Restoring balance through cultural safety & the medicine wheel

Restoring Balance through Cultural Safety & the Medicine WheelThe Canadian Federation of Mental Health Nurses 2013 National Mental Health Nurses Conference

To describe concepts related to the Medicine Wheel To broaden the understanding of Cultural Safety from an Aboriginal perspectiveTo identify the unique challenges faced by Aboriginal peoples and the need for a Balanced approach

Objectives

“We are like trees. Our roots are put down very deep. And we take things from the four directions and we take them into our lives. And if you pull us up by the roots, we are lost. We have to go back and find those roots, find those beginnings that are strong so that we can live a good life”.

Elder Betty McKenna, 2005.

Medicine Wheel Path to Wellness

The Medicine Wheel is a path, just like healthcare

Mental, spiritual, emotional, and physical health are addressed

Moving beyond our own culture is required to provide care, treatment, and support to clients from diverse backgrounds and experiences.

There are two parts of life that each person needs to pay attention to or risk imbalance…We cultivate our external self to fit into the current culture and times…We take care of our inner life by personal reflection…Through reflection we change and grow spiritually http://zone.biblio.laurentian.ca/dspace/bitstream/10219/387/1/NSWJ-V7-art6-p139-161.pdf

Mental Health

Invisible illness

Historically, Aboriginal people were made to feel invisible, to be ashamed

Most people are embarrassed to report mental illness. Pills are easy. Therapy is more stigmatizing. And more expensive.

Mental health needs same attention as physical health.

Do we provide health care or simply treat diseases?

Each area of the medicine wheel needs to be balanced for wholistic health for the client, where the client is the person, family, group, or community.

Indigenous teachings support addressing all areas of the person to achieve balance.

Imbalance creates illness

Culture is a world view

North American culture sees health as an individual problem, but we live in dynamic, intercultural communities.

We learn about disease models of health We need to focus on wellness and resilience models of

health

Health is multifaceted with issues related to mental, spiritual, emotional, and physical health.

Culture can be a barrier to caring for our clients.

Culture of Western Medicine

We look for a diagnosis as a central goal,of healing or ‘fixing’ the client

Aboriginal medicine focuses on the whole person and looks for a safe environment in which the patient may recover.

For conditions such as mental disorders, this latter approach may prove more effective than struggling to attach a label to the disorder.

Cultural Competence

Cultural Awareness

Cultural Sensitivity

Cultural Competence

Cultural Humility

Cultural Safety

An environment that is safe for people; where there is no assault, challenge or denial of their identity, of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience, of learning, living and working together with dignity and truly listening.

(Health Q. F., 2012)

Cultural Safety

I try to be skeptical (question things) and not cynical (dismiss ideas & find fault with them)

What is your role?

Cultural Respect

Unfair stereotypes and cultural misunderstandings overly affect aboriginal women

Restoring Balance

Collective cultures, like First Nations, have been impacted by colonialism, residential schools, changing gender roles, capitalism, and a foreign justice system, to name a few.

The loss of culture, language, traditions, and ceremonies has resulted in an imbalance to traditional ways of living.

The resulting loss of balance and harmony has resulted in pain: Mental, Spiritual, Emotional and Physical.

Restoring Balance

North American culture looks at health problems as individual problems or behaviour choices rather than looking at the larger societal picture.

In individualistic societies we blame the individuals, often missing the larger patterns and forces at work.

The individualistic perspective frequently narrows the ethical discussions to consideration of individual rights rather that collective goals and responsibilities.

• Do not look at health issues as a single category• Our clients are culturally diverse: First Nation, Métis, Inuit . . .• Our clients have diverse personal experiences: adoption, foster-

care, urban, on-Reserve, Residential School legacy, colonialism, loss of language, traditions, etc

• Our clients have diverse gender issues/sexual orientation needs(Heterosexual, Two-Spirit, Transgender)

Diversity is a factor in care

Traditional wellness practices

Whether or not people use traditional Aboriginal wellness practices is a very personal decision - varies according to family, spiritual/religious and cultural backgrounds, and individual experiences and beliefs

Nurse who support the use of traditional wellness practices may observe health benefits among their Aboriginal clients

Nurses need to accept & support client decisions

Aboriginal people can “either go the traditional route, the contemporary medicine route, or a combination of both.” Service providers should support those choices Clients who attend traditional ceremonies and

events like talking circles, sweats, dances, etc, experience a gradual “healing” due to social support and cultural connections (“belonging”) and spiritual teachings (“moments of peace”)

Partnerships with Aboriginal organizations work

Local or regional Aboriginal organizations are best able to provide cultural competence workshops and resources for mainstream service providers with Aboriginal clientele

Teach what you practice

It is Important to provide choices

Develop processes of identifying priorities and ho work with your clients to make choices accordingly

“Culturally competent” health care providers inform, encourage and support choices – including access to and use of traditional wellness practices

• Cultural safety stresses the importance of reflection & acceptance of differences.

• We should not treat everyone the same.

• We do need to recognize and acknowledge our blind spots.

“Ultimately we know deeply that the other side of every fear is a

freedom.” Marilyn Ferguson

Contact information

Greg Riehl RN BScN MA

Aboriginal Nursing Student Advisor

Aboriginal Nursing Student Achievement Program

SIAST

Wascana Campus

Email: greg.riehl@siast.sk.ca

Email: gregriehl@sasktel.net

@griehl