Clinical Nursing Experiences in Rural Aboriginal Settings

Clinical Nursing Experiences in Rural Aboriginal Settings
Steven Ross MN, BSN, RN

Thompson Rivers University

Kamloops, British Columbia, Canada

INTRODUCTION

In 2011, a nursing education practice hub was established at the Conayt Friendship Centre in Merritt, BC to address the identified shortage of registered nurses and their high rate of turnover in First Nations communities. The intentions of this partnership were to:

• strengthen relationships between Conayt, Aboriginal peoples of the Nicola Valley, and faculty/students of the TRU School of Nursing (SON)
• develop students’ competence to function in community health and relevant practice roles in Aboriginal rural communities
• promote students’ ability to support Aboriginal peoples’ health and well-being
• increase the number of new graduates planning to work within rural Aboriginal communities

 

BACKGROUND

Thompson Rivers University (TRU) is located in a region rich in both urban and rural Aboriginal communities that span a large geographical area which includes the traditional lands of five different Nations. TRU is committed to being the “University of Choice” for Aboriginal peoples and has one of the largest Aboriginal student populations in the BC post-secondary system. 

The SON has worked in partnership with many Aboriginal individuals, organizations, and communities over the years to increase the number of Aboriginal nursing graduates, and to develop practice opportunities with local Aboriginal peoples so that all its graduates are prepared to provide culturally safe care and address inequities experienced by Aboriginal peoples.

The Conayt Friendship Center is located in Merritt, a small city in the Nicola Valley of the south-central interior of BC, Canada. “Conayt” comes from the Nlaka’pumux word for “helping others”, and the Centre is devoted to improving holistically the quality of life and cultural distinctiveness of clients and families, and strengthening friendship and cooperation between the Aboriginal and Non-Aboriginal members in the territories. Conayt also offers numerous programs and services to address these aims.

 

THE CONAYT PROJECT

Drawing on the principles of community development, faculty worked with members of Conayt to develop opportunities for students that were responsive to both student learning and community health needs. Student and faculty engaged with Elders, members of interdisciplinary teams, and other community members to build trusting and reciprocal relationships as they worked in a variety of programs and services offered on and off reserve through Conayt and rural Aboriginal health centres and communities.

Students were involved in public health and home and community care when they worked with community nurses on reserve, they developed projects with community agencies addressing harm reduction, Youth programs in the community, pre and postnatal program for Aboriginal and families in need, and developed initiatives within the supported housing programs at Conayt. Weekly seminars connected students’ together and provided space and time to share their experiences, learnings and to address issues relating to race, power, privilege and cultural safety.

OUTCOMES

Elders valued opportunities to talk, share stories, explain and demonstrate elements of Aboriginal culture. This was seen as important in developing nurses that are holistic, understanding, connected, and respectful of the traditions of Aboriginal people. Elders embrace opportunities to pass along knowledge to youth and suggest it provides a sense of self-worth.

Faculty were valued as mentors, educators, and resources for some community health placements, particularly those with limited nursing supports.

Faculty identified the growth of both students and themselves in their cultural safety as a key outcome of the experience. They also noted the desire of the Aboriginal communities to work with students and share their knowledge and experience with both students and faculty. Embracing a community development approach, with emphasis on relationship building, was critical to the success of collaborating with Aboriginal people and communities

Students thought this practice placement provided many opportunities for them to:

• develop relationships based on trust and equity
• engage with and develop understanding of the lived experience of members of these Aboriginal communities
• understand the past and present impact of residential schools and colonization on the Aboriginal people of the region
• reflect on the impact that personal bias, misconceptions, and stigma could have towards culturally diverse populations
• recognize the prevalence, impact, and management of chronic health conditions in Aboriginal communities
• understand the value of alternative and traditional medicines
• consider career opportunities in Aboriginal communities

CHALLENGES

• Some of the second year students expected that all their clinical placements were going to be in an acute care setting.
• Merritt, which is a 45-60 minute drive from the TRU campus, is a high mountain highway subject to significant weather changes in the winter months.
• Initially, faculty and students were used to more structured practice placements. They learned to be more flexible and open to learning opportunities as these unfolded.

 

REFLECTIONS

• Cultural immersion experiences provide valuable learning for nursing students and are possible across a variety of geographic locations and cultures.
• Taking time to develop relationships and using a community development approach is critical to the success of collaborating with Aboriginal communities.