Nursing students focus on Indigenous health in new University of Calgary course

A new course offered to nursing students at the University of Calgary is shining a light on the impacts of colonization on the health experiences of Indigenous Peoples.

The required first-year course — co-created by an Indigenous scholar, an elder and an associate professor of nursing — is a key step in a wider push to incorporate Indigenous history and wellness into the nursing curriculum.

"My hope is they will learn how to be caring and to be compassionate, empathetic and to practise what's often called cultural humility … and understand that every single interaction they have with every single patient is a sacred act and a sacred encounter," said Michelle Scott, associate dean of Indigenous education and assistant professor (teaching) in the faculty of nursing.

According to Scott, a Mi'kmaq scholar, the creation of the course was sparked by the Truth and Reconciliation Commission's call to action No. 24, which urged nursing and medical schools to create courses for Indigenous education.

During the first eight weeks, students learn key historical context starting with Indigenous ways prior to colonization.

"Understanding that before contact there were health systems in place here," said Scott, noting they go on to study policies, including the Doctrine of Discovery, the Indian Act, residential schools and the Sixties Scoop.

"The students are really learning a lot about … assimilative policies that have inflicted colonial violence on Indigenous Peoples and the ongoing effects of this."

• Racism, discrimination may lead to First Nations patients leaving emergency rooms: Alberta study
• CMA apology a first step toward healing medical harms against Indigenous people, advocates say

The course then shifts into broader discussions, including how to be a good ally through the practice of nursing.

"This isn't about facts and dates and figures. This is about making meaning so that … you can enact good care to everyone, but especially to our Indigenous relatives."

The new course comes at a time when there are growing calls for steps to address systemic racism and inequities in health care.

"There is a dire importance for us to instill in these students from the very get-go the importance of "stop harming our people,'" said Scott, quoting advice given by a Blackfoot scholar and nurse who recently gave a class lecture.

Elder plays key role

There are 150 students enrolled, and Lakota Dakota Elder Evelyn Good Striker, who helped develop the course, speaks during every class.

"She says something and you could hear a pin drop," said Scott, who sees how Good Striker's stories enrich the students' understanding.

"She is a survivor of residential school. She went to day school. She's had so many experiences that she can speak into, and the students get to learn from a first voice of what happened."

• Photo appearing to show elder on hospital floor in Thunder Bay, Ont., raises concerns about Indigenous care
• CMA apologizes for harms to First Nation, Inuit and Métis Peoples

Heather Bensler, who teaches nursing at the University of Calgary and also helped create the class, sees students coming out of high school with "textbook knowledge" but lacking insight into how the lives of Indigenous people continue to be impacted.   

"When patients who are … Indigenous fear coming into health-care settings because they fear the way they will be perceived, then we have a problem," said Bensler, an associate professor and assistant dean in the faculty of nursing

"And it's an ethical responsibility to be able to provide culturally safe care … to both support health practices and to recognize and disrupt anti-Indigenous racism — and racism in general — that occurs in health care."

She hopes the information and stories shared equip students to engage with Indigenous patients in a positive way when they embark on their nursing careers.

"We can't make assumptions about people and what they want. But we can come with curiosity and openness and kindness.… And then if there is harm, they recognize it and know what to do."

Scott and Bensler are now working on next steps. They've created a framework to embed Indigenous health into the entire nursing curriculum. Part of that framework includes a focus on anti-Indigenous racism.

"We do know there is medical racism in Canada," said Scott.

"We're teaching our students how to recognize … racism in health care towards Indigenous peoples, then how to interrupt, how to disrupt [and] to be able to say 'wait a second, that's not OK.'"