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Phd Dissertation Mâmawoh kamâtowin: Coming Together To Help Each Other: Honouring Indigenous Nursing Knowledge by Raymonde Lisa L. Bourque A thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Faculty of Nursing University of Alberta © Raymonde Lisa L. Bourque, 2014 ii ABSTRACT “Mâmawoh kamâtowin: Coming Together To Help Each Other: Honouring Indigenous Nursing Knowledge is the result of coming to know and understand my own Indigenous experience while working with four Indigenous nurse scholars Alice Reid, Evelyn Voyageur, Madeleine Dion Stout, and Lea Bill. Using an Indigenous research approach I draw from the collective experience and attend to the question of how Indigenous knowledge manifests itself in the practices of Indigenous nurses and how it can better serve individuals, families and communities. This research framework centers Indigenous principles, processes, and practical values at the center of the design. It inclusively captures four key components of the entire research process, which are based on Cree/Métis understandings of creating respectful research activities; enacting ethical relationships; being responsible for the gathering, documenting and analyzing the data, and ensuring that mutual reciprocity is honoured. The findings from this research were four main threads of understanding including roots of being, entanglement of roots, on nursing terms and living the practice. These were further articulated through ontological and epistemological considerations. What was central to this study was that Indigenous knowledge has always been fundamental to the Indigenous nurses’ ways of undertaking nursing practice regardless of the systemic and historical barriers faced when providing healthcare for Indigenous peoples. The outcomes of this research showed many important aspects to building Indigenous knowledge in nursing scholarship such as how nursing education and the delivery of nursing service to Aboriginal iii communities needs to ensure that local Indigenous peoples and the community knowledge systems are at the core of nursing standards and healthy public policy. On a smaller, but more significant scale, this work helped me personally to look at my own Indigenous experience from which I glean meanings of belonging; these women helped me to come ‘home’ to a feeling of being in my own family and community and in the nursing discipline. iv PREFACE This thesis is an original work by R. Lisa Bourque Bearskin. The research project, of which this thesis is a part, received research ethics approval from the University of Alberta Research Ethics Board, Project title Mâmawoh kamâtowin: Working Together To Help Each Other: Honouring Indigenous Nursing Knowledge, study number, Pro00022568, September 12, 2011. v DEDICATION First, I give thanks to the Great Spirit for bringing me into this world as and for providing me a with a mother, grandmother, and family who have loved me unconditionally; and especially to my Uncle Gilbert Half, who has walked with me throughout this study, reminded me of our traditional ways, and instructed me to stay close to the women, because he knew that, traditionally, it would be the women who could teach me the knowledge. To the Indigenous scholars, Alice Reid, Evelyn Voyageur, Madeleine Dion Stout, and Lea Bill: Without your support this work would not have been possible. Thank you for your kinship while I learned more about the language and traditional ways of being and the opportunity to explore our history so that I could write an Indigenous nursing story of resilience, courage, compassion, and hope; for a future where Indigenous knowledge and our history contribute to the development of a more humanized Canadian society. Your giving of yourselves clearly marks the manifestation of Indigenous knowledge as a touchstone in nursing and informs how you approach you practice and service to Indigenous wellness. I will never be able to express my gratitude to each one of you forevermore. I will be forever indebted to you, and I will carry your spirits of Indigeneity in my own blood memory. I hope that this work will continue to bring those colourful meanings to the continued search for miyopitmasiwin (‘good life’). I will remember our experiences and use them as signposts as I navigate through my next journey. Your words will fuel my hunger and desire to know vi more about traditional understandings and how they will play out in our nursing fields. To the other part of me, my twin boys and my twin girls (Raymond, Riley, Danielle, and Domonique), I express my unconditional and enduring love to you; every day you watched over me as I wrote this dissertation. I can say that this work has also become part of you, and I am grateful for your unending support that helped me to see the completion of this writing. To my boys: Thank you for the daily hugs despite my daily resistance. You both have been gifted with compassion for others; please remember to take care of yourselves. To my daughters, who inspire me and leave me in awe: I would travel to the depths of the unknown for you, and as I watch you both enter your own journeys into a nursing career, I pray that you will never turn your face away from another, no matter the situations in which you might find yourselves. To my brothers, Oliver (passed), Claude, Philip, and Robert whom I have not seen in the last 20 year, I promise to find you. I write this for us so that a piece of our story can be told to our grandchildren who are yet to come. Your courage and determination in the face of adversity amaze me every day. Your weekly phone calls distracted me (smiling), but when I didn’t hear from you, I immediately became concerned. I loved knowing that you too were in this with me, and I know that hearing my distressed voice was difficult for you, but you still called back. We will never forget, and we will make our future better than our past. vii To my cousin Darlene: You are my rock as you carried my suffering with you and made me laugh all the way through, while reminding me why I needed to continue. To my nieces and nephews: Thank you for teaching me why this work is so important. After listening to you talk about your experiences in school, I want you to know that you can do anything you set your heart to do. Never let anyone tell you that you are not smart enough. You can be anything you want to be. To the Indigenous women in my research circle who listened to me lament and watched me cry many tears in our circles of conversations: You too have become part of me, and I am thankful to each of you for instilling seeds of love and hope in my beingness. Dr. Angeline Letendre, Dr. Evelyn Steinhauer, Dr. Rebecca Sockbeson, Dr. Jeannette Sinclair, Dr. Claudine Louis, and Annaleah King, and Rochelle Star, to name only a few, are the women with whom I have collectively shared this learning experience and made lifelong connections. To my nursing peers, who were always cheering me on from the sidelines: Your encouraging cues and warm smiles were extremely comforting. There are too many to list here, but I must give special attention to my friend Cheryl Robbins, who was not afraid to ask me those tough questions. Thank you for choosing me. I appreciate all of your reading and chopping of this document. To the Access research team: Thank you for asking what I thought and teaching me how to share what little I know. To Linda Pasmore, who helped me with edits, thank you. Your skill to see what I could not is amazing. viii Just as I began this acknowledgement, I want to finish by giving thanks for Creation and access to our natural bounties that are part of living our lives, simple things such as breathing, and the mental capacity to think through all of the diverse roadmaps so that I can follow with an open and responsive heart full of compassion and understanding to alternate ways of knowing and being in the world. This one little narrative contributes to the shift of the grand narrative of Indigenous peoples in nursing alongside Canadian history. I have been extremely fortunate to arrive at a place where we can come together not only through our families’ reconnection to our Cree roots and our Beaver Lake community, but also as concerned nurses who have worked towards the achievement of social justice for Indigenous peoples in Canada. Last to my dad, Raymond (whom I never met) and my grandmother Lucienne, Langevine who never forgot me and always protected me and made me aware of who I was. With all my love, all my relations. ix ACKNOWLEDGEMENTS To my supervisors, Dr. Brenda Cameron, Dr. Malcolm King, and Dr. Coar Webber Pillwax: Thank you for your tireless efforts to push me beyond what I thought was possible and, more important, what I thought I was capable of achieving. Your friendship, leadership, and scholarship have shaped this work into something manageable and inspiring. Brenda, thank you for your ability to push me further into the meaning of nursing practice and what it really means to be a nurse and how we act that out in the living; they are imprinted on my flesh, and I will learn to wear them in the most incredible ways. Philosophically, you helped me to discover the art of questioning by always asking, why? You opened up the world to me through your words and gave me access to my own being in nursing. Cora, no words can describe how I feel about your support and guidance.
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