Truth and Reconciliation

What responsibilities do RNs have regarding the recommendations found in the Truth and Reconciliation Commission of Canada: Calls to Action?

“In order to redress the legacy of residential schools and advance the process of Canadian reconciliation,” recommendations 18 through 24 contain health-related calls to action (1). Every RN is held to a standard of practice in which culturally safe care is provided. RNs, through continuing competence development, can begin to explore the recommendations individually and in groups to assist our health care system in moving forward with the recommendations and promoting reconciliation.

A full list of practice standards, entry-level competencies and code of ethics statements that apply to RN practice can be found in Appendix A of the CRNS Anti-Racism Guideline for Registered Nurses. Some of those are included below:

• RNs incorporate knowledge that reflects a deep understanding and respect for different ways of knowing which exhibits cultural competence and cultural humility (2).
• RNs practice a holistic, family-centred approach to ensuring culturally safe client care (3).
• RNs have a responsibility to conduct themselves according to the ethical responsibilities outlined in the CNA Code of Ethicsand in practice standards. This must be considered in what they do and how they interact with persons receiving care and other members of the health care team (4).
• RNs collaborate with other health care providers and other interested parties to maximize health benefits to persons receiving care and those with health care needs, recognizing and respecting the knowledge, skills and perspectives of all (5).
• RNs refrain from judging, labelling, stigmatizing and humiliating behaviors towards persons receiving care or toward other health care providers, students and each other (6).

What are some ideas I can use with my team to create a unit culture that embraces and acts towards reconciliation?

Here are ideas to consider:

• Engage the staff in exploring ideas on what might be helpful in creating a unit that is culturally competent.
• Invite an elder to a staff meeting or a series of meetings to teach Indigenous ways of knowing.
• Watch videos and explore websites related to truth and reconciliation. Discuss your learnings as a group to deepen your understanding.
• Offer a general cultural diversity education session about being aware of behaviours and how they can impact someone else.
• Invite an Indigenous RN to share cultural beliefs regarding Indigenous health issues.
• Create a small lending library of materials people can borrow and read.
• Remind staff of the organizational mission, vision and value statements that may include cultural competence.
• Consider incorporating cultural competence into your unit’s value statements.
• Explore learning modules that offer cultural awareness on the Indigenous Nurses PPG webpage.
• Check to see if your organization has internal resources to promote and support cultural safety.
• Connect with an Anti-Racism Network or organization.
• Review the CRNS Anti-Racism Guideline.
• Implement CPR RACISM including practicing ahead of time how you would respond if you witnessed racism.
• Include an acknowledgement of traditional lands at the start of meetings.
• As a unit, act on a priority health initiative highlighted in the TRC recommendation #19 and share your progress and key learnings.
• Become familiar with research and initiatives focused on Indigenous health.
• Review any client related complaints from a perspective of cultural vulnerability to use as a learning opportunity for staff and as a quality improvement initiative.

CRNS Resources

CNA Code of Ethics for Registered Nurses (2017)

Anti-Racism Guideline (2024)

Indigenous Nursing (kā-wīci-pimohtēmāt) Professional Practice Group

Embracing Truth & Reconciliation

External Resources

RNAO Nursing Best Practice Guidelines: Embracing Cultural Diversity in Health Care: Developing Cultural Competence (2007)

Institute of Indigenous Peoples’ Health

CNA Indigenous Health

CNA Nursing Declaration Against Anti-Indigenous Racism in Nursing and Health Care