Understanding Race and Racism in Nursing: Insights from Aboriginal Nurses (original) (raw)
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International Journal of Nursing, 2014
The work-life experiences of Aboriginal nurses in Atlantic Canada have been an understudied field. This paper will discuss the socio-political context of Aboriginal nursing, a major theme of a recent study which investigated the work-life experiences of Aboriginal registered nurses in Atlantic Canada. This major theme will be presented under three sub-headings; band politics, government-band relationship, and access to resources. The purpose of the study was to understand the quality and nature of their work-life as this understanding is fundamental to the development of effective health care programs for Aboriginal peoples. The research design was a grounded theory informed by community based participatory research (CBPR) approach. The primary mode of data collection was interviews with 22 registered Aboriginal nurses in the Atlantic region of Canada and constant comparative method facilitated data analysis. Atlas ti computer software was used for storage and data management. The discussion of these findingsilluminate the centrality of Aboriginal nursesin the delivery of healthcare in Aboriginal communities andprovides evidence of how Aboriginal nurses are delivering programs in the community. Implications for practice as Aboriginal nurses work to addressAboriginal health care and some suggestions for improving the work-life of Aboriginal nurses including some leadership and capacity building strategies are presented.
Caring About Racism: Early Career Nurses' Experiences With Aboriginal Cultural Safety
2017
The Aboriginal population in Canada is the youngest and most rapidly growing demographic in the country, and more than half of the 1.4 million Aboriginal people in Canada live in urban centres (Aboriginal Affairs and Northern Development Canada, 2013). As a result, all nurses can expect to provide nursing care to Aboriginal peoples during the course of their work, regardless of the setting of their employment. Since the beginning of the new millennium, however, Canadian researchers have documented that Aboriginal people encounter racism and discrimination at the hands of health professionals when they access health care in this country. In an effort to address this racism and improve the experience of Aboriginal peoples in health care, the Canadian Association of Schools of Nursing (2013) now recommends that undergraduate nursing students receive cultural safety education during their nursing programs. This recommendation is significant because cultural safety differs in important w...
2018
The purpose of this study was to critically examine the sociocultural context of nursing education as an institution. Using a postcolonial feminist theoretical framework and institutional ethnography, I illuminated the institutional complex of nursing education. This study addressed the following research questions: 1) How do practices, programs, and policies coordinate social relations within the institution of nursing education; and 2) How are Indigenous students' everyday lives shaped by the institution of nursing education? Multiple methods were used to collect data, including: interviews, observations, and text analysis. Interviews were conducted with students, educators, and administrators and others involved in nursing education. Observations were conducted both formally, during interviews and meetings and informally, during my daily work within nursing education. Texts were collected to further explicate the institutional complex. The findings from this study revealed that race and class ruled the institution. Analysis exposed two irreconcilable social relations: Identifying as Indigenous and Identifying as a Nurse, that were central work processes within nursing education. The intersection of race and class was organized around Cultural Competence that was prevalent throughout institutional discourse. Cultural competence reproduced colonial ideology that provided the basis for dominant knowledge and shaped inclusionary/exclusionary practices. Thus, idealized practices that were aimed at the inclusion of Indigenous students ran contrary to intentions, as students were socially stratified based upon race and class relations. The findings illuminate the need to cultivate additional attentiveness and action related to social inequities within nursing education. Recommendations have been made related to education, policy, and research.
International Journal of Environmental Research and Public Health
Background: Racism is responsible for health inequity and the harm perpetrated upon Aboriginal and Torres Strait Islander peoples by white institutions, building on attitudes and beliefs dominated by assumptions of white superiority. The National Aboriginal and Torres Strait Islander Health Curriculum Framework ‘Curriculum Framework’, released in 2014, was introduced to provide a framework for nursing programs and included the introduction of discrete Aboriginal and Torres Strait Islander health courses to draw attention to the relationship between racism health outcomes of Aboriginal and Torres Strait Islander peoples within health care settings. Methods: Using an Indigenist research paradigm with Colonial Critical Race Theory as the methodology and framework, this study presents a document analysis of discrete Aboriginal and Torres Strait Islander health courses taught in undergraduate nursing programs at 31 Australian Universities. Results: This work draws on the collective activ...
Engaging with Racism: An Opportunity to Advance Nursing Practice
This paper will present findings related to discrimination and racism from a study that examined White nurses’ perceptions of increasing diversity in Canadian nursing using grounded theory approach under the tenets of participatory Action Research. Methodology: This was a qualitative study using a grounded theory approach informed by the tenets of participatory action research. Twenty-one registered nurses who self-identified as White/Caucasian and who represented all levels of health care within five health facilities in a region of Canada were interviewed. The sample recruitment was facilitated by theoretical sampling. Data analysis was done using a constant comparison process. Atlas-ti facilitated data management and storage. Results: The nurses affirmed the presence of racism and discrimination within the Canadian nursing profession and the larger health care system and the need for change. However, recognizing racism and discrimination in issues of competency and standard-setting can challenge the cultural beliefs of nurses about the superior quality of Canada’s nursing professionals and the ‘equal opportunities’ available to all who meet Canadian standards. Conclusions and Implications: The successful integration of diverse nurses into the nursing profession will ultimately require change on the part of the nursing profession as a whole as well as individual Caucasian Canadian nurses and diverse nurses to address difference in positive ways. Increasing diversity among Canadian nurses changes Canadian nursing. We all need to adapt to this evolving reality. Keywords: Racism, Discrimination, Nursing The International Journal of Health, Wellness and Society, Volume 5, Issue 2, June 2015, pp.45-54. Article: Print (Spiral Bound). Published Online: June 16, 2015 (Article: Electronic (PDF File; 467.885KB)).
Aboriginal nursing education in Canada: an update
The Canadian nurse, 2008
Canada does not have enough aboriginal nurses and aboriginal nursing faculty. Consequently, there is an inadequate number of nurses to meet both on- and off-reserve and community health care staffing needs. In 2002, Health Canada asked the Canadian Association of University Schools of Nursing to facilitate a national task force that would examine aboriginal nursing in Canada. The task force engaged in an extensive literature review, conducted a national survey of nursing programs, and explored recruitment and retention strategies. In 2007, the association prepared an update on the current status. In this article, the authors review the progress made during the intervening five years in the recruitment, retention and education of aboriginal nursing students.
Uncovering Aboriginal Nursing Knowledge through Community Based Participatory Research (CBPR)
Indigenous Policy Journal, 2011
The significant under-representation of Aboriginal peoples in the health professions is problematic. Increasing representation is a promising strategy to narrow the gap in access to appropriate health care for Aboriginal peoples. A critical examination of the experiences of Aboriginal nurses working within the system enhances knowledge for promoting increased representation. This paper presents the Community Based Participatory Research (CBPR) process of a study with Aboriginal nurses in Atlantic Canada. The paper describes the innovative use of capacity building strategies to actively engage team members in all aspects of the research and in addressing the three goals of CBPR; research, education and action. The paper concludes with discussion of the significant role that CBPR can play in enabling people, especially those who have been historically marginalized, to reclaim their voices and engage in the participatory appraisal of the issues influencing the health and health care of Aboriginal peoples in the region.
Journal of Transcultural Nursing, 2014
Purpose: Substantial health disparities exist between Māori—the indigenous people of Aotearoa New Zealand—and non-Māori New Zealanders. This article explores the experience and impact of racism on Māori registered nurses within the New Zealand health system. Method: The narratives of 15 Māori registered nurses were analyzed to identify the effects of racism. This Māori nursing cohort and the data on racism form a secondary analysis drawn from a larger research project investigating the experiences of indigenous health workers in New Zealand and Canada. Jones’s levels of racism were utilized as a coding frame for the structural analysis of the transcribed Māori registered nurse interviews. Results: Participants experienced racism on institutional, interpersonal, and internalized levels, leading to marginalization and being overworked yet undervalued. Discussion and Conclusions: Māori registered nurses identified a lack of acknowledgement of dual nursing competencies: while their clin...
Nursing students' perspectives of the health and healthcare issues of Australian Indigenous people
Nurse Education Today, 2015
Background: Indigenous people are the most disadvantaged population within Australia with living conditions comparable to developing countries. The Bachelor of Nursing programme at the University of Western Sydney has embedded Indigenous health into the undergraduate teaching programme, with an expectation that students develop an awareness of Indigenous health and healthcare issues. Aim: To gain insight into students' perceptions of Indigenous people and whether the course learning and teaching strategies implemented improved students' learning outcomes and attitude towards Indigenous people and Indigenous health in Australia. Design: A mixed methods prospective survey design was chosen. Methods: Students enrolled in the Indigenous health subject in 2013 were invited to complete pre-and post-subject surveys that contained closed-and open-ended questions. Students' socio-demographic data was collected at baseline, but the 'Attitude Toward Indigenous Australians' (ATIA) scale, and the 3-item Knowledge, Interest and Confidence to nursing Australian Indigenous peoples scale were administered at both pre-and post-subject surveys. Results: 502 students completed the baseline survey and 249 students completed the follow-up survey. There was a statistically significant attitudinal change towards Indigenous Australians, measured by the ATIA scale, and participants' knowledge, intent to work with Indigenous Australians and confidence in caring for them increased significantly at follow-up. Based on the participants' responses to open-ended questions, four key themes emerged: a) understanding Indigenous history, culture and healthcare; b) development of cultural competence; c) enhanced respect for Indigenous Australians' culture and traditional practices; and d) enhanced awareness of the inherent disadvantages for Indigenous Australians in education and healthcare. There were no statistically significant socio-demographic group differences among those who commented on key themes. Conclusion: Addressing health inequalities for Indigenous Australians is paramount. Nurses need cultural awareness and sensitivity to deliver culturally appropriate healthcare in Australia.