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Toward a Decolonized Future in Nursing

Decolonizing Canadian healthcare may be a massive and complex undertaking but, thanks to the 94 Calls to Action released in the Truth and Reconciliation Commission鈥檚 (TRC) final report, we now have a path forward.

Professor Archana Paul's class
Associate Professor Archana Paul (centre) and her class. Photo by Atmiya Jadvani.

Seven of the 94 Calls to Action to redress the legacy of residential schools and advance the process of reconciliation are specifically about healthcare reform and one in particular鈥擟all to Action #24鈥攁ddresses the changes needed at nursing and medical schools. Over the past few years, the community of scholars and learners at 快播视频鈥檚 School of Nursing within the Faculty of Health have heard the call and are starting to do the work.

鈥淭he goal is to better align the school of nursing with the Truth and Reconciliation calls to action,鈥 explains Kate Dunn, Assistant Professor and an Anishnaabe scholar at the School of Nursing within the Faculty of Health. 鈥淭he challenge is how to do this respectfully, tactfully and carefully, while maintaining requirements of the accrediting bodies.鈥

Kate Dunn
Kate Dunn

Dunn, who has worked on liver wellness and hepatitis C elimination in Indigenous communities, is a new appointment, who, in January, will teach Introduction to Social Justice and Advocacy in Nursing Practice. This is a second-year course in the process of being revised to come closer to meeting the central call in Action #24鈥攁 mandatory course in 鈥淎boriginal health issues鈥 including the history and legacy of residential schools.

This isn鈥檛 the only course at the School of Nursing that acknowledges the history of settler colonialism in Canada. Associate Professor Archana Paul says that, in her second-year course, Mental Health Across the Lifespan, the first two weeks are focused on the history of Indigenous people being harmed by institutions (including psychiatry), stigma as a source of discrimination, as well as trauma-informed care. Paul, who received the 2024 Council of Ontario University Programs in Nursing (COUPN) Award for excellence in teaching earlier this year, takes care to ensure the conversation is threaded throughout the rest of the course, with a goal to help future nurses become better patient advocates.

Vanesa S., a BScN Nursing student, says that Paul鈥檚 use of real-life examples of people harmed by the healthcare system, such as Brian Sinclair, who, in 2008, died in the waiting room of a Winnipeg hospital after not being seen for 34 hours, had a big impact.

鈥淚t was a case I wasn鈥檛 aware of and it really made me resolve to be sure to have my own reflective practice and check my own bias,鈥 she recalls.

It also inspired her to research the systems in which medical trauma has been鈥攁nd still is鈥攊nflicted on Indigenous people, such as pregnant women who are forced to leave remote communities to give birth, even when they are low-risk. Vanessa adds: 鈥淲ith everything that鈥檚 happened with the forced sterilizations and forced birth evacuations, it鈥檚 so important to be mindful not to retraumatize patients.鈥

鈥淪upporting the calls that Indigenous communities continually ask for involves, not only learning about the historical and contemporary issues, but also has to have a connection with activism.鈥

鈥 Associate Professor Ruth Rodney

In Health and Healing: Global Context of Nursing, a fourth-year class with three sections taught by three different educators, Ruth Rodney, Ivona Mostarac and Sandra Peniston, their shared goal is to delve into the history and current reality in a way that doesn鈥檛 tokenize the subject matter and takes exercises beyond merely performative gestures.

When it comes to land acknowledgements, for example, Rodney asks students to reflect on them in various ways by bringing in resources such as the 鈥淎lternative Campus,鈥 a Faculty of Environmental and Urban Change project that invites people to think critically about the land York is situated on.

鈥淚 think that, if we are really serious about it, there always has to be an action component,鈥 says Rodney. 鈥淪upporting the calls that Indigenous communities continually ask for involves, not only learning about the historical and contemporary issues, but also has to have a connection with activism.鈥

Sandra Peniston challenges her students to consider the role nursing has played in settler colonialism.

鈥淲e, as nurses, we were there in those residential schools, we were part of this,鈥 she says. 鈥淲e鈥檝e kind of whitewashed our nursing history but, whether it was in Canada, the United Kingdom or across Africa, we shaped colonialism as well. We need to own that.鈥

Students enrolled in The Canadian Health Care System鈥攁 third-year course taught by Mohammed Anwar Majid that examines residential schools, trauma and violence against women, including the national inquiry into Missing and Murdered Indigenous Women and Girls鈥攁re also encouraged to take action with an exercise that sees them write letters to the Minister of Health.

鈥淢y expectation was for students to provide some general recommendation but, instead, students have committed themselves to continuously exploring Indigenous history and culture, volunteering with Indigenous elders and knowledge keepers and advocating for Indigenous rights,鈥 says Majid. 鈥淚 am humbled to be in the presence of these future leaders and they are helping me become a better person.鈥

Often as not, students seem to be ahead of the curve when it comes to wanting more Indigenous content. Vanessa S., for example, would like more material about traditional medicine in the curriculum and more emphasis on different conceptions of well-being and ways of knowing.

Similarly, first-year nursing student, Jessica Houf, would like to see more of a strengths-based approach when it comes to learning about Indigenous health issues.

Nursing Simulation Centre
Nursing Simulation Centre

鈥淲e often talk about Indigenous health primarily in terms of disparity and framed as a problem,鈥 says Houf. 鈥淚鈥檇 like to see more about possibilities for improving health overall by incorporating Indigenous practices and Indigenous thinking.鈥

Houf adds that she鈥檚 begun exploring these topics for her own research papers and independent work, which she sees as part of the job of being a student as well as working on decolonization.

鈥淔or so long, we talked about the harm,鈥 says Karen Campbell, who teaches Qualitative Research Methods in Nursing. 鈥淎nd we need to talk about that. We need to continue to talk about cultural genocide and to understand the legacy of colonialism. And then we need to say, 鈥極kay, now what?鈥欌

鈥淪ome students are afraid to research within Indigenous populations because Indigenous populations have been harmed by researchers,鈥 Campbell adds. 鈥淏ut now we have to look at some ways that we can work with and collaborate with these groups.鈥

Associate Professor Lisa Seto Nielsen, who teaches a different section of Qualitative Research Methods, says it鈥檚 important to avoid burdening Indigenous colleagues by asking them to be responsible for educating settlers. 鈥淎 colleague pointed out that the work of decolonizing isn鈥檛 the work of Indigenous academics and scholars in the community,鈥 Nielsen notes. 鈥淚t's really our job to decolonize.鈥

And we鈥檙e only just getting started on the hard work, says Kate Dunn.

鈥淭here鈥檚 pressure to do things quickly, of course, but it鈥檚 been 150 years of colonizing education and you can鈥檛 just decolonize and re-indigenize in a few months,鈥 she points out. 鈥淚t鈥檚 a big process.鈥

鈥淚 think the greater conversation might even be, 鈥楬ow do we all take part in this process?鈥欌