a synopsis of Cree culture

A Synopsis of Cree
Culture
With Implications for Nursing
Assessments

"ka-kí-kiskéyihtétan human beings
Realize that we as óma, namoya
kinwés maka aciyowés earth for only
have been put on thispohko óma óta a
ka-hayayak wasétam askihk, ékwa this
short time and that we must usekakakwéy miskétan
time to gain wisdom, knowledge,
kiskéyihtamowin, iyinísiwin, kistéyitowi
respect and the understanding for all
n, mina nánisitotatowin kakiya
human beings since we are all
ayisiniwak,
relatives. ékosi óma kakiya kawahkotowak."
http://www.sicc.sk.ca/archive/heritage/sils/ou
rlanguages/plains/eldersquotes/index.html

A study recently
published in the journal
Nature reports that
present day aboriginal
peoples of Canada have
clear genetic links to
Palaeolithic Europeans.

How that came to be can be debated.

The Nature study argues that ancestral
Europeans intermingled as they wandered
eastward through Asia and Siberia. Near the
end of the last ice age (about 13,000 years
ago), successive waves of migrants began to
transit the “Bering Land Bridge” to Alaska.

They could be the ancestors of
hundreds of aboriginal nations that
then spread throughout the Americas.
http://news.nationalpost.com/2013/12/02/surprise-dna-profile-linking-24000-yearold-siberian-skeleton-to-modern-native-americans-could-rewrite-first-nations-story/

A well rounded introduction
to the historical presence of
First Nations in what would
become Canada can be found
online at...

http://www.aadncaandc.gc.ca/eng/1307460755710/1307460872523
#chp2

Aboriginal Affairs and
Northern Development
Canada is a key player in the
wellbeing of First Nations
people.

AANDC

Visit the AANDC website and wander
through the links “All Topics” and “About
AANDC”

AANDC

The mandate of this governmental department
is built on the premise that, “Canada's economic
and social well-being benefits from strong, selfsufficient Aboriginal and northern people and
communities.”

AANDC
They go on to write – “(AANDC) supports
Aboriginal people (First Nations, Inuit and Métis)
and Northerners in their efforts to: improve social
well-being and economic prosperity; develop
healthier, more sustainable communities; and
participate more fully in Canada's political, social
and economic development - to the benefit of all
Canadians.”

Reconciliation from our colonial past
will likely see an ongoing evolution
of terminology.

Language that was regarded as
acceptable in previous centuries
may be seen as politically incorrect
now. The AANDC website provides a
brief tutorial on the history and use
of some relevant terms.
http://www.aadncaandc.gc.ca/eng/1100100014642/1100100014643

No discussion of the history of First Nations in
Canada can ignore the tragic legacy of residential
schools. It still haunts many individuals and
continues to impact their health and the wellbeing
of their communities.

“Two primary objectives of the residential school
system were to remove and isolate children from
the influence of their homes, families, traditions
and cultures, and to assimilate them into the
dominant culture. These objectives were based on
the assumption Aboriginal cultures and spiritual
beliefs were inferior and unequal. Indeed, some
sought, as it was infamously said, “to kill the Indian
in the child.” Today, we recognize that this policy of
assimilation was wrong, has caused great
harm, and has no place in our country.”
Prime Minister Stephen Harper, official apology, June 11, 2008

The remainder of that website
explores the tragedy of residential
schools in detail.

http://indigenousfoundations.arts.ubc.ca/home/governm
ent-policy/the-residential-school-system.html

In my mind, it would be wise for nursing
assessments to routinely ask Native clients if
they feel residential schools impact their
current health in any way.

If they feel there are residual effects –
further exploration can begin. The resulting
discussions could, if nothing else, begin a
work towards reconciliation.

Animism - anthropologist Sir Edward
Burnett Taylor (1832-1917) defined it as
the "theory of the universal animation of
nature," from Latin anima
"life, breath, soul".
http://www.etymonline.com/index.php?term=
animism

Animism is common among many of the world’s
hunter-gatherer peoples and is one of the oldest
religious beliefs. Its most basic tenet is that all things
are endowed with souls or spirits. Subsequent to that
central belief some tribes believe certain spirits or
characteristics empower particular animals and that
those characteristics can be passed on to individuals
via totems or fetishes.
http://www.warpaths2peacepipes.com/nativeamerican-culture/fetishism.htm
http://www.warpaths2peacepipes.com/native-americanculture/native-american-religion.htm

Since the earliest European contact there has
been a Christian missionary outreach to the native
inhabitants found here. Catholic and Anglican
powers vied for influence as early factions within
Canadian politics waxed and waned. The most
profound religious impact would begin in the 19th
century with the indoctrination of children forced
to attend residential schools administered by
various churches.

The resulting mosaic of religious/cultural beliefs
within most Aboriginal people means that no one
can assume that a First Nation client must embrace
a particular belief. Individual beliefs must be
determined on a case by case basis. Even within
families belief systems can vary profoundly from
simple animism to more formalized traditional
ceremonies to “high church” adherence to modern
evangelicalism. And even if an individual selfidentifies with a particular group they may well
embrace aspects of other traditions depending on
the circumstance.

Do not make assumptions about what a First
Nations client must believe or how they
choose to worship...

The participation in “sweats” exemplifies the
above polychotomy. For the more traditional
participants, led by a ceremonial leader, it
invites openness to a spiritual realm where
spirits can advise on life choices or facilitate
healing. At the other end of the spectrum
others may see it as a healthy, social endeavor
akin to using a sauna.
http://voices.yahoo.com/inipi-historymeaning-sweatlodge-370823.html?cat=34

Faced with a wide array of traditions it would be
wise for institutions to be proactive and enact
well conceived policies before they are needed.
Issues like allowing pipe ceremonies or
smudging in a client’s room ought to be decided
ahead of time. At some point someone will ask
if we would consider allowing a person’s
medicine bag to accompany them into the
operating room. If institutions attend to the
issues in a culturally safe manner then
consistent application can be observed for all
clients.

There are many other
traditions and observances
which also draw in a wide
range of religious or cultural
beliefs. Interested readers
can discover more at the
following link.
http://www.rcmp-grc.gc.ca/pubs/abo-aut/spiritspiritualite-eng.htm

Holistic health is the foundational understanding of
wellbeing among First Nations people. Sickness is
rarely viewed as a condition solely of the body – it
signals an imbalance among all systems.
The “medicine wheel” is a
graphic reminder that
balance must be maintained
between physical, emotional,
mental and spiritual.

Many native people foster abiding ties to their
traditional lands, the indigenous foods found there
and the herbal medicines gathered from them.
Living away from their reserve, eating “white” foods
and relying on western medicine are often seen as
the root of many problems facing Native people.

During initial nursing assessments clients may
deny using any traditional forms of medicine
because they have been repeatedly told by nonnatives that they are useless, dangerous or
sinful. Only a culturally sensitive approach will
initiate a helpful discussion.

A non-judgemental focus on whether a treatment is
effective rather than a dismissive superiority will
promote openness. Asking the client if they are using
any traditional medicines that they find helpful
comes across as caring and accepting. From there the
nurse can reinforce that medicine is medicine and
that both traditional and western forms should be
used with cautious respect.

“Traditional medicines and practices remain an
important part of the lives of Inuit, Métis and First
Nations in Canada. A report conducted for the
Ontario Women’s Health Council in 2003 indicates
that of 276 Aboriginal women respondents, 72.1 per
cent reported consulting traditional healers, and
42.0 per cent sought out the services of medicine
people. Even in an urban setting, a significant
number of Aboriginal Peoples access traditional
medicines. According to the 2001 Aboriginal
Peoples Survey, about 34 per cent of Aboriginal
people living in urban areas had access to
traditional medicines.”

“Traditional medicines and practices remain an
http://www.naho.ca/documents/naho/publications/t
important part of the lives of Inuit, Métis and First
kOverviewPublicHealth.pdf
Nations in Canada. A report conducted for the
Ontario Women’s Health Council in 2003 indicates
that of 276 Aboriginal women respondents, 72.1 per
cent reported consulting traditional healers, and
42.0 per cent sought out the services of medicine
people. Even in an urban setting, a significant
number of Aboriginal Peoples access traditional
medicines. According to the 2001 Aboriginal
Peoples Survey, about 34 per cent of Aboriginal
people living in urban areas had access to
traditional medicines.”

It is also important to note here that tobacco is
considered a sacred plant. As such it is may be given
as a symbolic gift in certain circumstances. Tobacco
use remains far more common among Aboriginals
than in the broader Canadian population. A
dictatorial attitude coming from a health worker
will only impinge on any helping relationship

Two influences can profoundly limit discussion of
pregnancy or gynecological concerns with a Native
client - general taboos against discussing sexuality
plus the sacredness of motherhood in general and of
the womb specifically. Consequently, the health of
aboriginal women and their children can be
negatively impacted. Add in the tenuous access to
specialists and even physicians in isolated
communities and there can be tragic lack of
examinations, diagnoses and treatments. Too often a
delayed assessment will uncover a health concern
that has progressed to dreadful stages
http://www.collectionscanada.gc.ca/obj/s4/f2/dsk4/etd/MQ81349.pdf

A wealth of information related to maternal and child
health on First Nations can be found at the following
link...
http://www.pwhce.ca/program_aboriginal.htm

“When dying, a traditional person will call for the
ceremonies, medicine and prayers that will guide
his/her spirit back to the spirit world. A spiritual
leader or medicine person close to the dying person
will conduct the ceremonies. As many family and
clan members as possible will be present...”
http://www.cme.utoronto.ca/endoflife/PPT
Indigenous Perspectives.pdf

“Traditionally, it was women who washed and
dressed the body in preparation for its burial. Women
also made the moccasins which are placed on the
feet. Sweetgrass, our sacred and purifying plant is
placed in the right hand of the deceased. Tobacco, the
instrument to aid communication between the
Creator and ourselves, is also placed in the casket. As
well, personal property, especially the deceased
person's pipe, is left with the body as these articles
are, in essence, part of the person.”
www.sicc.sk.ca/archive/saskindian/a89mar11.htm

Various social and economic factors directly impact
the health of First Nations people...

Overcrowded housing


Lack of educational
resources

And the underemployment that follows


Issues of addiction


Food insecurity


Health service unavailability...


All of those issues will have an insidious
effect on a persons wellbeing

A client assessment on an isolated reserve could
uncover circumstances more common to thirdworld nations.
http://www.nccah-ccnsa.ca/docs/social%20determinates/nccah-loppie-wien_report.pdf

Specific articles of established treaties – in
particular the “medicine chest” clause of treaty
number six, extend certain entitlements to some
First Nations people.

“To support First Nations people and Inuit in
reaching an overall health status that is
comparable with other Canadians, Health
Canada's Non-Insured Health Benefits (NIHB)
Program provides coverage for a limited range of
these goods and services when they are not
insured elsewhere.”
http://www.hc-sc.gc.ca/fniah-spnia/nihb-ssna/index-eng.php
http://www.pwhce.ca/pdf/entitlementsHealthServices.pdf

Questions about why a status Indian receives
some coverage not afforded other Canadians
requires extreme tact.

Predominant
Present Health
Concerns

“The drastic changes that have occurred over the
past 130 years have led to disproportionately high
incidences of preventable disease among First
Nations...

“For example, some First Nations have diabetes
rate 40 percent higher than the rate of the
general population...”

“Additionally, First Nations populations have
higher levels of injuries such as motor vehicle
crashes, as one of the leading causes of injury and
death...”

“First Nations peoples have higher rates of
arthritis; high blood pressure; diabetes; asthma;
heart disease; cataracts and chronic conditions...”

“Food insecurity is a major issue and a precursor
to many health problems such as malnutrition, low
birth weight babies, unhealthy pregnancies and
poor health in seniors...”

“Deaths due to medically treatable diseases are
higher among First Nations than the rest of the
population, mainly due to untimely access to
medical intervention. Deaths for HIV are higher as
are rates of HIV per capita.”
All above quotes are from the following link...
http://www.fnhc.ca/index.php/health_actions/primary_care/

Direct, extended eye-contact could be interpreted
as an attempt at intimidation. Similarly, direct
questioning (particularly of an elder or someone
you do not know well) is rude because it
precludes their ability to answer in a roundabout
fashion seen by them as respectful of your right
to arrive at your own conclusions.

Respect is paramount – they resist telling
someone precisely how something is and reject
being told an absolute truth. It is expected that
everyone will find their own way to the truth.

That poses a particular challenge to any nursing
assessment based on direct questions and the
expectation of unambiguous responses.

Silence truly is golden among many natives.
Elders may pause for awkward amounts of time
(by Western standards). It ought not to be
interpreted as an opportunity for you to speak as
they may be using silence to underscore what
they just said. When in doubt – just continue to
listen quietly.
http://cosmicserpent.org/uploads/downloadables/Communication%20
Styles%20of%20Indian%20People.pdf

Suggested Reading List
•A Guide for Health Professionals Working With Aboriginal Peoples - Cross
Cultural Understanding
http://www.cfpc.ca/uploadedFiles/Resources/Resource_Items/
Health_Professionals/GuideHealthProfessionalsAboriginal.pdf
•From Intercultural Awareness to Intercultural Empathy
http://www.ccsenet.org/journal/index.php/elt/article/viewFile/9671/6919

•Culturally Competent Care for Aboriginal Women
http://www.naho.ca/jah/english/jah04_02/03_V4_I2_Competent03.pdf

•Stories About Cancer From The Woodland Cree Of Northern Saskatchewan
http://www.collectionscanada.gc.ca/obj/s4/f2/dsk3/SSU/TC-SSU-01042006163028.pdf

•Indigenous Perspectives on Death and Dying
http://www.cme.utoronto.ca/endoflife/Slides/PPT%20Indigenous%20Perspectives.pdf

•Health Determinants for First Nations in Alberta 2010
http://publications.gc.ca/site/eng/367385/publication.html

•First Nations And Inuit Regional Health Survey
http://uregina.ca/library/holdings/FN_Inuit_Health_Survey.pdf

•An Overview Of Traditional Knowledge And Medicine And Public Health In Canada
http://www.naho.ca/documents/naho/publications/tkOverviewPublicHealth.pdf

a synopsis of Cree culture

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