Reconciliation in Practice: The Role of RNs and NPs

As we approach the National Day for Truth and Reconciliation on September 30, we are reminded of the importance of acknowledging the truths of Canada's colonial history, the harms experienced by Indigenous Peoples and the ongoing impacts of colonialism within our health care system.

The health care system has not always been safe for Indigenous Peoples. Colonial policies, systemic racism and discrimination have contributed to harms that continue to influence the health and health care experiences of First Nations, Métis and Inuit Peoples today.

For Registered Nurses (RNs) and Nurse Practitioners (NPs), understanding this history is connected to the professional responsibility to provide safe, competent and ethical care. The Truth and Reconciliation Commission of Canada’s Calls to Action identify an important role for health professionals in recognizing the impacts of colonialism and improving health outcomes for Indigenous Peoples.

CRNS has taken steps to reflect these responsibilities within nursing regulation and practice:

• The CRNS Anti-Racism Guideline provides RNs and NPs with guidance and practical tools to recognize, address and respond to racism in nursing practice.
• The CRNS Code of Conduct reinforces expectations related to cultural safety, cultural humility and the responsibility of nurses to recognize how bias, discrimination and unequal power relationships can affect client care.
• CRNS supports opportunities for learning, dialogue and Indigenous leadership through initiatives such as the kā-wīci-pimohtēmāt (Indigenous Nursing) Professional Practice Group and resources focused on Truth and Reconciliation and cultural safety.
• Resources and practical tools are available to help RNs and NPs recognize and respond to racist behavior in nursing practice, including the CPR RACISM Guide, designed to support a speak-up culture and reinforce safe, competent, ethical and trauma-informed nursing care.
• Registrants are encouraged to incorporate learning related to Indigenous health, anti-racism, trauma-informed practices and cultural safety into their Continuing Competence Program.

In practice, RNs and NPs should reflect on how their own assumptions and biases may affect care, recognize and respond to racism and discrimination when they occur, and respect Indigenous perspectives, knowledge and ways of knowing. They also have a responsibility to contribute to environments where Indigenous clients feel respected, heard and safe.

RNs and NPs are expected to ensure these responsibilities are reflected in their own practice and workplace – an expectation that requires more than awareness. Understanding the history and ongoing impacts of colonialism, recognizing and responding to Indigenous-specific racism, and providing culturally safe care are an important part of professional nursing practice.

We are all Treaty People.