Introducing 

Prezi AI.

Your new presentation assistant.

Refine, enhance, and tailor your content, source relevant images, and edit visuals quicker than ever before.

Loading content…
Loading…
Transcript

Enhancing the In-Patient Experience for Indigenous People by Utilizing Trauma-Informed Care Within the Context of the Western Healthcare System: A Group Project

By: Farah Abdi, Auldrey Basallo, Cassie MacDonald, River Martin

19/04/2022

Why is it Important?

Land Acknowledgment

Aski Pumenikewin

Land Acknowledgment

Our names are Farah Abdi, Auldrey Basallo, Cassie MacDonald, and River Martin. We are a blend of settlers, immigrants, and second-generation immigrant settlers living and going to school on the traditional lands of Nisichawayasihk Cree Nation (NCN) in Thompson, Manitoba. We recognize the colonial role of the healthcare system in Thompson as it has historically excluded sacred Indigenous teachings regarding spirituality and health, as well as historically excluded Indigenous people from participating as healthcare workers. Colonial violence continues to negatively affect Indigenous people within the context of the healthcare system. We make this statement to affirm our commitment to improve the healthcare system's practices. We are thankful for the opportunity to live, work and gather on these lands while simultaneously learning how to use the lands well. We acknowledge that the lands we gather on are part of Treaty 5 and many Indigenous groups now reside here, and the spiritual practices, languages and cultures of each group continue to positively influence us. In light of our discussion today, we would like to draw attention to the Aski Pumenikewin (NCN Land Code) which is an ongoing effort of NCN to self-govern the use of their land and move away from the Indian Act. As well, NCN has made efforts to create an urban development in Thompson. As we continue to learn and grow in our relationships to the people, and physical presence of this space, we invite anyone present to discuss the words we have said so we can reciprocally learn and make efforts towards continued improvement.

(Northern Alberta Health Services Library Association, 2019)

https://www.ncncree.com/about-ncn/photo-gallery/#iLightbox[gallery_image_1]/1

Treaty 5: The Winnipeg Treaty (1875)

Traditional lands of Denesuline, Ininew, Anishaabe and Anishininew people (Rarihokwats, 2019).

Treaty 5

(Signed 1875)

https://recherche-collection-search.bac-lac.gc.ca/eng/Home/Search?q=treaty%20medal&DataSource=Images&

Aski Pumenikewin

This land code will restore power over the land to NCN and remove the effects of the paternalistic Indian Act

(NCN, n.d.a).

(NCN Land Code)

https://www.ncncree.com/about-ncn/our-lands/aski-pumenikewin-ncn-land-code/

Urban Development: Thompson

Urban Development

NCN has developed an urban reserve at the Mystery Lake complex in Thompson. This is one way that NCN has been able to restore sovereignty over their traditional lands for current and future NCN people.

(NCN, n.d.b).

https://m.facebook.com/104487694767249/photos/a.104487764767242/104508561431829/?type=3

What's the issue?

The effect of

  • Colonization
  • Cultural Genocide
  • Exclusion
  • Dehumanization
  • Western Healthcare Systems

On the

  • Mental, physical, emotional, spiritual and social health of Indigenous people

(Brooks-Cleator et al., 2018; Venugopal, 2021)

What's the Issue?

https://www.nami.org/Blogs/NAMI-Blog/October-2019/Mental-Health-Conditions-Seen-in-Childhood

Why is it an issue?

Why is it an issue?

Created inequities between Indigenous and non-Indigenous people:

  • Mentally
  • Physically
  • Emotionally
  • Socially
  • Spiritually

(Hadjipavlou et al., 2018; Harding et al., 2021; Venugopal, 2021; Cleator et al., 2018)

https://pdhpe.net/better-health-for-individuals/what-does-health-mean-to-individuals/meanings-of-health/dimensions-of-health/

Effects of mental health on client/population

https://www.canada.ca/en/health-canada/services/substance-use.html

https://www.vectorstock.com/royalty-free-vector/identity-crisis-and-personality-loss-concept-vector-36785962

Effects of mental health on client/population

  • Depression
  • Addiction
  • Suicidal ideation/suicide attempts
  • Isolation
  • Loss of identity
  • Mistrust of western-based healthcare
  • Loss and grief

(Hadjipavlou et al., 2018; Harding et al., 2021; Venugopal, 2021; Cleator et al., 2018)

https://www.mountelizabeth.com.sg/healthplus/article/dealing-with-depression

https://www.nytimes.com/2020/03/23/well/family/coronavirus-loneliness-isolation-social-distancing-elderly.html

Why is Trauma-Informed Care Significant to Nursing?

https://www.traumainformedcare.chcs.org/what-is-trauma-informed-care/

CRNM Entry-Level Competency, 7.3:

College of Registered Nurses of Manitoba (CRNM)

"Advocate for the use of Indigenous health knowledge and healing practices in collaboration with Indigenous healers and Elders consistent with the Calls to Action of the Truth and Reconciliation Commission of Canada."

(CRNM, 2019).

https://wiki.mcmaster.ca/Northern_Health/mod2:session3

Barriers to Healthcare Access for Indigenous Patients:

Barriers

https://www.google.com/search?q=hurdles&sxsrf=APq-WBviBK7vKgiNF65-ZeDApbtMCFm4Jg:1650342266979&source=lnms&tbm=isch&sa=X&ved=2ahUKEwicztKEpJ_3AhWKaM0KHUgvA44Q_AUoAXoECAIQAw&biw=1280&bih=632&dpr=2#imgrc=mh7Ofl6SqEejtM

  • Proximal: Geography, education attainment, and negative biases among healthcare providers resulting in a lack of adequate immediate care

  • Intermediate: Employment and income inequities; and health education systems that are not accessible to Indigenous people

  • Distal: colonialism, racism and social exclusion resulting in limited involvement of indigenous people in policy making and planning to address community healthcare needs

(Nguyen, 2020).

The Impact of ACES

Adverse Childhood Experiences (ACES)

  • Cardiovascular disease
  • Respiratory disease
  • Cancer
  • Mental health challenges
  • Memory issues
  • Decision making issues
  • Difficulty articulating information

(Oral et al., 2016)

https://www.google.com/search?q=sad+teddy+bear&tbm=isch&ved=2ahUKEwjMn4S_pJ_3AhV_sHIEHZpnDzgQ2-cCegQIABAA&oq=sad+teddy+bear&gs_lcp=CgNpbWcQAzIFCAAQgAQyBQgAEIAEMgUIABCABDIFCAAQgAQyBQgAEIAEMgUIABCABDIFCAAQgAQyBQgAEIAEMgUIABCABDIFCAAQgAQ6BwgjEO8DECc6BggAEAgQHjoICAAQgAQQsQM6BAgAEEM6BwgAELEDEENQsBBYySlgwCpoAHAAeACAAeUBiAH5DJIBBjAuMTEuMZgBAKABAaoBC2d3cy13aXotaW1nwAEB&sclient=img&ei=9TleYozRGf_gytMPms-9wAM&bih=632&biw=1280#imgrc=_qk9aWuOwxBqXM

Trauma Informed Care- TIC

What Now?

It has been said that the ‘‘systematic neglect of culture in health is the single biggest barrier to advancement of the highest attainable standard of health worldwide.’’

(Harding, 2021)

https://www.google.com/search?q=healthcare+love&tbm=isch&ved=2ahUKEwiChKz8pJ_3AhW9sHIEHeSAAsQQ2-cCegQIABAA&oq=healthcare+love&gs_lcp=CgNpbWcQAzIFCAAQgAQyBAgAEBg6BwgjEO8DECc6BwgAELEDEEM6BAgAEEM6CggjEO8DEOoCECc6CAgAEIAEELEDOgYIABAIEB5Q4ARY5CFg3iJoAXAAeAGAAYgBiAGXEZIBBDAuMTmYAQCgAQGqAQtnd3Mtd2l6LWltZ7ABCsABAQ&sclient=img&ei=dTpeYsL1PL3hytMP5IGKoAw&bih=632&biw=1280#imgrc=TqVJKCYLWAZ4gM&imgdii=v6TUzK8SXz-aRM

Trauma informed Care in the sense of cultural safety.

Intervention

https://passthefeather.org/jessica-somers/

"All my relations": About this study

Including Elder's

in Patient care

https://www.vernonmorningstar.com/news/interior-health-commits-2-million-annually-for-first-nations-elders-care/

Participants:

  • 41 patient participants with diverse indigenous backgrounds were inlcuded in the study
  • age ranged from 25 to 61 years old
  • 65% female
  • 71% had a history of foster care
  • 61% had parents who attended residential schools
  • 27% had themselves atteneded residential schools
  • The Elders came from 4 different territories

The Study:

  • they evaluated the impact of the Elder's program using a mixed-method investigation.
  • they have interviewed the participants multiple within 6 months

(Hadjipavlou et al,. 2018)

Cultural Safety in the Study

Cultural Safety

  • Theme 1: Finding healing after a prolonged period of seeking and desperation
  • Theme 2: Strengthening cultural identity and belonging
  • Theme 3: Developing Trust and "opening up"
  • Theme 4: Coping with Losses
  • Theme 5: Engaging in ceremony and spiritual dimensions of care as a resource for hope

(Hadjipavlou et all,. 2018)

https://www.todocanada.ca/city/calgary/event/cifrs-indigenous-art-exhibit/

Nurse's Role

Nurse's Role

  • Collaboration/ Partnerships
  • Power sharing
  • Address the broader context of the patient's life
  • Safe environment
  • Organizational and individual level of self-reflection
  • Training for health-care providers

(Brooks-Cleator et al., 2018)

https://www.ualberta.ca/folio/2020/08/u-of-a-online-course-on-indigenous-culture-sees-popularity-surge-amid-black-lives-matter-movement.html

In summary, the effects of colonization, cultural genocide, and western-based healthcare systems have created mental, physical, social, and spiritual health inequities between Indigenous and non-Indigenous people. Some barriers they face when accessing healthcare include, but are not limited to negative biases among healthcare providers resulting in lack or inadequate immediate care, employment and income inequities, colonialism, racism, and social exclusion resulting in limited involvement of Indigenous people in policy making and planning to address community healthcare needs. Trauma-informed care, can help healthcare providers to understand how traumatic experiences can affects a person’s health. It can also improve patient care by creating more positive health care experiences and by promoting healthy relationships between patients and the health care team. Having Elders as part of the health care team can also help provide trauma- informed care in the sense of cultural safety. Having them as part of the team can help create an environment where Indigenous people can feel safe and get the treatments they need. Nurses also have a role to play and apply trauma-informed care into their everyday practice by working with the community, respecting Indigenous culture and practices, providing a safe environment, self-reflecting and attending trainings to gain more knowledge of Indigenous culture.

Conclusion

Group Discussion

Question: What do you think are the benefits of having a paid Elder on staff vs. a volunteer?

Do the Kahoot!

Group Discussion

https://www.inc.com/kat-boogaard/5-mistakes-youre-making-when-asking-questions.html

References

Brooks-Cleator, L., Phillipps, B., & Giles, A. (2018). Culturally safe health initiatives for

Indigenous peoples in Canada: A scoping review. Canadian Journal of Nursing Research, 50(4), 202-213. DOI: 10.1177/0844562118770334

College of Registered Nurses of Manitoba. (2019). Entry-level competencies (ELCs) for

the practice of registered nurses (2019). https://crnm.mb.ca/wp-content/uploads/2022/01/Entry-Level-Competencies-ELCs.pdf

Fiolet, R., Roberts, V., & Bloomer, M. (2021). Trauma-informed care: Why is it so

important in primary health care? Collegian, 28(3), 253-254. https://doi.org/10.1016/j.colegn.2021.03.005

Fleishman, J., Kamsky, & H., Sundborg. (2019). Trauma-informed nursing practice.

Online Journal of Issues in Nursing, 24(2), 1–9. https://doi.org/10.3912/OJIN.Vol24No02Man03.

Harding, J., MacKinnon, K., Sangster-Gormley, E., Gordon, C. (2021). Indigenous

peoples’ positive experiences of culturally safe health care: A qualitative systematic review protocol. JBI Evidence Synthesis, 19(9), 2434-2440. DOI: 10.11124/JBIES-20-00181

Kokokyi S., Klest B., & Anstey, H. (2021). A patient-oriented research approach to

addressing patients’ and primary care physicians’ opinions on trauma-informed care. PLOS ONE, 16(7), e0254266. https://doi.org/10.1371/journal.pone.0254266

Nguyen, N., Subhan, F., Williams, K., & Chan, C. (2020). Barriers and mitigating

strategies to healthcare access in Indigenous communities of Canada: A narrative review. Healthcare, 8(2), 112. https://doi.org/10.3390/healthcare8020112

Nisichawayasihk Cree Nation. (n.d.a). Nisichawayasi Aski Pumenikewin (NCN Land

Code). NCN Cree. https://www.ncncree.com/about-ncn/our-lands/aski-pumenikewin-ncn-land-code/

Nisichawayasihk Cree Nation. (n.d.b). Thompson Urban Reserve. NCN Cree. https://

www.ncncree.com/about-ncn/our-lands/thompson-urban-reserve/

Northern Alberta Health Libraries Association. (2019). NAHLA land acknowledgement,

template for personalization, definitions, and speaker protocol. https://www.chla-absc.ca/docs/NAHLALandAcnowledgement_4.pdf

Oral, R., Ramirez, M., Coohey, C., Nakada, S., Walz, A., Kuntz, A., Benoit, J., & Peek-Asa,

C. (2016). Adverse childhood experiences and trauma informed care: The future of health care. Pediatric Research, 79(1), 227-233.

Papadopoulos, I., Lazzarino, R., Wright, S., Logan, P., & Koulouglioti. (2021). Spiritual

support during COVID-19 in England: A scoping study of online sources. Journal of Religion and Health, 60(4), 2209–2230, https://doi.org/10.1007/s10943-021-01254-1.

Venugopal, J., Ninomiya, M., Green, N., Peach, L., Linklater, R., George, P., & Wells, S. (2021). A scoping review of evaluated Indigenous community-based mental wellness

initiatives. Rural and Remote Health, 21(1), 6203. https://doi.org/10.22605/RRH6203

World Health Organization. (2020). Practical considerations and recommendations for

religious leaders and faith-based communities in the context of COVID-19: Interim guidance. https://apps.who.int/iris/bitstream/handle/106

References

Learn more about creating dynamic, engaging presentations with Prezi