Restoring balance through cultural safety & the medicine wheel

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North American culture sees health as an individual problem, but we live in dynamic, intercultural communities. Health is multifaceted with issues related to mental, spiritual, emotional, and physical health. Our culture can be a barrier to caring for our clients. Each area of the medicine wheel needs to be balanced for wholistic health for the client, where the client is the person, family, group, or community. Indigenous teachings support addressing all areas of the person to achieve balance. Cultural safety stresses the importance of reflection and acceptance of differences. We should not treat everyone the same, but we do need to recognize and acknowledge our blind spots.

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  • To increase awareness of Medicine Wheel teachings to support health care workers to care effectively for their clients.
  • http://www.webpanda.com/There/uot_directions-colors.htm (1) The four points of the compass, each with a guiding spirit, symbolize stages in the life journey. The East, direction of the daily birth of the sun, represents a person's birth and early years. The South relates to childhood and intellectual growth. The West symbolizes adulthood and introspection, while the North represents the old age, wisdom and the spiritual aspects of life. The centre of the wheel is symbolic of Mother Earth and the Creator, and their role in the beginning and continuation of life.(2) The four points can also represent the balance between spiritual (East), mental (North), physical (West) and emotional (South) aspects of health. (3) The wheel can also represent values and decisions. Here, values (drawn in the East, where the sun rises) influence decisions taken in the mental realm (drawn in the North, at the top). Then, decisions are implemented in the physical realm (West), and actions produce reactions in the emotional realm (South). Finally, these reactions provide feedback into the value system, completing the circle of value - action - evaluation.If we do not honour the negative side of life we as humans either fall very ill or, worse, inflict our pain upon each other. Touching the negative aspects of life can be beneficial. If we learn to honour and recognize all of our emotions, including the negative qualities, we can and will become the bearers of our own pearls of wisdom (pp. 53-54).http://zone.biblio.laurentian.ca/dspace/bitstream/10219/387/1/NSWJ-V7-art6-p139-161.pdf
  • http://www.shannonthunderbird.com/medicine_wheel_teachings.htm
  • culture no one has to talk about it, it doesn’t have to be written down, yet everybody knows it.Aboriginal teachings encompass a totality of the human condition – physical, spiritual, mental and emotional – and the significance of balance is emphasized. All aspects of life are intricately interconnected. Relationships are fundamental to understanding the nature of events, and establishing standards of behavior. Separating things out from each other and studying them as singular entities without a wholistic viewpoint as an organizing point does not fall within the natural way of thinking in Aboriginal epistemology.
  • Cultural Awareness – is concerned about acceptanceCultural Sensitivity – is about respecting differences often uses neutral language, and neutral communicationCultural Humility – self reflection acknowledges power differences, white privelegeCultural 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 safetyCultural Safety – relationships and partnerships, power shifts to the client, to decide what is safe and what is not
  • http://pub209healthcultureandsociety.wikispaces.com/%27A+Tree+Without+Roots%27+-+The+Importance+of+Cultural+Safety+in+the+Healthcare+System
  • This is how I learn.
  • http://www.ottawacitizen.com/opinion/op-ed/Cultural+respect+health+issue+Canadian+aboriginals/8803694/story.html
  • There is little recognition that the history of near extermination, cultural genocide, land loss, oppression, ongoingracism, and poverty are related to not only emotional, spiritual, and mental disease but also physical disease. http://www.med.uottawa.ca/sim/data/Aboriginal_medicine_wheel.pdf http://www.fourdirectionsteachings.com/transcripts/cree.html
  • http://www.addictionresearchchair.ca/creating-knowledge/provincial/sharing-the-role-of-aboriginal-traditional-culture-in-healing-from-addictions/
  • Restoring balance through cultural safety & the medicine wheel

    1. 1. Restoring Balance through Cultural Safety & the Medicine Wheel The Canadian Federation of Mental Health Nurses 2013 National Mental Health Nurses Conference
    2. 2. To describe concepts related to the Medicine Wheel To broaden the understanding of Cultural Safety from an Aboriginal perspective To identify the unique challenges faced by Aboriginal peoples and the need for a Balanced approach Objectives
    3. 3. “We are like trees. Our roots are put down very deep. And we take things from the four directions and we take them into our lives. And if you pull us up by the roots, we are lost. We have to go back and find those roots, find those beginnings that are strong so that we can live a good life”. Elder Betty McKenna, 2005.
    4. 4. Medicine Wheel Path to Wellness The Medicine Wheel is a path, just like healthcare Mental, spiritual, emotional, and physical health are addressed Moving beyond our own culture is required to provide care, treatment, and support to clients from diverse backgrounds and experiences.
    5. 5. There are two parts of life that each person needs to pay attention to or risk imbalance…We cultivate our external self to fit into the current culture and times…We take care of our inner life by personal reflection…Through reflection we change and grow spiritually http://zone.biblio.laurentian.ca/dspace/bitstream/10219/387/1/NSWJ-V7-art6-p139-161.pdf
    6. 6. Mental Health  Invisible illness  Historically, Aboriginal people were made to feel invisible, to be ashamed  Most people are embarrassed to report mental illness. Pills are easy. Therapy is more stigmatizing. And more expensive.  Mental health needs same attention as physical health.
    7. 7. Do we provide health care or simply treat diseases?  Each area of the medicine wheel needs to be balanced for wholistic health for the client, where the client is the person, family, group, or community.  Indigenous teachings support addressing all areas of the person to achieve balance.  Imbalance creates illness
    8. 8. Culture is a world view  North American culture sees health as an individual problem, but we live in dynamic, intercultural communities.  We learn about disease models of health  We need to focus on wellness and resilience models of health  Health is multifaceted with issues related to mental, spiritual, emotional, and physical health.  Culture can be a barrier to caring for our clients.
    9. 9. Culture of Western Medicine  We look for a diagnosis as a central goal,of healing or ‘fixing’ the client  Aboriginal medicine focuses on the whole person and looks for a safe environment in which the patient may recover.  For conditions such as mental disorders, this latter approach may prove more effective than struggling to attach a label to the disorder.
    10. 10. Cultural Competence  Cultural Awareness  Cultural Sensitivity  Cultural Competence  Cultural Humility  Cultural Safety
    11. 11. 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
    12. 12. I try to be skeptical (question things) and not cynical (dismiss ideas & find fault with them)
    13. 13. What is your role?  Cultural Respect  Unfair stereotypes and cultural misunderstandings overly affect aboriginal women
    14. 14. Restoring Balance  Collective cultures, like First Nations, have been impacted by colonialism, residential schools, changing gender roles, capitalism, and a foreign justice system, to name a few.  The loss of culture, language, traditions, and ceremonies has resulted in an imbalance to traditional ways of living.  The resulting loss of balance and harmony has resulted in pain: Mental, Spiritual, Emotional and Physical.
    15. 15. Restoring Balance  North American culture looks at health problems as individual problems or behaviour choices rather than looking at the larger societal picture.  In individualistic societies we blame the individuals, often missing the larger patterns and forces at work.  The individualistic perspective frequently narrows the ethical discussions to consideration of individual rights rather that collective goals and responsibilities.
    16. 16. • Do not look at health issues as a single category • Our clients are culturally diverse: First Nation, Métis, Inuit . . . • Our clients have diverse personal experiences: adoption, foster-care, urban, on- Reserve, Residential School legacy, colonialism, loss of language, traditions, etc • Our clients have diverse gender issues/sexual orientation needs(Heterosexual, Two-Spirit, Transgender) Diversity is a factor in care
    17. 17. Traditional wellness practices Whether or not people use traditional Aboriginal wellness practices is a very personal decision - varies according to family, spiritual/religious and cultural backgrounds, and individual experiences and beliefs Nurse who support the use of traditional wellness practices may observe health benefits among their Aboriginal clients
    18. 18. Nurses need to accept & support client decisions Aboriginal people can ‚either go the traditional route, the contemporary medicine route, or a combination of both.‛ Service providers should support those choices  Clients who attend traditional ceremonies and events like talking circles, sweats, dances, etc, experience a gradual ‚healing‛ due to social support and cultural connections (‚belonging‛) and spiritual teachings (‚moments of peace‛)
    19. 19. Partnerships with Aboriginal organizations work Local or regional Aboriginal organizations are best able to provide cultural competence workshops and resources for mainstream service providers with Aboriginal clientele
    20. 20. Teach what you practice
    21. 21. It is Important to provide choices Develop processes of identifying priorities and ho work with your clients to make choices accordingly ‚Culturally competent‛ health care providers inform, encourage and support choices – including access to and use of traditional wellness practices
    22. 22. • Cultural safety stresses the importance of reflection & acceptance of differences. • We should not treat everyone the same. • We do need to recognize and acknowledge our blind spots.
    23. 23. ‚Ultimately we know deeply that the other side of every fear is a freedom.‛ Marilyn Ferguson
    24. 24. Contact information Greg Riehl RN BScN MA Aboriginal Nursing Student Advisor Aboriginal Nursing Student Achievement Program SIAST Wascana Campus Email: greg.riehl@siast.sk.ca Email: gregriehl@sasktel.net @griehl

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