PPN101 - week 7

PPN101 - week 7

  • Define the Calls to Action for Health in the Truth and Reconciliation Commission of Canada report.
  • Define structural racism and how it can be manifested in the health care system.
  • Understand the history of Residential Schools and the impact on survivors today.
  • Expand on the concept of cultural safety and its relevance for Indigenous people in Canadian healthcare.
  • Describe fundamental aspects of nursing practice related toIndigenous people’s values, health and well-being.
  • Discuss the relevance of two-eyed seeing for nursing care in Canada.
  • Describe the UNDRIP and its relevance to nursing practice

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 - Euro-Christian Canadian culture
  • The central goals of canada's aboriginal policy were to eliminate aboriginal governments, ignore their rights, terminate the treaties, and through the process of assimilation, cause aboriginal peoples to cease to exist in every aspect in Canada
    • Best described as “cultural genocide”
  • The Truth and Reconciliation Commision of Canada was a commission that spent 6 years travelling to all parts of canada to hear from the aboriginal people who had been taken from their families as children and places into residential schools
  • The Commision heard from over 6000 witnesses
  • Getting reconciliation is a hard process that requires rejecting the racist foundations of residential school system
  • It requires a new relationship based on commitment and mutual respect be reached
    • 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 and been raised to have for their aboriginal neighbours

Calls to action

  • Child welfare
  • Education
  • Language and culture
  • Health
  • Justice

Calls to action for health

  • To recognize and implement the health-care rights of Aboriginal people as identified in international law, constitutional law, and under the Treaties.
  • 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
  • To recognize, respect, and address the distinct health needs of the Métis, Inuit, and off-reserve Aboriginal peoples
  • To provide sustainable funding for existing and new Aboriginal healing centres to address the physical, mental, emotional, and spiritual harms caused by residential schools
  • 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
  • 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
  • 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

Structural racism

  • Legitimized and normalized spectrum of attitude, practices, and policies that consistently results in chronic and continuous substandard outcomes for indigenous peoples

Indigenous people

  • 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
  • Resolve to maintain and reproduce their ancestral environments and systems as distinctive peoples and communities

Social determinants of health through an indigenous lens

  • Proximal determinants → direct influence on health
    • Ex. poor diet, limited access to nutritious food, lack of exercise, smoking
  • Intermediate determinants → indirect influence on health
    • Ex. poor community infrastructure, resources, underfunded education system
  • Distal determinants → most influence on health
    • Ex. historical, political, social, and economic contexts where social determinants of health are constructed (stable governance, fair distribution of power and resources, competent leadership)

Indigenous peoples health and nursing practice

  • Fundamental aspects of nursing practice can be related to indigenous peoples values, health and wellbeing
  • Values include → respect, trust, spirituality
  • Different indigenous groups have their own interpretations and may emphasize unique beliefs, world views, and theories of indigenous health

Two-eyed seeing in health care

  • A perspective that utilizes both western health care knowledge and indigenous knowledge
  • Combines their strengths to better meet health care needs of indigenous people
  • Grounded in nurturing positive relationships focused on building trust
  • FIRST approach → enhances cultural safety
    • Family
    • Information
    • Relationship
    • Safe Space
    • Treatment