Rec­on­cil­i­a­tion: A path for­ward for bet­ter in­dige­nous health

BY MIKE VILLENEUVE

Policy - - Before The Bell | From The Editor -

In­dige­nous peo­ples are highly di­verse pop­u­la­tions whose health is af­fected by all the same kinds of de­ter­mi­nants as other peo­ple in Canada. But in ad­di­tion, a com­plex his­tory of colo­nial­ism and racism has had a sub­stan­tial and on­go­ing im­pact on the types and rates of in­juries and ill­nesses in these com­mu­ni­ties as well as ac­cess to and ex­pe­ri­ences with health care. Com­pli­cat­ing phys­i­cal health is­sues, for too long, we have watched a cri­sis of men­tal health is­sues and sui­cide rates rise among In­dige­nous youth. While we have seen some progress re­cently, much more must be done to ad­dress in­equities in health, so­cial and ser­vices pro­vided to Canada’s In­dige­nous peo­ples.

Nurses have a re­spon­si­bil­ity to re­spect and value each per­son’s in­di­vid­ual cul­ture, and con­sider how cul­tures may im­pact an in­di­vid­ual’s ex­pe­ri­ence of health care. The Cana­dian Nurses As­so­ci­a­tion (CNA) has had a long­stand­ing part­ner­ship with the Cana­dian In­dige­nous Nurses As­so­ci­a­tion (CINA) in­tended to pro­mote cul­tural safety as a core value of nurs­ing in Canada. In our 2017 up­date to the Code of Ethics for Reg­is­tered Nurses, we’ve in­cluded mul­ti­ple ref­er­ences to the sig­nif­i­cant im­pact of his­tory and cul­tural dif­fer­ences on health out­comes.

Un­for­tu­nately, we do not hear enough about the im­por­tant con­tri­bu­tions from In­dige­nous nurses in Canada. Ev­ery day, In­dige­nous nurses bring an ex­tra­or­di­nary un­der­stand­ing of health-care is­sues, con­cerns, needs and cul­tural safety to the care of peo­ple across First Na­tions, Métis and Inuit com­mu­ni­ties. As a first point of con­tact in many com­mu­ni­ties, they have a priv­i­leged and trusted ca­pac­ity within In­dige­nous pop­u­la­tions and are ex­tremely re­source­ful when pro­vid­ing the health care re­quired for their pa­tients. In some cases, they are able to in­cor­po­rate tra­di­tional lessons and heal­ing meth­ods to im­prove health out­comes.

CINA mem­bers have much to of­fer to health de­ci­sion mak­ers across the coun­try. Re­cently, the as­so­ci­a­tion rec­om­mended one in­ter­est­ing learn­ing so­lu­tion to the On­tario gov­ern­ment – propos­ing the cre­ation of a mo­bile health-care sim­u­la­tion lab­o­ra­tory to al­low In­dige­nous nurses from First Na­tions and ru­ral com­mu­ni­ties across the prov­ince to di­rectly ac­cess key ed­u­ca­tional ser­vices. In this model, In­dige­nous nurses could more read­ily gain the prac­ti­cal skills that are re­quire­ments for ac­cred­i­ta­tion. This rec­om­men­da­tion fits re­ally well with CNA’s core val­ues of bring­ing care closer to home and com­mu­ni­ties.

CNA is on its own jour­ney to un­der­stand the truth of our his­tory, both in our ad­vo­cacy work and as a cor­po­rate ci­ti­zen. We are en­gag­ing a se­ries of ac­tiv­i­ties with our board of di­rec­tors and staff to im­prove our abil­ity to en­gage in mean­ing­ful and au­then­tic rec­on­cil­i­a­tion. We en­cour­age ev­ery­one – in­di­vid­u­als and or­ga­ni­za­tions – to truly en­gage in un­der­stand­ing our shared his­tory and re­flect on ways we can work to­gether to put strate­gies in place to close gaps and im­prove In­dige­nous health out­comes.

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