Towards Cultural Safety for Métis: an Introduction for Health Care Providers

Métis SETTING THE CONTEXT TOWA R DS CULTURAL SAFETY FOR MÉTIS: AN INTRODUCTION FOR HEALTH CARE PROVIDERS

Prepared by the Métis Centre of the health care workers. Cultural safety is an when caring for Métis patients. To do this, National Aboriginal Health Organization on-going and evolving process that will each of these building blocks – cultural require health care providers to revisit awareness, sensitivity, competency, and BACKGROUND and adjust modes of services in order to safety – will rst be dened. is will be meet the needs of Métis. Culturally safe followed by the presentation of various e concept of cultural safety was rst health care systems and environments are health care scenarios that highlight introduced in New Zealand in response established by a continuum of building dierences in the provision of health to ongoing concern over the eects of blocks – cultural awareness, cultural care services to Métis patients when that colonialism and the perpetuation of sensitivity, and cultural competency – as building block is lacking and when it is inequities from neo-colonial processes that outlined in Figure 1 below. being actively practiced. At the end of each “disregarded” the beliefs of the Maori and scenario are tips on how to be culturally “instead privileged those of the dominant is fact sheet aims to demonstrate aware, culturally sensitive, culturally ‘Euro-white’ culture” (University of how health care providers can provide a competent, and culturally safe. Victoria, n.d. – a). As a result, New culturally safe health care environment Zealand implemented changes to health care practices that included cultural safety Figure 1 - Goal: Cultural Safety training in nursing programs and in health care settings. Similarly, in Canada the Cultural Cultural Cultural Cultural health care system is based on mainstream Awareness Sensitivity Competency Safety Euro-Canadian culture that may not meet the specic needs of Métis patients and

1 ‘Aboriginal’ throughout this fact sheet refers collectively to the Indigenous inhabitants of Canada, including First Nations, Inuit and Métis peoples (as stated in Section 35(2) of the Constitution Act, 1982).

sharing knowledge making a dierence partager les connaissances faire une différence Who Are the Métis? e term “culture” refers to “shared beliefs, CULTURAL AWARENESS values, customs, behaviours and artifacts Métis are one of the three constitutionally that the members of society use to cope What is it? recognized Aboriginal1 groups in Canada. with their world and with one another” In French, the word “Métis” translates (Bates & Plog, 1976, p. 6). Culture adapts Cultural awareness is the rst step towards as “mixed,” yet the Métis people do not to changing environments and can be achieving cultural safety. It can be built simply have a “mix” of European and dened as generation-to-generation by observing activities and how people First Nations heritages; they have distinct transmission of knowledge and ways of participate in them, and involves being able languages, cultures, values, and beliefs being as a result of peoples’ collective and and willing to recognize or acknowledge that vary between communities and personal histories and experiences (Hart- and accept dierence within a population geographic regions all across Canada. For Wasekeesikaw, 2009). e Aboriginal (University of Victoria, n.d. – b). Cultural membership purposes, the Métis National Nurses Association of Canada denes awareness is limited in that it does not Council denes Métis as individuals who culture as: consistently encourage sta or educators self-identify as Métis, are of historic Métis to change their practices, ask about their Nation ancestry, are distinct from other …a process through which ordinary patient’s activities, or adjust organizational Aboriginal peoples, and are accepted activities and conditions take on an activities in order for Métis patients to be by the Métis Nation. It is important to emotional tone and a moral meaning fully supported during their care. keep in mind that all self-identied Métis for participants. ese processes deserve to be treated with respect and [include] the embodiment of meaning dignity regardless of their citizenship in psychological and social interactions; Why is it important to Métis? status. the development of interpersonal attachments; the performance of It is important to be culturally aware of Fast fact about Métis: religious practices; common sense Métis so that they do not feel the need to Métis are recognized in the Constitution interpretations; and the cultivation rationalize or explain their identity when of Canada as possessing Aboriginal rights. of collective and individual identities. expressing specic needs to health care With the exception of some rights related Frequently, cultural characteristics providers. When professionals within to harvesting, other rights, such as the right dier within the same ethnic or social the health care system are culturally to health, have not been as clearly defined group because of dierences in age, aware, Métis patients may feel more at or even fully discussed. As a result, unlike gender, sexuality, life history, political ease and more open to receiving medical other constitutionally recognized Aboriginal peoples in Canada, Métis do not have access association, class, religion, ethnicity, and attention because they will not feel the to federally funded non-insured health even personality. (Ibid., p. 20) need to change the manner in which benefits (Statistics Canada, 2008). they participate in their daily lives. Métis Like other groups of Aboriginal peoples, patients will be more receptive to health Métis need to feel safe from discrimination care workers who are culturally aware of The role of culture in the provision based on cultural aliation or background. diversity and dierences. However, in striving to create a more of health care services culturally safe health care environment for e following scenarios showcase one Métis patients, health care professionals situation where there is a lack of cultural As previously mentioned, Canada’s will need to consider that Métis culture is awareness and another where cultural health care system is based on Euro- not static or unchanging and will need to awareness is part of the exchange between Canadian standards of care, yet Canada evolve their knowledge accordingly. patient and health care worker, followed is oen referred to as a multicultural by some tips on how to be culturally aware country. ere are signicant cultural and of Métis. Fast fact about Métis: physical distinctions between groups and In the 2006 Census, approximately one-third individuals within any given population, of the Aboriginal population in Canada, Scenario 1 and the same is true for Métis. Expecting almost 400,000 people, identified as Métis. everyone to conform to colonially-based Close to 44 percent of the total Métis Sam and Joanna are nurses at an urban health care systems may be unfair to those population is under the age of 25 (Statistics walk-in clinic and were asked to host a not accustomed to the cultural biases on Canada, 2011). one-day immunization clinic for people at which these modes of health care delivery a Métis local oce. Upon arriving, Sam depend. and Joanna are shown where to set up their

2 station. For Sam and Joanna, they see no  Metis vary in their appearance; while of dierence among patients, it means need to change how they perform their some may “look” Aboriginal and have respecting these dierences and knowing procedures and though some people are dark features, others may have blond that no two people (even from the same sensitive to the sight of needles, they are hair, blue eyes etc. cultural group) experience the world in condent that their training is enough to  Métis are distinct so it is important exactly the same way. Cultural sensitivity help participants feel comfortable. not to apply or adopt pan-Aboriginal also includes understanding that people approaches when caring for Métis may share similar experiences, but their Lack of cultural awareness patients. reactions or responses may be very Once the clinic is set up and participants  While many believe that Métis only live dierent. Understanding and respecting start arriving, Sam and Joanna notice in the prairies, the truth is that today Métis culture means being sensitive to the cultural diversity of people and Métis live in every province across the fact that customs can also be uniquely quickly explain that the clinic is strictly Canada and all areas have their own individual (University of Victoria, for Métis. Sam invites those who are not traditions, values and cultural practices. n.d. – c). Métis to visit the walk-in clinic for their  Michif is the historical language of immunizations. One participant admits Métis and the three primary forms are Assumption: to feeling insulted and explains that they commonly referred to as Michif-Cree, Métis culture and traditions are based on are all from the Métis community. ough Michif-French, and Ile-à-la-Crosse those of their European ancestors. Sam and Joanna quickly apologize for their (Métis Nation of Ontario, n.d.). error, several participants feel excluded, so  In 2006, Statistics Canada reported that Reality check: Métis “adapted European technology to decide not to get their immunizations. the majority of Métis now speak English the wilderness, through innovations such as followed by French, with the lowest the Red River Cart and York Boat, making Cultural awareness percentage speaking an Aboriginal it possible to transport large volumes of As soon as Sam and Joanna learn that they language. Among Métis who speak an goods and supplies to and from the far flung will be hosting an immunization clinic at a Aboriginal language, the most common outposts of the fur trade. As people of mixed Métis local oce, they decide to learn what is Cree (64%), followed by Ojibway ancestry increased in number and married they can about Métis from the Internet. (10%), and Michif (7%) (Kumar & Janz, amongst themselves, they developed a new Sam and Joanna learn how diverse Métis 2010). culture, neither European nor Indian, but are and so on the day of the immunization a fusion of the two and a new identity as clinic they are not surprised by the Metis” (Turtle Island Productions, 1995: para. What does Pan-Aboriginal mean? 4). diversity in appearance of participants. The Ontario Federation of Indian Friendship As a result, the Métis participants have a Centres defines “pan-Aboriginal” as the positive experience. People are welcomed amalgamation of “all Aboriginal cultures into to enter as they like rather than being a single melting pot” – it is a process that Why is it important to Métis? told to stand in waiting lines, and seeing erases “crucial aspects of identity specific many of their community members in one to different Aboriginal peoples” (Ontario Cultural sensitivity is important because it place helps the elderly and children feel Federation of Indian Friendship Centres, n.d.). means Métis will feel less alienated by the more relaxed and at ease. As a result of health care they receive. Métis patients these small but signicant changes, many CULTURAL SENSITIVITY receiving care from culturally sensitive people express how much they appreciate health care workers may be more inclined the convenience of having a clinic come to What is it? to share details about their health care them. preferences. For example, patients with a Cultural sensitivity is the second step on culturally sensitive doctor or nurse may feel Tips to be culturally aware of the continuum towards achieving cultural more condent and comfortable expressing their need to have family members present Métis: safety. Cultural sensitivity is recognizing and being sensitive to the dierent ways during certain examinations or for specic people do things; it means taking the ceremonies marking various life stages,  Be aware that Métis are a distinct cultural background and experiences of or they may be more inclined to request Aboriginal group. Métis into consideration while reecting dietary considerations that are not part of a  Remember that the values, beliefs, and on the ways in which we view the world. mainstream Euro-Canadian diet. connections to spirituality among Métis To be culturally sensitive means not can vary across space and time. only acknowledging the importance e following scenarios involve a couple

3 who are about to become rst time nurse informs the couple that smudging Mark’s baby will be a joyous occasion and parents. e rst reects a lack of cultural has never been allowed at the hospital. As will include their loved ones at the baby’s sensitivity and the second showcases this is the only hospital in their area, Abby Welcoming Ceremony. cultural sensitivity as part of the exchange and Mark are saddened that their baby between the patient and health care will not receive a traditional welcoming Tips to being culturally sensitive worker. and are considering a home birth despite their remote location. As an alternative to towards Métis: Scenario 2 a home birth (which could be dangerous if anything goes wrong) the couple is also  It is important for health care providers Abby and Mark are expecting their rst considering giving birth at a hospital that to listen to Métis patients with respect child and have scheduled a tour of the is more sensitive to their needs but is at a and remain non-judgmental of held hospital’s birthing centre. e hospital greater distance from home. Giving birth values and spiritual beliefs. they plan to give birth at is the only one in in a hospital further away would mean that  Before asking for certain information, their area. Abby and Mark are hoping that not all of their family would be able to take the time to explain why it is both their mothers will attend the birth visit the baby on her rst day in the world. important. of their rst grandchild, as they want to ese dicult decisions have turned a  Remember that historical Métis culture, have a Welcoming Ceremony following the joyous time into one of emotional turmoil. spiritual, or traditional practices are baby’s birth. is is a traditional practice not primitive, nor are they worse or in both their families and is a tradition Cultural sensitivity better than your own – they are simply Abby and Mark want to continue. While Abby and Mark receive a tour of dierent. the birthing centre, they are happy to  Remember that not all Métis choose Lack of cultural sensitivity learn that the sta have had some cultural to take part in traditional activities Abby and Mark are struck by the clinical training and will be as culturally sensitive and practices, and instead prefer more atmosphere of the birthing centre and as possible in supporting Métis customs contemporary approaches. Some may express concerns about the limited amount and traditions. e nurse asks them to also follow religious practices that are of space in the birthing room. Abby submit a birth plan and explains that while not grounded in traditional or historical asks the nurse if there is a dierent room they cannot change the birthing room, Métis beliefs. is does not mean that where they can host a Métis Welcoming the family will have access to the multi- they are less Métis or that they are in less Ceremony following the birth of their faith room where they can gather with need of culturally sensitive care. baby that would allow for smudging. e family and friends. e birth of Abby and  Remember Métis family units go beyond

4 that of the immediate family. Extended practitioners which revolve around Lack of cultural competency families consisting of aunts, uncles, empowering clients (University of On the morning of his release, Jerry’s grandparents, and close community Victoria, n.d. – d). In other words, doctor arrives wearing a serious expression relations oen play an equal and vital cultural competency is about action and and states, “Well, according to the tests, role in the lives of Métis. It is important refers to the delivery of health care both you have cardiovascular disease.” Jerry that these individuals be included in safely and satisfactorily to Métis patients is overcome by anxiety when the doctor the continuum of care for Métis as they (Hart-Wasekeesikaw, 2009). Cultural says “You will have to make considerable may want to be at their loved ones’ sides competency means being able to meet changes in your lifestyle.” Jerry feels during care as well as in celebration of the social, cultural, and sometimes even ashamed that his body is not as strong births and in mourning. It is important the linguistic needs of Métis patients anymore and his mind races as he wonders to be sensitive to these needs when by adapting the delivery of health care how he might continue to be involved with trying to limit access to patients by services. the community. How will these changes visitors. aect the hunt and what will the other  Remember that historical traumas Why is it important to Métis? men think of him? Does this mean he may still aect Métis so being sensitive will have to stop eating traditional food? to history and the impacts of Euro- Cultural competency is important because Before the doctor leaves the room, he Canadian modes of care are important it means Métis patients may feel more in hands Jerry a package of literature which to ensuring patient comfort and trust. control of the health care they receive, and includes the Canada Food Guide and a  You can learn about Métis through will perhaps be more receptive to accessing list of exercises that Jerry has never heard literature, community involvement, health care. Métis patients receiving of. As he glances through the literature, and interaction (if you do not know culturally competent care may be more Jerry notices that the food guide does not something or are unsure of protocol, inclined to return and may be more open include traditional foods, making this ask). to accepting and following treatment plans whole situation seem hopeless.  Remember to consider the spiritual, recommended by health care professionals. Culturally competency emotional, and mental needs of Métis Outlined below are scenarios involving While waiting to be released from the rather than simply focusing on the a Métis Residential School survivor and hospital, Jerry is anxious to hear his test physical aspects of well-being. his doctor – the rst reects culturally results. Upon his arrival, the doctor incompetent care and the second scenario greets Jerry warmly and informs him that Assumption: depicts culturally competent care. Tips on Ensuring the physical health of Métis is the the tests indicate cardiovascular disease. ways to be culturally competent follow the health care provider’s only responsibility and is means Jerry will have to make some scenarios. it is up to the patient or family members to signicant lifestyle changes. Noticing his define and request what is needed. patient growing anxious, the doctor asks Scenario 3 Reality check: Assumption: For many Métis, health is not simply about Jerry is a 60 year old Métis survivor of Métis children did not attend Indian physical well being; it can often mean Residential School where he was physically Residential Schools being emotionally, spiritually, and mentally and verbally abused for not understanding balanced. These areas of wellness include Reality check: individual, family, and even community the lessons. When he returned to his Though the exact number remains unknown, involvement. Métis may be hesitant to make community, Jerry immersed himself back Métis children did attend residential schools reasonable requests or may delay seeking into his culture but carried the scars of and continue to feel the effects of historical treatment until later stages of an illness (i.e. humiliation and distrust of authority. trauma resulting from the residential school diabetes) if they feel they will not be treated Recently Jerry was diagnosed with legacy. Clément Chartier, President of in a culturally sensitive way. cardiovascular disease and was hospitalized the Métis National Council, states “I must as a result of the condition. e news remind Canadians that there are thousands CULTURAL COMPETENCY of this diagnosis worries Jerry especially of Métis Nation citizens that attended Métis residential schools, who experienced the because his Métis local just named him What is it? same policies that Canada apologized for, Captain of the Hunt - an honoured role that have been excluded from the Settlement that he is sure the doctor will tell him he Agreement and mandate of the Truth and Cultural competency refers to the will have to relinquish. Reconciliation Commission” (Métis Nation knowledge, skills, and attitudes of Council, 2011).

5 Jerry if he has any questions. Jerry relaxes Tips to becoming culturally Organization [NAHO], 2008, p. 3). In and talks about being named Captain competent with Métis: other words, cultural safety requires a of the Hunt for his Métis local and asks systemic approach that encompasses an if he will have to give up that honoured understanding of the power dierentials role including eating traditional foods.  Hiring Métis health care workers who that are inherent in health service delivery. e doctor listens to Jerry’s concerns and are familiar with the culture may help It requires practitioners to be aware of their then presents some options that include patients feel more comfortable. own cultural values, beliefs, attitudes, and a traditional diet and exercise, such as  Sta should be people-oriented and outlooks that consciously or unconsciously taking daily walks in the bush. e perform their duties with attitudes free aect their behaviours. Certain behaviours doctor encourages Jerry to continue being of discrimination, with the goal for can intentionally or unintentionally involved with his community as a way to Métis patients to feel respected at all cause clients to feel accepted and safe, or sustain emotional, mental, spiritual, and times. rejected and unsafe. Additionally, cultural physical balance and well-being. While  Provide information and training about safety is a systemic outcome that requires listening to the doctor, Jerry feels more health care that oers a Métis-specic organizations to review and reect on their at ease and readily agrees to bi-weekly perspective. own policies, procedures, and practices in checkups over the next few months to order to remove barriers to appropriate develop a health care plan that includes CULTURAL SAFETY care. community activities. Jerry is surprised by how good he feels despite his diagnosis and What is it? Why is it important for Métis? is looking forward to his role as Captain of the Hunt. Jerry is also provided with a e concept of cultural safety moves Cultural safety is important for Métis copy of the Aboriginal Food Guide which beyond cultural awareness, cultural patients because it requires health care includes nutritional information on sensitivity, and cultural competency providers to “be respectful of nationality, traditional foods. by challenging “power imbalances, culture, age, sex, political and religious institutional discrimination, colonization beliefs, and sexual orientation,” while also and colonial relationships as they apply to recognizing that health care providers health care” (National Aboriginal Health bring their own “culture and attitude

6 into the relationship” (NAHO, 2008, p. Cultural safety terms, and explain things simply and 4). Culturally safe health services means When Mike enters the walk-in clinic, clearly. However, it is important that Métis patients are involved as partners he immediately notices the posters plain language should not be used in in the process of health care. Métis who with people from dierent cultural a way that makes the patient feel they receive culturally safe care are recognized backgrounds, including faces he recognizes are considered less intelligent (NAHO, and encouraged to state their needs and as Métis. ough the workers appear to be 2008). how they can best be met by their health non-Aboriginal, they all smile and make  Provide training to all sta in cultural care provider. Cultural safety includes him feel welcome. Mike takes comfort safety and review all policies and empowering Métis patients to openly from the cultural diversity of patients procedures for unintended bias and/or discuss or request that their health care and notices an Aboriginal family who administrative and other barriers to care. practitioner be able and willing to deliver appear relaxed and familiar with the  Understand that cultural safety involves culturally safe services. A culturally facility. ough this is nothing at all like deep systemic change and is much more safe environment is also supportive of the health centre in his home community, than interior design. e inclusion Métis sta and students working in that Mike feels at ease while waiting to see of Métis art and symbols in health environment, as racism and discrimination the doctor. While looking around the care facilities, however, is still a step are not acceptable in either behaviours or room, Mike notices a framed policy on towards establishing safe, Métis-friendly policies. Below are two scenarios depicting the wall indicating that the oce wants environments. a culturally unsafe environment and a to serve all their clients in a culturally safe culturally safe environment followed by environment, encouraging patients to What can organizations and some tips on how to provide culturally safe discuss traditional medicines or spiritual healthcare. beliefs with their health care team. Mike is health care providers do to amazed to read this statement and relaxes implement and maintain cultural Scenario 4 a bit more, especially aer meeting the safety within their environments? doctor who listens to him as he describes his symptoms. Mike opens up when the Mike is a 19 year old Métis who recently  Ensure new and existing employees doctor asks if he has any other needs or moved to Ottawa from his small receive cultural safety training as part of concerns. Aer getting his prescription community in northern Manitoba, the job requirements and performance lled, Mike has a smile on his face as he and who is still adjusting to the urban reviews. decides to go to a Métis event at the local environment. He has not been feeling well  Host on-going workshops to continue community centre that the doctor suggests and has decided to go to a walk-in clinic. to develop knowledge and skills. he might want to check out for support  Hire culturally competent health and friendship. Lack of cultural safety care providers to ensure Métis feel As Mike walks to the building, he comfortable with sta and do not feel overhears two sta members outside Tips to provide culturally safe care they have to explain or validate their making jokes and comments about “those to Métis: Aboriginal identity. Indians” and all the hassle of documenting  Create environments where all their health claims. Upon entering the employees and patients feel safe and free clinic, Mike immediately feels invisible and  Recognize the social, political, and from racism. out of place as all the images on the posters historical contexts of health care and  Invite Métis community members and magazines are of non-Aboriginal advocate for Métis patients and their to participate in the development of people. Furthermore, the workers and cultural preferences to help establish culturally safe health care environments. other clients in the clinic are non- trust.  Conduct self-assessments regarding Aboriginal. is really makes Mike miss  Challenge power relations by values and experiences, recognizing that his family and his community. As a result, encouraging patients to discuss their cultural dierence does in fact play a Mike feels alienated and does not disclose health care needs. part in the values and lived experiences all of his symptoms to the doctor which  Discussions and explanations should be of others. leads to other complications that impact in plain language, recognizing that the  Reect on personal cultural values, his overall health and mental well-being. language of care may not be the patient’s beliefs, and ideologies and compare rst language. Care providers must learn them to the values of people outside not to use jargon, technical, or academic your own culture and the culture of

7 standard medical practices. CONCLUSION health care administrators, providers and educators.  Provide in-service education and Ottawa, ON: NAHO. Retrieved February 12, 2012 from www.naho.ca/documents/naho/publications/ discuss cultural safety in sta meetings, e road to cultural safety is a continually culturalCompetency.pdf so health care providers have a safe evolving journey that supports all patients environment to consciously release any and sta. Providing a culturally safe health Ontario Federation of Indian Friendship preconceived stereotypes or assumptions Centres (OFIFC) (n.d.). OFIFC statement on care environment is critical for improving the “Pan-Aboriginal” approach. Toronto, ON: about Métis peoples and move towards patient outcomes. In this environment, OFIFC. Retrieved February 13, 2012 from respecting dierences and diversity. patients are more likely to feel at ease http://74.213.160.105/ofchome/page/Document/ discussing their symptoms with their health UP_FILE/20070424234846WIL.pdf A culturally safe environment involves the care providers and following health care Statistics Canada (2008). Aboriginal Identity. Five integration of cultural awareness, cultural advice because they will feel their wishes Facts about Métis. Ottawa, ON: Métis Centre, competency, and cultural sensitivity. e and needs are being respected. Remember National Aboriginal Health Organization. scenario below showcases what a culturally that maintaining a culturally safe safe environment might look like. Statistics Canada (2011). Selected Language environment for both patients and health Characteristics (165), Aboriginal Identity (8), Age care providers requires ongoing systemic Groups (7) and Sex (3) for the Population of Canada, Scenario 5 and individual eorts, and that each Provinces, Territories and Census Metropolitan Areas, 2006 Census - 20% Sample Data. 2006 Census data stage of the continuum must be regularly products. Ottawa, ON: Statistics Canada. Retrieved When Abby and Mark’s time for delivery revisited and built upon. November 4, 2012 from http://www12.statcan.gc.ca/ came, they were happy to learn that the census-recensement/2006/dp-pd/tbt/Rp-eng.cfm?TA hospital had embarked on the journey BID=1&LANG=E&APATH=3&DETAIL=0&DIM REFERENCES =0&FL=A&FREE=0&GC=0&GK=0&GRP=1&P to become a culturally safe facility. As ID=89150&PRID=0&PTYPE=88971,97154&S=0 a result, all sta and volunteers were Bates, D.G., & Plog, F. (1976). Cultural anthropology, &SHOWALL=0&SUB=0&Temporal=2006&THE receiving training and a policy review had 3rd Ed. New York: McGraw-Hill. ME=73&VID=0&VNAMEE=&VNAMEF= indicated a number of areas that needed Hart-Wasekeesikaw, F. (2009). Cultural competence Turtle Island Productions (1995). Métis history and change, with a priority going to the and cultural safety in First Nations, Inuit and culture. As cited from Métis Nation Council (1989, renovation of the birthing centre. ey Métis nursing education – An integrated review October). Canada and the Métis. Retrieved November had already retted one larger birthing of the literature. Ottawa, ON: Aboriginal Nurses 2011 from http://www.turtle-island.com/native/the- room that could hold larger gatherings of Association. Retrieved November 4, 2012 from ojibway-story/metis.html http://www.anac.on.ca/Documents/Making%20 people in the room, if that was what the It%20Happen%20Curriculum%20Project/ University of Victoria. (n.d. - a). Cultural safety. mother wanted, and the multi-faith room FINALReviewofLiterature.pdf Cultural safety: Module 1 Peoples’ experiences of could also be used as a gathering place for colonization - Glossary. Victoria, BC: e Author. relatives. A new re safety protocol was Kumar, M.B., & Janz, T. (2010). An exploration Retrieved July 9, 2012 from http://web2.uvcs.uvic.ca/ of cultural activities of Métis in Canada. Canada, courses/csafety/mod3/glossary.htm put in place that allowed for smudging, 2006. Ottawa, ON: Statistics Canada, Catalogue if requested. Abby and Mark were #11-008-x/2010001. Retrieved March 19, 2012 from University of Victoria (n.d. – b). Cultural awareness. excited and relieved that the hospital and http://www.statcan.gc.ca/pub/11-008-x/2010001/ Cultural safety: Module 1 Peoples’ experiences of sta could support Métis customs and article/11142-eng.htm#a9 colonization - Glossary. Victoria, BC: e Author. Retrieved November 12, 2011 from http://web2.uvcs. traditions regarding child birth. As they Métis Nation Council (2011, October 28). Métis uvic.ca/courses/csafety/mod1/glossary.htm#ca had already submitted a detailed birth Nation reminds Canadians that thousands of Métis plan, the health team was able to ensure residential school survivors remain unacknowledged. University of Victoria (n.d. – c). Cultural sensitivity. that their needs were met. e birth Ottawa, ON: Métis Nation Gateway. Retrieved Cultural safety: Module 1 – Peoples’ experiences of February 12, 2012 from http://metisportals.ca/ colonization - Glossary. Victoria, BC: e Author. of Abby and Mark’s baby was a joyous metishealing/?page_id=3&sourcePage=55 Retrieved November 12, 2011 from http://web2.uvcs. occasion that included family and friends uvic.ca/courses/csafety/mod1/glossary.htm#ca who came out to greet the new baby at Métis Nation of Ontario (n.d.). Ispayin Métis Youth the Welcoming Ceremony. In turn, the Express Yourself! Michif Language. Retrieved University of Victoria (n.d. – d). Cultural competence. November 12, 2012 from www.metisyouthexpressions. Cultural safety: Module 1 – Peoples’ experiences of family was thankful for the good care ca/michif-e.php colonization - Glossary. Victoria, BC: e Author. they received and invited the doctor and Retrieved November 12, 2011 from http://web2.uvcs nurses to the Welcoming Ceremony, and National Aboriginal Health Organization [NAHO]. uvic.ca/courses/csafety/mod1/glossary.htm#ca. those who could attend were delighted to (2008). Cultural competency and safety: A guide for witness this tradition.

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