Understand aboriginal health: What all nurses need to know
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1 CNA Webinar Series: Progress in Practice Understand aboriginal health: What all nurses need to know 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 Canadian Nurses Association, 2012
2 Debbie Grisdale BNSc, MHSc Policy Advisor Policy and Leadership Canadian Nurses Association Fjola Hart Wasekeesikaw, RN, MN Executive Director Aboriginal Nurses Association of Canada
3 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.
4 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.
5 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.
6 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.
7 Lisa Perley-Dutcher, RN, MN Director Aboriginal Health Human Resources Initiative University of New Brunswick
8 Cultural Competency & Safety: Working with Aboriginal Peoples in Canada Lisa Perley-Dutcher, RN, MN
9 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
10 My Context: Tobique First Nation (Wolastoqiyik People) Seven Sacred Teachings: Respect, Truth, Honesty, Humility, Wisdom, Courage and Love
11 Lisa Perley-Dutcher June 10, 2009
12 Some Common Core Aboriginal Values: 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
13 General Health Status of First Nations and Inuit Peoples in Canada Tuberculosis: 8-10x higher Diabetes estimates: 2-5x higher Cardiovascular disease: 3x higher Suicide/self-inflicted injury: Inuit rates 6-11x higher (Reading, 2009) Aboriginal youth aged 10 to 29 are 5-6x higher (Canadian Mental Health Association, 2013) )
14 Consider Colonization as a Social Determinant of Health Stella s Story
15 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)
16 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
17 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)
18 Recommendations for Health-care Providers 1) Learn appropriate names of Aboriginal peoples in Canada 2) Understand current sociodemographics of Aboriginal People in Canada 3) Learn traditional geographic territories & language groups 4) Impact of colonization on health status 5) Understand that sociodemographics 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 selfdetermination (Smylie, 2000)
19 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)
20 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
21 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
22 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)
23 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)
24 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
25 Woliwon, Wela lieg Merci Thank You
26 For more information: Debbie Grisdale Fjola Hart Wasekeesikaw Lisa Perley-Dutcher Photo credits: istock Canadian Nurses Association, 2012
27 Upcoming Webinar Upcoming webinars will be announced on August 7, 2013 Canadian Nurses Association, 2012
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