Cultural safety and competence in addressing structural inequities

The article titled “Aboriginal Women’s Experiences With Gestational Diabetes Mellitus: A Participatory Study With Mi’kmaq Women in Canada” is now featured on the ANS website.  In this article the authors, Joanne Whitty-Rogers, PhD, RN; Vera Caine, PhD, RN and Brenda Cameron, PhD, RN, explore and gain insight into the experiences of Mi’kmaq women with gestational diabetes mellitus in 2 First Nations communities in Nova Scotia. You can download the article at no charge while it is featured, and we encourage you to return here to share your comments!  Dr. Whitty-Rogers shared this message for ANS readers:

This research arose from my experience working as a non-Aboriginal Registered Nurse with Aboriginal women and families in maternal child nursing as a new nurse in a the Neonatal Intensive Care Unit. It was at this time in my nursing career that I began to care for many Mi’kmaq babies and mothers.  My encounters with the parents were frequent, yet I felt a sense of distance between them and myself and did not understand why.  Although I

Joanne Whitty-Rogers

tried to communicate in a caring and professional manner, I felt that my knowledge, skills, and understanding of how to communicate effectively with Mi’kmaq mothers and families were not meeting their needs.  This lack of effective communication created frustration for me and I believe was the reason why some Mi’kmaq women would not attempt to engage in any dialogue and would limit their time visiting their babies in the Neonatal Intensive Care Unit.  Looking back, I realize I was experiencing disembodiment because I was unable to verbally communicate in a way that the women could understand.

As the years went by, and I continued to study and do research as part of my Masters and PhD in nursing, I knew I needed to explore more about the experiences of Aboriginal women and families in the area of Perinatal nursing. I believe that build a trusting and collaborative relationship with the women was going to be critical in working together. At the time,   gestational diabetes mellitus was and continues to be a serious and prevalent health problem for Aboriginal

Vera Caine

women. I wanted to gain a better understanding of their experiences and glean ways to help them improve their health outcomes.

Fortunately, I met Dr. Brenda Cameron and Dr. Vera Caine who both agreed to be co-supervisors for my PhD study. They were both researching in Aboriginal women’s health and understood the barriers to receiving access to equitable healthcare.  We have had very rich conversations about ways to improve Aboriginal women’s help which has been beneficial in the work we do with Aboriginal people.

Despite educated health care providers and extensive research in health care, Aboriginal women continue to experience discrimination, and marginalization in healthcare settings across Canada.  Recognizing racism and

Brenda Cameron

injustices embedded in life experiences can provide a beginning point for the health care system to respond in a way that is culturally competent, caring, and humane.

Our nursing education has helped us to develop an understanding of diversity, inclusivity, and to be more pro-active and responsive to the changing health care needs of society. We believe that sharing this research with nurses and other health care providers will help them gain more knowledge into the importance of providing more culturally competent and culturally safe health care.