PPN101 Week 7 Indigenous Populations 2024 PDF

Indigenous Populations and Health Equity PPN101 Fall 2024 Week 7  Objectives 1. Define the Calls to Action for health in the Truth and Reconciliation Commission of Canada report. 2. Define structural racism and how it can be manifested in the health care...

Indigenous Populations and Health Equity PPN101 Fall 2024 Week 7  Objectives 1. Define the Calls to Action for health in the Truth and Reconciliation Commission of Canada report. 2. Define structural racism and how it can be manifested in the health care system. 3. Understand the history of Residential Schools and the impact on survivors today. 4. Expand on the concept of cultural safety and its relevance for Indigenous people in Canadian healthcare. 5. Describe fundamental aspects of nursing practice related to Indigenous people’s values, health and well-being. 6. Discuss the relevance of two-eyed seeing for nursing care in Canada. 7. Describe the UNDRIP and its relevance to nursing practice. PPN101 Fall 2024 Week 7  Tedx Talk: Please view before class Gabrielle Scrimshaw A brighter future through Indigenous prosperity https://www.youtube.com/watch?v=9z9QKRsiql8&t =467s PPN101 Fall 2024 Week 7 Honouring the Truth, Reconciling for the Future Residential schools were created for the purpose of separating Aboriginal children from their families, in order to minimize and weaken family ties and cultural linkages, and to indoctrinate children into a new culture - the culture of the legally dominant Euro-Christian Canadian society. That experience was hidden for most of Canada’s history, until Survivors of the system were finally able to find the strength, courage, and support to bring their experiences to light in several thousand court cases that ultimately led to the largest class- action lawsuit in Canada’s history. Summary of the Final Report of the Truth and Reconciliation Commission of Canada, 2015 PPN101 Fall 2024 Week 7 Honouring the Truth, Reconciling for the Future For over a century, the central goals of Canada’s Aboriginal policy were to eliminate Aboriginal governments; ignore Aboriginal rights; terminate the Treaties; and, through a process of assimilation, cause Aboriginal peoples to cease to exist as distinct legal, social, cultural, religious, and racial entities in Canada. The establishment and operation of residential schools were a central element of this policy, which can best be described as “cultural genocide.” The Truth and Reconciliation Commission of Canada was a commission like no other in Canada – spending 6 years travelling to all parts of Canada to hear from the Aboriginal people who had been taken from their families as children, forcibly if necessary, and placed for much of their childhoods in residential schools. Summary of the Final Report of the Truth and Reconciliation Commission of Canada, 2015 Summary of the Final Report of the Truth and Reconciliation Commission of Canada, 2015 PPN101 Fall 2024 Week 7 Honouring the Truth, Reconciling for the Future The Commission heard from more than 6,000 witnesses, most of whom survived the experience of living in the schools as students. The stories of that experience are sometimes difficult to accept as something that could have happened in a country such as Canada, which has long prided itself on being a bastion of democracy, peace, and kindness throughout the world. Children were abused, physically and sexually, and they died in the schools in numbers that would not have been tolerated in any school system anywhere in the country, or in the world. Summary of the Final Report of the Truth and Reconciliation Commission of Canada, 2015 PPN101 Fall 2024 Week 7 Honouring the Truth, Reconciling for the Future Getting to the truth was hard, but getting to reconciliation will be harder. It requires that the paternalistic and racist foundations of the residential school system be rejected as the basis for an ongoing relationship. Reconciliation requires that a new vision, based on a commitment to mutual respect, be developed. It also requires an understanding that the most harmful impacts of residential schools have been the loss of pride and self- respect of Aboriginal people, and the lack of respect that non-Aboriginal people have been raised to have for their Aboriginal neighbours. Reconciliation is not an Aboriginal problem; it is a Canadian one. Virtually all aspects of Canadian society may need to be reconsidered. PPN101 Fall 2024 Week 7 Reconciliation will take some time. Truth and Reconciliation Commission In order to redress the legacy of residential schools and advance the process of Canadian reconciliation, the Truth and Reconciliation Commission makes the following Calls to Action: Child Welfare Education Language and culture Health Justice PPN101 Fall 2024 Week 7  Calls to Action for Health 1) To recognize and implement the health-care rights of Aboriginal people as identified in international law, constitutional law, and under the Treaties. 2) In consultation with Aboriginal peoples, to establish measurable goals to identify and close the gaps in health outcomes between Aboriginal and non-Aboriginal communities. Such efforts would focus on indicators such as: infant mortality, maternal health, suicide, mental health, addictions, life expectancy, birth rates, infant and child health issues, chronic diseases, illness and injury incidence, and the availability of appropriate health services. PPN101 Fall 2024 Week 7 Calls to Action for Health (cont’d) 3) To recognize, respect, and address the distinct health needs of the Métis, Inuit, and off-reserve Aboriginal peoples 4) To provide sustainable funding for existing and new Aboriginal healing centres to address the physical, mental, emotional, and spiritual harms caused by residential schools 5) To recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients PPN101 Fall 2024 Week 7 Calls to Action for Health (cont’d) 6) To increase the number of Aboriginal professionals working in the health-care field, ensure the retention of Aboriginal health-care providers in Aboriginal communities, and provide cultural competency training for all healthcare professionals 7) To call upon medical and nursing schools in Canada to require all students to take a course dealing with Aboriginal health issues, including the history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples, Treaties and Aboriginal rights, and Indigenous teachings and practices. This will require skills- based training in intercultural competency, conflict resolution, human rights, and anti-racism. PPN101 Fall 2024 Week 7 Structural Racism & Health Care “…legitimized and normalized spectrum of attitude, practices and policies that consistently results in chronic and continuous substandard outcomes for…Indigenous peoples.” (Potter & Perry, 2024,p.154) Funding & delivery of health care: Jordan’s Principle Equitable access, respect for Indigenous health knowledge: Joyce's Principle Child welfare system: removing children from their families Poverty: low income and related issues, such a poor housing conditions Racist assumptions about Indigenous patients: the story of Brian Sinclair PPN101 Fall 2024 Week 7  Brian Sinclair Ignored to death: Brian Sinclair's death caused by racism, inquest inadequate, group says… https://www.cbc.ca/news/canada/manitoba/wi nnipeg-brian-sinclair-report-1.4295996 What would you have done as an ER Nurse, meeting Brian Sinclair for the first time? PPN101 Fall 2024 Week 7  Cultural Safety You learned about Cultural Safety in Week 6. How does your understanding of Indigenous people, their history, the Calls to Action and their overall health needs affect and/or expand on your understanding of this concept? How has your understanding of Cultural Humility expanded? Cultural Competence? Cultural Safety Cultural Sensitivity Cultural Awareness PPN101 Fall 2024 Week 7  Indigenous People WHO’s (2007) understanding of Indigenous includes people who: Identify themselves and are recognized and accepted by their community as indigenous. Demonstrate historical continuity with pre-colonial and/or pre-settler societies. Have strong links to territories and surrounding natural resources. Have distinct social, economic or political systems. Maintain distinct languages, cultures and beliefs. Form non-dominant groups of society. Resolve to maintain and reproduce their ancestral environments and systems as distinctive peoples and communities. PPN101 Fall 2024 Week 7 United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) “It establishes a universal framework of minimum standards for the survival, dignity and well-being of the indigenous peoples of the world… … it elaborates on existing human rights standards and fundamental freedoms as they apply to the specific situation of indigenous peoples.” (Source: United Nations Declaration on the Rights of Indigenous Peoples | United Nations For Indigenous Peoples Adopted by the UN General Assembly on 13 September 2007 Canada voted against it in 2007 (1 of 4 countries who did so) but officially endorsed it in 2016. PPN101 Fall 2024 Week 7  Indigenous People and the Metaparadigm concept of Health Health is a concept that has multiple meanings. It is related to quality of life, is individually defined and is in dynamic interaction with the environment. Individuals, families, groups, communities and society share responsibility for health. The major principles of primary health care: health promotion, accessibility, public participation, appropriate use of technology and multi-disciplinary collaboration, are seen as fundamental in achieving health for all. Student Handbook, Collaborative Program, 2024-25 How does this concept of health resonate with the TRC Calls to Action? PPN101 Fall 2024 Week 7  Social Determinants of Health (introduction) Social determinants of health refer to a specific group of social and economic factors within the broader determinants of health. These relate to an individual's place in society, such as income, education or employment. Experiences of discrimination, racism and historical trauma are important social determinants of health for certain groups such as Indigenous Peoples, LGBTQ and Black Canadians. https://www.youtube.com/watch?v=8PH4JYfF4Ns  Health continued… It is imperative that nurses understand the social determinants of health though an Indigenous lens, which helps to explain the underlying economic and social conditions that shape health / health concerns. For example, impaired access to appropriate and adequate housing, income, education and health care, as a result of historical colonialism and current day post-colonial racism – significantly contributes to these health concerns. PPN101 Fall 2024 Week 7  Social determinants of Health through an Indigenous lens 1) Proximal determinants: direct influence on health, e.g. poor diet / limited access to nutritious food; lack of exercise; substance abuse; smoking 2) Intermediate determinants: indirect influence on health, e.g. poor community infrastructure, resources and underfunded education systems (leading to lower education and income levels; poorer living conditions) 3) Distal determinants: MOST influence on health, e.g. historical, political, social and economic contexts from which intermediate and proximal social determinants of health are constructed, such as stable governance, competent leadership, and fair distribution of power and resources. Potter and Perry, 2024, p.161 PPN101 Fall 2024 Week 7  Indigenous People’s health and Nursing practice Fundamental aspects of nursing practice can be related to Indigenous people’s values, health and well being Important values include: 1) Respect 2) Trust 3) Spirituality Although there may be similarities, different Indigenous groups have their own interpretations and may emphasize unique beliefs, world views and theories of Indigenous health. In caring for Indigenous people, PPN101 Fall 2024 Weeknurses 7 must work Two-Eyed Seeing in Health Care A perspective that utilizes both Western health care knowledge and Indigenous knowledge, combining the strengths of each to better meet the health care needs of indigenous people. Grounded in nurturing positive relationships; a relational approach that focuses on building trust. The FIRST approach: practices to enhance cultural safety Family Information Relationship Safe Space Treatment (Sylliboy & Hovey, 2020) PPN101 Fall 2024 WeekFrom: 7 http://www.integrativescience.ca/Principles/TwoEyedSeeing/  Racism and impact on health and well being Racial scholars argue that racism produces rates of morbidity, mortality, and overall well-being that vary depending on socially assigned race. Eliminating racism is therefore central to achieving health equity, but this requires new paradigms that are responsive to structural racism's contemporary influence on health, health inequities, and research. Think about what’s happened, and what’s happening in our world today. Are we on the cusp of a new paradigm?? What does this mean in terms of equitable health care – for all? PPN101 Fall 2024 Week 7 Working with Canada’s Indigenous people Case study You are the coordinator for a liver transplant team. Mr. S. comes to see you for his pre-evaluation. He is an Indigenous man with liver cancer who lives on a reserve a couple of hours drive away from Toronto. Over the course of a few months, you meet with him three times to explain the process for a liver transplant and answer any questions. He attends all appointments and appears to understand your explanations. On the day of a procedure to place radiation beads into his liver to combat the liver cancer, he does not show up and you cannot reach him. He calls you 2 weeks later, saying that he was too scared to come in for the procedure. (Adapted from Potter & Perry, 2019, p. 151) PPN101 Fall 2024 Week 7  Case study questions Using the concepts of cultural safety and humility, and considering the historical context of Indigenous Canadians’ experiences, discuss the following: What may have kept Mr. S. from attending his procedure? What could you, as a nurse, do to encourage Mr. S. to follow through with treatment plans? What other concerns do you have about Mr. S., beyond his health needs? What questions would you ask? PPN101 Fall 2024 Week 7 Other important video clips https://www.youtube.com/watch?v=MkxcuhdgIw Y https://www.youtube.com/watch?v=pWK6ChJw8 hs https://www.youtube.com/watch?v=a2tOddj6ypk https://www.youtube.com/watch?v=IXr-Cfj3EPM PPN101 Fall 2024 Week 7 Presentations Next Week! PPN101 Fall 2024 Week 7 References Astle, B.J., Duggleby, W., Potter, P.A., Perry, A.G., Stockert, P.A. & Hall, A.M. (2024). Potter and Perry’s Canadian Fundamentals of Nursing (7th Cdn. ed.). Elsevier. Sylliboy, J. & Hovey, R. (2020). Humanizing indigenous people’s engagement in health care. Canadian Medical Association Journal, 192 (3), E70-2.