Culture, everybody does it, everybody knows about it, nobody talks about it. Culture is more than food fashion and fun. And Nursing culture is Nursing culture. Focus on the Platinum Rule

1. Culture for Jaime’s class
October 26th, 2017
Greg Riehl RN BScN MA

2. Outline
Communication
Culture
World View
Balance
Walking wounded, warrior, healer
Platinum Rule
Lateral Violence
Lateral Kindness

4. Where am I and
Why am I here?
• I would like to acknowledge Treaty 4
• I ask myself this every day, and I also ask those who I am working with from time to
time…
• I would also like to acknowledge the prisoners, vacationers, keeners and experts with
us today

5. What kind of learner are you?

6. Stories
 I will use some of my experiences working in health,
in the north, and as a nurse, often an outsider,
working in different situations.
 You are a part of the story.

7. What
do
you
see?

9. ᒥᐢᑕᑎᒼ mistatim [NA]
 horse
 a spotted horse, i.e.: a pinto, masinâsowatim (na); a stud or
male horse, nâpestim (na); a young horse, i.e.: usually refers
to a yearling, oskastim (na); a harness horse or a work
horse, otâpahâkan (na); s/he has horses or dogs, otemiw
(vai); an untamed horse, pikwatastim (na) (Northern Cree);
an untamed horse, pakwatastim (na) (Plains Cree); it is a
good or nice horse or dog, takahkatim (na); a white horse
or white dog, wapâstim (na); a saddle horse, tehtapîwatim
(na)

11. “We walk into the future backwards
because we are looking to our
Ancestors, listening to our Elders, and
learning our traditions and cultures”
Chief Jo Mathias

12. Communication is about Listening
 My job description does not say, Greg, you will have to listen to a lot of
your co workers bitching and complaining about each other, they will
want you to fix their conflicts, and will want you to keep it a secret and
tell no one.
 This will happen on a very regular basis, consider this ‘duties as assigned’

13. First quiz of the afternoon
 1. How do you put a giraffe into a refrigerator?
 2. How do you put an elephant into a refrigerator?
 3. The Lion King is hosting an animal conference. All the animals attend.... except one. Which
animal does not attend?
 4. There is a river you must cross but it is used by crocodiles, and you do not have a boat. How
do you manage it?

14. “What we see, we do not see.”
 Archie Weenie

15. Invisible Backpack
“all of us carry an invisible ‘backpack’ of our culture, experiences, beliefs,
values and morals. Whenever we encounter another person, our backpack
is present with us and influences how we interact with our patients and
their families”.
Scott Harrison
Invisible Knapsack Peggy McIntosh

17. Invisible Backpack

18. Invisible Backpack

19. We Don’t See Things As They Are, We See
Them As We Are
“It has been well said that we do not see things as they are, but as we are
ourselves. Every man looks through the eyes of his prejudices, of his
preconceived notions. Hence, it is the most difficult thing in the world to
broaden a man so that he will realize truth as other men see it.”
Anaïs Nin

20. What is Culture?
 Behaviour is what you do…
 Culture is how you do it…

21. Everything is about CULTURE!
 Everybody knows about it
 Everybody does it
 Nobody talks about it
 Kathleen Bartholomew, RN, MN

22. What is Culture?
 Behaviour is what you do…
 Culture is how you do it…

23. Cultural Awareness
Is really concerned about acceptance

24. Cultural Sensitivity
Is about respecting differences and often uses neutral language, and neutral communication

25. What happens if a bird poops on
you?
 Bird poop brings good luck! There is a belief that if
a bird poops on you, your car or your property, you
may receive good luck and riches. The more birds
involved, the richer you'll be! So next time a bird
poops on you, remember that it's a good thing.

26. Cultural Knowledge
Familiarization with selected cultural characteristics, history, values, belief systems, and
behaviours of the members of another ethic group

27. Cultural Knowledge
Familiarization with selected cultural characteristics, history, values,
belief systems, and behaviours of the members of another ethic group

28. Cultural Competence
Is about understanding, knowledge skills and attitudes, working effectively
in cross cultural and intercultural situations, this is the application of
knowledge, creates the environment of cultural safety

29. Cultural Humility
Focuses on self reflection and acknowledges power differences,
and privilege.

30. Cultural Safety
Stresses the importance of relationships and partnerships, power shifts to
the client, to decide what is safe and what is not

31. An environment that is safe for people; where there is no assault, challenge or denial of
their identity, of who they are and what they need. It is about shared respect, shared
meaning, shared knowledge and experience, of learning, living and working together
with dignity and truly listening.
(Health Q. F., 2012)
Cultural Safety

33. Bronze rule
Do unto others as they have done unto you

34. Silver
What you do not want done to yourself, do not do to
others

35. Gold
Do unto others as you would have them do unto you.

37. Platinum
Do unto others as they want done unto them

38. THE PLATINUM RULE.
TREAT OTHERS
HOW THEY WANT TO BE TREATED

39. Here are some differences between
maintaining classroom control and bullying
 Educators let students know they care. Bullies let students know who’s the boss.
 Educators teach self-control. Bullies exert their own control.
 Educators set ironclad expectations. Bullies rule with whims of steel.
 Educators diffuse minor disruptions with humor. Bullies to disruptions into confrontations.
 Educators privately counsel chronic discipline problems. Bullies publically humiliate chronic
misbehaviors.
 Educators are judicious. Bullies are judgmental.
 Educators, aware of the power they wield over their students, choose their words and actions carefully.
Bullies wield their power, recklessly, frequently resorting to anger and intimidation.

40. Here are some differences between
maintaining classroom control and bullying
 Educators help all students feel successful. Bullies punish students for being unsuccessful.
 Educators address misbehavior. Bullies attack the character of the misbehaviors.
 Educators see each student’s uniqueness. Bullies compare children to one another.
 Educators treat all students with respect. Bullies make it clear that not all students deserve respect.
 Educators highlight good behavior. Bullies make examples of poor behavior.
 Educators are proactive; they create classroom environments that minimize student misbehavior.
 Bullies are reactive; they blame students for the lack of order in their classroom.
 Educators educate. Bullies humiliate.

41. Seriously, Conflict It’s not all Bad
 Functional Conflict is considered positive, as it can increase performance,
support change, and identify weaknesses or areas that need to be
supported.
 Dysfunctional Conflict is harmful to people and the organization. This
type of confrontation does nothing to support goals or objectives.

44. Imbalance Creates Illness
 Holistic approach to address issues and factors that impact illness
targeting not just the disease, but also the social determinants of
health and economic circumstances.
 It is recognized that the whole family (broadly defined) is as impacted
by disease and needs healing just as the individual who is ‘sick’
requires care, treatment and support.

45. How do you define health
 Holistic Health and Traditional Knowledge
“balance the mind, body, and spirit with community and environment”

46. Physical Mental Emotional Spiritual Health
My perspective is that each of these four parts can be treated as its own
body.
Each requires its own form of sustenance and exercise to be healthy

47. BALANCE
Wheel of Life

49. How many Directions are there?

50. Seven Directions!
 East
 South
 West
 North
 Life Above the Earth
 Life Below the Earth
 Life on the Earth (and within ourselves)

51. Tips for Creating a Healthy Work
Environment by Kathleen Bartholomew
 Never be a “silent witness”. Never stand by and listen while others are gossiping,
criticizing or talking badly about someone else
 Be a team player. If you see someone in need of help, offer assistance. The greatest
safety net cast is to catch mistakes and this is only as strong as your relationships
 Speak your truth – always say what’s on your mind. Start the conversation by sharing
your perception of what happened and then what you need
 Always stay client focused and problem solving focused (personally I want a win-win)
 Address issues directly. Ask the manager or your mentor to help role model difficult
conversations with you

52. Walking Wounded
The ‘journey of the walking wounded’ is an ideal pathway to bring about
this healing.

53. Theory of the Wounded Healer
 We often witness traumatic events or have experienced traumatic events
in our own lives
 Ineffective coping, leads to impacts of trauma that become unresolved
 When we deny the stresses and stressors in our lives, we become
wounded
 We can project the stress, from our wounds, onto others

54. Theory of the Wounded Healer
 When we deal with trauma effectively, we may be wounded, but we can
transform the pain into understanding, empathy, and healing
 We build better relationships with our patients and colleagues,
 This is part of the Nursing Culture, and it is part of carers
 interactions, connections, relationships, and integrations
 We gain understanding on how to help others
 A lot of ‘helping’ professions have Wounded Healers

55. Recognition
 Awareness that something is affecting a person in a negative manner,
either through his/her own thought processes and self-evaluation, or
with the assistance of other people in his/her life.

56. Transformation
 Seeking affirmation and control over feelings of pain and/or fear through
counseling and/or sharing; using energy from the past to increase
understanding of the present and future.

57. Transcendence
 A higher level of understanding (can be spiritual and/or higher thinking)
that allows the person to use the understanding achieved to increase
their therapeutic relationship with others.

58. Walking Wounded
 Those who have experienced either physical or verbal trauma in their
lives that they have not dealt with, allowing alterations in their ability to
cope with current stressors, leading to negative results.

59. Wounded Healer
 Those who, through self-reflection and spiritual growth, achieve
expanded consciousness, through which the trauma is processed,
converted, and healed. The scar remains, giving the person a greater
ability to understand others’ pain.

60. Recognition, Transformation, Transcendence
 Recognition
 What happened?
 What could be changed?
 How should it have been handled?
 Transformation
 What can be learned from the incident?
 Has this changed me or the people I care about?
 How can this be used to make things better?
 Transcendence
 I understand your pain.
 How can I make things better for you?

61. To be healthy, to have healthy workspaces…
The Walking Wounded needs to become the Wounded
Healer
...if subjected to personal trauma or LV again, nurses must repeat the
process...

62. Hurt People Hurt People
Abusive patterns get passed on,
Generation after generation,
But the chain can be broken.
Meet anger with sympathy,
Meet contempt with compassion,
Meet Cruelty with kindness,
Meet grimaces with smile.
When you forget about the fault, there is nothing to forgive. Love is the weapon of the future.
Yehuda Berg

63. Lateral Kindness
 Please be kind to each other
 Respectful and responsible relationships, there are no apps for that.
 Be Grateful
 Be Great!

64. “Reconciliation is about forging
and maintaining respectful
relationships.
There are no shortcuts.”
Justice Murray Sinclair

66. Discussion, questions,
comments!!!
Thank you for your participation

67. Contact information
Greg Riehl RN BScN MA
Aboriginal Nursing Student Advisor
Aboriginal Nursing Student Achievement Program
Saskatchewan Polytechnic
Regina Campus
Email: greg.riehl@saskpolytech.ca

68. DESC COMMUNICATION MODEL
Describe – the behavior
Explain – the effect the behavior has on you, coworkers, patient care
State – the desired outcome
Consequences – what will happen if the behavior continues?

69. Statement of Commitment to Co-workers
As your co-worker with a shared goal of providing excellent service to people
and families, I commit the following:
I will accept responsibility for establishing and maintaining healthy
interpersonal relationships with you and every member of this staff.
I will talk to you promptly if I am having a problem with you. The only
time I will discuss it with another person is when I need advice or help
in deciding how to communicate with you appropriately.
I will establish & maintain a relationship of functional trust with you and
every member of this staff. My relationships with each of you
will be equally respectful, regardless of job titles or levels of educational preparation.
I will not engage in the '3B's (bickering, back-biting and bitching) &
will ask you not to as well.
I will not complain about another team member & ask you not to as well.
If I hear you doing so, I will ask you to talk to that person.
I will accept you as you are today, forgiving past problems,
& ask you to do the same with me.
I will be committed to finding solutions to problems rather than
complaining about them or blaming someone, & ask you to do the same.
I will affirm your contribution to quality service.
I will remember that neither of us is perfect, & that human errors
are opportunities not for shame or guilt, but for forgiveness and growth.
(Adapted from Marie Manthey, President of Creative Nursing Management in Caroline Flint's Midwifery Teams and Caseloads 1993; p. 138)