smylie, 2000)
Lisa Perley-Dutcher 2013
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Woliwon, Wela’lieg Merci
Thank You
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© Canadian Nurses Association, 2012
For more information: Debbie Grisdale [email protected] Fjola Hart Wasekeesikaw [email protected] Lisa Perley-Dutcher [email protected] http://www.cna-aiic.ca/en/on-the-issues/better-health/aboriginal-health-and-nursing/ Photo credits: iStock
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© Canadian Nurses Association, 2012
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