A Nurse\u27s Journey with Cultural Humility: Acknowledging Personal and Professional Unintentional Indigenous-specific Racism

This is a first-person reflection of my journey through cultural humility to identify a connection between my inherent beliefs about Indigenous Peoples and Indigenous-specific systemic racism. The co-authors of this paper provided guidance, mentorship, and support in organizing the framework due to the challenging and sensitive nature of the content. As part of my relational practice, I worked with a Cree scholar to write this paper. As a descendant of white European colonial settlers, I grew up in a small community in western Canada populated by people of similar backgrounds. My exposure to Indigenous Peoples and culture was very minimal; however, conversations and attitudes about Indigenous Peoples generally centered around negative and racist stereotypes. Childhood games and jokes insidiously contributed to the construction of my worldview by dehumanizing, belittling, and humiliating Indigenous Peoples. A necessary part of my journey was to recognize how these words and attitudes have informed my worldview and at the same time hurt Indigenous Peoples. Historical facts of Indigenous treatment were brushed off or minimized as something that happened in the past. Although sharing my experience is uncomfortable, I am compelled to identify and acknowledge how the deep-rooted beliefs and attitudes that I have towards Indigenous Peoples have been shaped by my education, culture, and experiences. I hope that my own developing journey with cultural humility may serve as a guide to deconstructing the historical, personal, and professional ways in which Indigenous-specific racism exists and is perpetuated in health care. My own first steps are an open invitation for the nursing profession to similarly begin to address unintentional and intentional racism in healthcare. By understanding Canadian history, committing to allyship, advocating for social justice, actively intervening by speaking up, and integrating trauma-informed care/principles into our practice, we may begin to effectively address Indigenous-specific racism in health care. Résumé Il s’agit d’une réflexion personnelle sur mon parcours en matière d’humilité culturelle afin d’identifier le lien entre mes croyances inhérentes au sujet des peuples autochtones et du racisme systémique dont ils sont victimes. Les coauteures de cet article ont fourni des conseils, de l’encadrement et du soutien pour développer le contexte en raison de la nature délicate du contenu. Dans le cadre de ma pratique relationnelle, j’ai rédigé cet article en collaboration avec un universitaire crie. Je suis descendante de colons européens blancs, j’ai grandi dans une petite communauté de l’ouest du Canada entourée de personnes aux origines similaires. J’ai été très peu exposée aux Autochtones et à leur culture, toutefois, les conversations et les mentalités les concernant étaient habituellement négatives et racistes. Les jeux et les blagues de mon enfance ont influencé ma conception du monde en déshumanisant, rabaissant et humiliant les peuples autochtones. Une des étapes cruciales de mon cheminement a été de reconnaître la façon dont ces mots et ces mentalités ont influencé ma perception du monde et par la même occasion, ont blessé les Autochtones. Les faits historiques et les traitements qui leur étaient réservés ont été balayés du revers de la main ou atténués en raison de leur nature ancienne. Bien que je sois mal à l’aise de vous raconter mon expérience, je me vois obligée d’identifier et de reconnaître que mes croyances et mes mentalités profondément enracinées envers les Autochtones ont été façonnées par mon éducation, ma culture et mes expériences. Je souhaite que mon cheminement vers l’humilité culturelle puisse servir de guide afin de déconstruire le racisme systémique envers les Autochtones présent dans les sphères personnelles, professionnelles et historiques et que cela se reflète dans les soins de santé. Cette première étape, bien que personnelle, constitue une invitation à la profession infirmière à s’investir dans la lutte contre le racisme volontaire ou involontaire dans les soins de santé. En comprenant l’histoire canadienne, en nous engageant à nous allier, en plaidant pour la justice sociale, en prenant la parole activement et en intégrant des soins et des principes qui tiennent compte des traumatismes dans notre pratique, nous pouvons commencer à lutter efficacement contre le racisme systémique envers les Autochtones dans les soins de santé

Addressing Indigenous-Specific Racism in Healthcare as Part of Reconciliation: A Nurses Responsibility to Mitigate Racism in Healthcare

Background: Reports of racism and discrimination, particularly Indigenous-specific racism within the Canadian health care system, has become common in the news. The November 2020 report entitled In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B. C. Health Care and the September 2020 death of Joyce Echaquan clearly indicate immediate action is required by all nurses to address current practice and to be accountable for delivering safe, competent, and ethical care to Indigenous peoples (First Nations, Métis, and Inuit). As a registered nurse and a white settler mother of two Indigenous sons, I cannot ignore Indigenous-specific racism. In alignment with the Truth and Reconciliation recommendations, I recognize the necessity to address the truth - the history of colonization in Canada and how it has affected and continues to affect Indigenous health and wellness. There are numerous publications that have described the legacy of both residential schools and the Indian hospitals, along with numerous anecdotal stories of the deplorable care provided to the First Peoples of Canada. This historical relationship has resulted in Indigenous peoples feeling deep mistrust towards the healthcare system. This sociopolitical history directly affects my Indigenous sons and their personal wellness as they navigate growing up in an environment of racism. Purpose: The purpose of this paper is to share with healthcare professionals the effects Indigenous-specific racism has on Canadian Indigenous people with the hope of fostering more authentic conversations to guide policy change and create an environment for safe, competent, compassionate, and ethical healthcare delivery. Implications: It is necessary for all health care providers to engage in safe, compassionate, competent, and ethical care for all patients. Practicing cultural safety an important first step when engaging with Indigenous peoples. This colonial history impacts my sons’ wellness and I have prepared a letter to share with them and my nursing colleagues. My hope is twofold: 1) that they will keep this letter and read it as they face unnecessary challenges simply because they are Indigenous; and secondly, the nursing profession will address and eliminate Indigenous-specific racism in healthcare.&nbsp

Placental Origins of Chronic Disease.

Epidemiological evidence links an individual's susceptibility to chronic disease in adult life to events during their intrauterine phase of development. Biologically this should not be unexpected, for organ systems are at their most plastic when progenitor cells are proliferating and differentiating. Influences operating at this time can permanently affect their structure and functional capacity, and the activity of enzyme systems and endocrine axes. It is now appreciated that such effects lay the foundations for a diverse array of diseases that become manifest many years later, often in response to secondary environmental stressors. Fetal development is underpinned by the placenta, the organ that forms the interface between the fetus and its mother. All nutrients and oxygen reaching the fetus must pass through this organ. The placenta also has major endocrine functions, orchestrating maternal adaptations to pregnancy and mobilizing resources for fetal use. In addition, it acts as a selective barrier, creating a protective milieu by minimizing exposure of the fetus to maternal hormones, such as glucocorticoids, xenobiotics, pathogens, and parasites. The placenta shows a remarkable capacity to adapt to adverse environmental cues and lessen their impact on the fetus. However, if placental function is impaired, or its capacity to adapt is exceeded, then fetal development may be compromised. Here, we explore the complex relationships between the placental phenotype and developmental programming of chronic disease in the offspring. Ensuring optimal placentation offers a new approach to the prevention of disorders such as cardiovascular disease, diabetes, and obesity, which are reaching epidemic proportions.The authors thank the various funding agencies that have generously supported their research over the years; GJB, the Medical Research Council, the Wellcome Trust and Action Medical Research; ALF, the Biotechnology and Biological Sciences Council, the Medical Research Council and the Wellcome Trust; KLT, the National Institutes of Child Health and Human Development, the Nation Heart Lung and Blood Institute, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Aging, the American Heart Association and the M. Lowell Edwards Endowment.This is the author accepted manuscript. The final version is available from the American Physiological Society via https://doi.org/10.1152/physrev.00029.201

Praxis: An Editorial Statement

Praxis: An Editorial Statemen