Foreword

Improving Health Outcomes of Indigenous People

Wendy Whitebear

The majority of my career and volunteer activities have been dedicated to the betterment of Indigenous people and communities. I strive to find positive outcomes for the pressing realities our people experience by working with like-minded people in every aspect of my life. In order to speak for those who cannot, I volunteer as a co-host of a local Indigenous women’s talk show “The Four” that brings a voice to these contemporary issues. Our goal is to tackle Indigenous stereotypes and encourage discussion on the political and social issues that have shaped our existence.

During my employment with the Indigenous Peoples’ Health Research Centre (IPHRC) I had the opportunity to meet allies such as Dr. Joan Wagner. As part of her ongoing research to identify solutions for inadequate health outcomes, especially for the Indigenous population, she became actively involved in a Saskatchewan Centre for Patient-Oriented Research project. Dr. Wagner expressed concern that the needs of First Nations people were not being met within the health care system. As she teaches students located in Treaty 4 and 6 territories, she is adamantly aware that she needs to educate future leaders who are sensitive to the diverse nature of Indigenous people within these territories.

I am acutely conscious of the fact that Indigenous people are over-represented in the health care system. This is a direct result of systemic policies developed to eradicate the Indigenous population from this country. These acts of cultural genocide have created extreme health disparities between Indigenous people and the general Canadian population. Without adequate knowledge of the true history of Indigenous people, racism and stereotyping will continue to be rampant among health care practitioners. Unless educators willfully guide our next generation of learners to develop into culturally sensitive leaders, this practice will continue and the health outcomes for the Indigenous population will remain the same or continue to deteriorate.

The modern social issues and poverty that plague Indigenous communities in our country adversely affect health outcomes. Indigenous people experience high rates of mental illness, alcoholism, fetal alcohol spectrum disorder, domestic violence, diabetes, and tuberculosis. Without holistic interventions and culturally sensitive care, these health issues will continue to spiral. For future leaders in the health care system, it is imperative to take historical factors into consideration, as well as to take the time necessary to work with each patient, while always being respectful of cultural needs.

Since the inception of the reserve system, residential schools, and the Indian Act, First Nations people have experienced inherently unequal power relations with the rest of the Canadian population. “Cultural Competence and Cultural Safety in Nursing Education: A Framework for First Nations, Inuit and Métis Nursing” outlines six core competencies that are essential in working with Indigenous patients and colleagues. This framework recognizes that mitigating factors have contributed to the poor health outcomes of Indigenous people. The post-colonial understanding of cultural competence encourages the learning required to explore these issues so that health care providers become more proficient leaders within the health care system.

In order to assist the learner in understanding that First Nations people have health views that are beyond the physical nature of institutional concepts, “Guidelines for Cultural Safety, the Treaty of Waitangi, and Maori Health in Nursing Education and Practice,” which explores the multidimensional beliefs of Indigenous people, is a vital resource. As with the Maori people, First Nations people are diverse in their cultural beliefs and practices. Saskatchewan is made up of five different linguistic groups: Cree, Saulteaux, Dakota, Nakota, and the Dene. Each group has its own unique customs and beliefs; however, they do share some similarities. For example, during a health crisis, families will gather to show support and to assist in providing healing energy to the patient. It is common for the family to be present until the crisis is over. It is important for the well-being of the family and the patient that this custom is respected.

Learning the true history of First Nations and Métis and being sensitive to their cultural needs will have a positive effect on the learner and also assist in improving the poor health outcomes of Indigenous people. Health care workers who acquire the necessary tools to become competent health practitioners and who utilize best practices when working with Indigenous patients will make a significant difference to our people. The teachings in Leadership and Influencing Change in Nursing also offer the learner the opportunity to build confidence, integrity, inspiration, and passion that will serve them well as leaders in the health care industry. The textbook guides the student to a deeper understanding of what it means to be culturally sensitive, and utilization of the additional references will enrich and enhance these nursing leadership skills in a meaningful way.

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Foreword by Wendy Whitebear is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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