Nursing Fundamentals Indigenous Studies Quiz

Course Information

• Course Name: Nursing Fundamentals Indigenous Studies
• Course Code: BNUR19000
• Instructor: Peter Kennedy RN, BScN, MBA
• Date: November 28, 2023

Learning Objectives

• Examine reports from the Truth and Reconciliation Commission
• Describe structural racism, child welfare, poverty, and the justice system in relation to nursing practice
• Describe components of Indigenous cultural orientation in relation to nursing practice
• Examine chronic illness experiences relevant to Indigenous peoples of Canada
• Apply research findings to the provision of nursing care to Indigenous peoples of Canada, considering cultural safety, health equity, and social justice
• Differentiate between Indigenous health from a global perspective and a Canadian perspective
• Consider the provision of health care for Indigenous elders

Entry to Practice Competencies

• Engage in self-reflection to interact from a place of cultural humility
• Create culturally safe environments where clients perceive respect for their unique health care practices, preferences, and decisions.

Indigenous Learning Outcomes

• Relate principles of Indigenous knowledge to the career field
• Analyze the impact of colonialism on Indigenous communities
• Explain the relationship between land and identity within Indigenous societies
• Compare Indigenous and Canadian perceptions of inclusion and diversity
• Analyze racism in relation to Indigenous people
• Generate strategies for reconciling Indigenous and Canadian relations
• Formulate approaches for engaging Indigenous community partners

Plan

• Independent study and review of assigned readings
• Guest speaker in classroom (date TBD)

Land Acknowledgement

• St. Lawrence College is situated on the traditional lands of the Anishinaabe and Haudenosaunee peoples.

Indigenous People of Canada

• In 2021, 1.8 million Canadians identified as Indigenous (4.7% of the population)
• This groups includes First Nations, Métis, and Inuit
• 56% resided in urban centres
• 46% were children and youth under 24 years of age
• Each group (and subgroup) has distinct languages, histories, cultural practices, and spiritual beliefs

Structural Racism

• Legitimized and normalized spectrum of attitudes, practices, and policies that consistently result in chronic and continuous substandard outcomes for Indigenous peoples.
• Examples: Jordan's Principle, Missing and murdered Indigenous women, Forced sterilization and abortion for Indigenous women in Quebec.

Child Welfare

• The "Sixties Scoop" was a phenomenon where children were apprehended from Indigenous families due to poverty, poor health conditions, and other issues.
• These children were often placed in non-Indigenous homes, disrupting family structures, undermining culture and leading to generational trauma.

Poverty

• Indigenous children face much higher rates of poverty than non-Indigenous children.
• Factors contributing: poor housing, underfunded education, systemic issues influencing income.
• Additional challenges include high levels of violence, addiction, alarming health statistics, and a lack of potable water.

The Justice System

• The Canadian justice system disproportionately incarcerates Indigenous people (28% compared to 4% of the population).
• Indigenous people encounter racism and lack of cultural programming within correctional facilities, sometimes rooted in the prior enforcement of attendance at residential schools.

Intergenerational Trauma

• Trauma experienced by Indigenous community members from residential schools impacts future generations.
• Children and grandchildren of survivors experience similar impacts such as abusive homes, strict discipline, and a lack of affection.
• The impact is transmitted from one generation onwards.

Historic Trauma Transmission

• Multigenerational trauma is experienced due to cultural, racial, or ethnic group oppression.
• Trauma impact has been pervasive in the Indigenous community, stemming from colonialism, disease and epidemics.
• Two forms: Initial traumatic event, and the destruction of community life and social contacts.

Historic Trauma Transmission: Five Key Areas of Impact

• Physical: Colonization, infectious disease introduction.
• Economic: Loss of land, resources, cultural disruption.
• Psychological: Marginalization, societal oppression, reduced control over lives.
• Cultural: Cultural dispossession, imposed cultural transformation.
• Social: Displacement, traditional coping mechanisms disruption, family damage.

Truth and Reconciliation Commission (TRC)

• TRC mandate: Inform all Canadians of residential school experiences, documenting truth, survivors' stories, and families' experiences.
• Report produced: 10 principles for Reconciliation and 94 Calls to Action.

TRC Report (2015): 94 Calls to Action

• Covers various topics like child welfare, education, language and culture, health, justice, reconciliation, equity for Indigenous people in legal systems, and many more.

TRC Calls to Action: Health

• Addressing historical government policies/actions behind the Indigenous peoples' health issues.
• Calls for medical and nursing schools to include courses for Aboriginal health.

TRC: What Unlearning Must Take Place

• Acknowledging past teachings, focusing on Indigenous Peoples' history, and understanding systemic injustices are crucial.
• Unlearning past biases, recognizing and acknowledging past and present discriminations against Indigenous people, and acknowledging personal privilege are important steps towards promoting reconciliation.

United Nations Declaration on the Rights of Indigenous Peoples (2007)

• Outlines how governments should respect Indigenous peoples’ rights.
• Contains 46 articles of rights and actions governments must take to protect Indigenous rights.

United Nations Declaration on the Rights of Indigenous Peoples (2007) – Article 24

• Indigenous peoples have the right to their traditional medicines, health practices and conservation of vital medicinal plants, animals and minerals
• Indigenous individuals right to access without discrimination social and healthcare services.
• Indigenous individuals right to the enjoyment of the highest attainable standard of physical and mental health.

Cultural Competency

• Improve health care access for patients
• Recognize that people are bearers of culture
• Consider historical and social contexts of health care
• Understand concepts like racism, discrimination and prejudice
• Acknowledge cultural safety is determined by those receiving care
• Understand the limitations of "culture" within healthcare contexts
• Challenge unequal power relations.

Cultural Safety and Humility

• Cultural safety is an outcome based on respectful engagement (reducing power imbalances), and providing environments where people receive care.
• Cultural humility is a process of self-reflection aimed at understanding, respect, and development of mutual trust and processes within relationships.

First Nations, Inuit, Métis and Urban Indigenous Health Framework

• Addresses the need for action to enhance Aboriginal health outcomes through partnerships with Indigenous leaders and organizations.

Areas of Focus for the Up-Coming Health Plan

• Build and sustain productive relationships
• Equitable access to culturally safe care
• Build and enhance capacity and education
• Measure, monitor, and evaluate
• Coordinate regional and provincial programs and services

Nursing Considerations

• Respect, trust, and spirituality are essential for nursing practice. Nursing has a clear mandate to ensure sensitive, empowering care to those facing inequities and working towards social change.

Considerations when Working with Indigenous Clients

• Indigenous communities have different perspectives on mental health, emphasizing balance and harmony, sometimes contrasting culturally insensitive approaches.
• Focus on presenting problems should be balanced with client beliefs and understanding to avoid further harming relationships.

Indigenous Health

• Health disparities exist within Indigenous populations in Canada.
• Social determinants and culturally safe programs are critical for addressing healthcare disparities.

Indigenous Health and Chronic Conditions

• Indigenous communities experience higher rates of certain chronic conditions (e.g. diabetes, COPD, HIV, TB).
• Significant disparities are apparent compared to non-Indigenous populations.

Caring for Indigenous Elders

• The prevalence of residential school survivors is high, creating significant disparities and inequities within the Indigenous population.

This quiz evaluates your understanding of nursing practices in relation to Indigenous peoples in Canada. Test your knowledge on the Truth and Reconciliation Commission, structural racism, and the importance of cultural safety and health equity. Prepare to engage with key issues affecting Indigenous health care and practices.