Restoring balance through cultural safety & the medicine wheel WNRCASN
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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. Through literature reviews and interviews with elders, it is clear health care providers can serve clients better with knowledge related to the medicine wheel. Cultural safety stresses the importance of reflection and acceptance of differences. As health care providers, and teachers, we should not treat everyone the same, but we do need to recognize and acknowledge our blind spots. Increasing awareness of Medicine Wheel teachings will support health care workers to care effectively for their clients. Moving beyond our own and into the culture or the ‘other’ is required to provide care, treatment, and support to clients, and students, from diverse backgrounds and experiences. The culture of Western medicine places diagnosis as a central goal, whereas other approaches, including Aboriginal medicine, see diagnoses and the physical aspects of health as less central and pay more attention to finding a safe environment in which the patient may recover.
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Restoring balance through cultural safety & the medicine wheel WNRCASN
- 1. RESTORING BALANCE THROUGH CULTURAL SAFETY & THE MEDICINE WHEEL WNRCASN Feb 19-21, 2014 Winnipeg, MB
- 3. Objectives To describe concepts To broaden To identify related to the Medicine Wheel the understanding of Cultural Safety from an Aboriginal perspective the unique challenges faced by Aboriginal peoples and the need for a balanced approach
- 4. PHYSICAL MENTAL EMOTIONAL SPIRITUAL 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
- 5. 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
- 7. “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.
- 8. • 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.
- 11. EAST
- 12. SOUTH
- 13. WEST
- 14. NORTH
- 15. SEVEN DIRECTIONS! • East • South • West • North • Life Above the Earth • Life Below the Earth • Life on the Earth (and within ourselves)
- 16. THE CIRCLE The Circle lies at the centre of First Nation's spirituality.
- 17. CULTURAL COMPETENCE • Cultural Awareness • Cultural Sensitivity • Cultural Competence • Cultural Humility • Cultural Safety • respect
- 18. Cultural Safety 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)
- 19. CULTURE IS A WORLD VIEW • North American culture sees health as an individual problem, but we live in dynamic, intercultural communities. • Culture can be a barrier to caring for our clients. • 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.
- 20. 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.
- 21. Diversity is a factor in care • Do not look at health issues as a single category • Our clients/students are culturally diverse
- 22. NURSES NEED TO ACCEPT & SUPPORT CLIENT DECISIONS Aboriginal people can “either go the traditional route, the contemporary medicine route, or a combination of both.” Healthcare 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”)
- 23. 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
- 25. 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
- 26. STAR BLANKET - SYMBOL
Editor's Notes
- 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. Through literature reviews and interviews with elders, it is clear health care providers can serve clients better with knowledge related to the medicine wheel. Cultural safety stresses the importance of reflection and acceptance of differences. As health care providers, and teachers, we should not treat everyone the same, but we do need to recognize and acknowledge our blind spots. Increasing awareness of Medicine Wheel teachings will support health care workers to care effectively for their clients. Moving beyond our own and into the culture or the ‘other’ is required to provide care, treatment, and support to clients, and students, from diverse backgrounds and experiences. The culture of Western medicine places diagnosis as a central goal, whereas other approaches, including Aboriginal medicine, see diagnoses and the physical aspects of health as less central and pay more attention to finding a safe environment in which the patient may recover.
- To increase awareness of Medicine Wheel teachings to support health care workers to care effectively for their clients.
- http://cjmcpherson.com/2012/02/28/physical-mental-emotional-spiritual/This is one of the meanings of the four sections of the medicine wheel, along with the seasons, directions, stages of life and countless other things. It’s a symbol overflowing with meanings, most of which I don’t pretend to know or understand.Physical – The BodyThe medicine wheel represents mind, heart, body and spirit, among other things.The obvious of the four. The physical body and its physical, observable needs. Made of matter, driven by chemistry and studied by the physical sciences, most of us have some idea how our body works. The body is fed by chemical energy and nutrients from food and is exercised by movement and strenuous activity. When the body is well nourished and well exercised you get vitality, when it is not you get sickness.The body also includes our sexual needs. The body is designed to require sex in the same way it requires food, which is why prolonged abstinence is as unpleasant as it is. Why some religions are so fond of it I cannot understand.Despite all the fuss about weight loss and dieting, most North Americans don’t take good care of their physical bodies. Rates of obesity and other illness attest to this.I like to place the physical aspect at the base of the medicine wheel, as it forms the foundation that the other three build on. The body needs to be fed before you can even begin thinking about the needs of the mind or emotions. But if you have a healthy body, taking care of the rest of your being is easier.Mental – The MindIt could be said that the mind is made of thoughts, but I think it is more accurate to say thoughts are the actions of the mind. The mind works with relations of ideas, concepts and pattern recognition. It processes information sequentially, using words and other symbols to make sense of what it observes. Logic, memory and conscious thought are all within the domain of the mind.The mind is fed by knowledge and exercised by thinking. Solving challenging problems and creative work are examples of a workout for the mind. Like with physical muscles, the stronger the mind is, the more it needs to lift to feel challenged. An underused mind becomes bored. A well fed and challenged mind becomes intelligent.Emotional – The HeartLike thoughts are the actions of the mind, I like to think of emotions as the actions of the heart. The heart, or socio-emotional center if you want to sound scientific, goes much deeper than the emotions we are aware of. It contains all of our connections, desires and repressed feelings, among other things.The heart can be said to have an internal and external side. The internal is our own emotional state, while the external is our relationships with other people. As social beings, the relationships we have are extremely important. As I have learned the hard way, a lack of good quality relationships will make you miserable no matter how much attention you pay to your emotions.The heart is fed by supportive relationships and positive experiences. It is exercised by compassion, giving and generosity. Like how some foods are filling but bad for you, not all relationships are equally nutritious to the heart. Abusive relationships certainly fall under this category, but so does any relationship that isn’t what you as a person need. The same goes for experiences, what thrills one person would bore another to death. This specifics are different for everyone, so no one can tell you a relationship or experience is right for you but yourself, especially not the other people involved.A well fed heart creates joy, a neglected heart creates misery, guilt, resentment, anger and a host of other negative emotions. The heart is a very complicated area and I’ve only scratched the surface in terms of my understanding of it. More will come in this area when I know more.Spiritual – Spirit, Soul, Consciousness, Etc. . .This is the hardest area to really understand, as it forms the absolute core of our being. It is the innermost ‘us’ beyond all our self-identifiers, beliefs and experiences. It doesn’t matter of you believe the soul or consciousness has a spiritual or material origin, it still has its own workings that must be addressed.Like thoughts and emotions are the actions of the mind and heart, the spirit has its own form of activity. The spirit works with beliefs. It doesn’t reason or question these beliefs like the mind, but holds them. The spirit deals only with is, not with because.For this reason, every belief is treated as an absolute. It doesn’t matter how accurate or inaccurate it is. It doesn’t matter where it came from or who first said it. Once the spirit believes something, the mind and heart will believe it as well. The spirit acts like a metronome keeping time for the rest of your being.The spirit is fed by meaning and exercised by spiritual growth. When the spirit is taken care of you get fulfilment, when it is neglected you get spiritual apathy, nihilism and depression. The spirit’s needs are the most subtle of all, because they work on a longer time scale than most human activities. A deficit in the spirit will take a long time to appear, but a well balanced spirit creates benefits over a lifetime.By meaning I’m referring to the sense our lives mean something within the larger scheme of things. Whether to the universe as a whole or to the human race, we as humans need to feel we’ve done something worthwhile. The specific meaning you give your life will depend on your beliefs about the world and how it works. The important thing is that your life has meaning within what those believes. This requires great introspection and consistent effort, but it is necessary. I’ve only taken a few steps down this road myself.Spiritual growth is increasing your understanding of the world and your place in it. It is finding more powerful beliefs and leaving behind old ones. It is becoming more aware and capable as a human being. Most people pay little, if any, attention to this area, but those who do can achieve amazing things within their lifetime. Just look at Jesus, Buddha and Gandhi.Separate but ConnectedThese four areas are separate, but connected. They work independently of one another most of the time, but depend on each others’ existence and continued functioning. No one area can exist without the others.For example, the body and mind are never sure of what the other is doing. Out thoughts are separate from our autonomic functions. But should the mind be put under stress, it will cause a stress response in the body as well, raising heart rate, blood pressure and metabolism, among other things. The same is true of the reverse, stress to the body (like illness) will negatively impact the mind.Each of the four areas are equally essential and are equally ‘you.’ The key is to have them all working and in balance. Any one neglected area will throw the whole system out of balance, becoming progressively worse until it is addressed or causes a complete breakdown.But when all four areas are fed and used properly, happiness is the result. One area, once healthy, can help you to work through other areas.I certainly haven’t got it all figured out. There are some areas I’m only beginning to work on now, so don’t think perfection is necessary. All that’s necessary is being honest with yourself. The rest will follow from that.http://karenvelen.wordpress.com/2010/03/25/the-medicine-wheel-balance-within-and-without/
- Fond du lac SK
- 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
- When you are balanced, when you are able to be who you truly are, when you can express your authentic nature – it doesn’t matter what others think, say or do. When you are integrated and balanced with self, you are the master of you, you aren’t feeding off others and they cannot feed off you. You can express who you are with ease, grace and beauty and it doesn’t matter what they say or how they react. It only matters what is real to you, what is your truth and to be able to live your authentic nature. If someone belittles you, if you are intimidated, humiliated, mocked or scorned at, it is only their perception that they are reflecting at their present level of consciousness. Greet and invite in that critical or judgmental energy, know that words are meaningless, because it is just energy. Let stuck energy go, nothing can disempower, you unless your give your permission to do so. When you begin to express your truth, to state your point of view, when you begin to change your perceptions, and when you begin to love, honor and accept yourself and when you begin to be the manager of your life, you will begin to change your reality and you will attract different people into your life.http://walkashamanspath.com/
- Beginnings start in the east - from where the sun rises we begin a new dawn. Each day is a good new day with a fresh beginning, a new start. East is the direction of the physical body and newness including children and infants. It is the time of change for all is a new beginning. Spring is the season when all things begin to grow and awaken. Yellow is the path of Life, to begin the walk as a warrior, to shine in all that you do. The sun rising in the east empowers each of us. The energy to do and to begin the action of the mind and heart is there.Animals from that Direction Animals of wings and flight include hummingbird, the owl, and the hawk. Our words are given to the east that the smoke in the air or the voices in the air may be carried to Spirit.Picture from - http://pursuitofexcitement.wordpress.com/2010/10/28/vintage-airplanes-wild-horses-and-farmer-golf-courses-a-eastern-saskatchewan-primer/Some of the most important worldwide rituals surround the preparation for the birth of a child.
- Growth in the South it is the time of Summer. From the bloom we transform into the fruit of the labors. It is the time of mid-day, the hottest part of the day, the part when the sun is overhead and no shadows are cast.. Maturing and growing into an adult to be that who was are. It is the time to accept the change and learn, to understand.Red is for fire, passion, time of fertility. The South is the place of passion in all things, sex, fertility, mating - the fires that burn within. The direction of fire, like the phoenix we can rise from the flames, we take and rise again from childhood into being an adult in the direction of the South.Animals from that Direction - The animals of the South represent pride, strength and courage. The eagle with keen sight and strong wings. The lion for the strength and courage to speak out and roar. The wolf so proud as to be a team member of a pride.Picture from - http://www.hicker-stock-photography.com/zoom/road-to-castle-butte-big-muddy-badlands-of-so-saskatchewan-712.htm
- The daylight fades and brings a new awareness in this time of gradual change. When the darkness comes we must look inward to find the light and have courage. To understand what we see in the darkness may not be real but only shadows.This is the emotional part of ourselves, like the flowing water we must learn to go with the flow of life. The time of the West is when we learn that we are responsible to all things and to each other. It is the time to prepare, to finish things for the time of Winter is coming. We gather ourselves and family, working together to prepare for what is to come. As the place of emotions it is the place of family and love - of responsibility from our hearts because of the love. It is hard work and team effort. Black symbolizes change from this life.Animals from that Direction - The Beaver shows us of the team work and pre-paredness needed for the winter which is coming. The snake reminds us to shed our skin to grow and change.Picture from - http://saskatchewanderer.ca/?p=311
- As we get older our hair turns white, as we come to our time of winter. White (and purple) also symbolize spirituality. With experience and age we gain wisdom. Now we have time to rest and contemplate the lessons. North is purity and wisdom, a great place of healing. This is the time after midnight, a dream time. The time to be grounded within yourself and deep within, like a bear in a cave.North is the place of winter. This reminds us to stop and listen. That we must have prepared for the long time of winter. Having been in action the other seasons we now rest and contemplate to understand the wisdom we have been given.Animals from that Direction - The white buffalo, moose and bear. Each is prepared and has a layer of fat to sustain them through the winter. They are also the primary source of meat during the winter time for people. They rest and take things slow, not wasting energy and have the understanding of what winter brings.http://theconference.ca/medicine-wheel http://www.spiritualnetwork.net/native/medicine_wheel.htm
- ON THE EARTH: Honour yourself and all life, for that is one of the mainstays of your personal journey. It is the essential INNER self of each person which is every-changed and transforming, that moves you beyond time and beyond seasons. LIFE ABOVE THE EARTH: Father Sky the protector of the Universe, Star Nation. Planets are the keepers of the wisdom of the ages. LIFE BELOW THE EARTH: Provides balance, cohesion, connections and rootedness with Mother Earth and the four great winds that founds their origins in the lower world.http://www.shannonthunderbird.com/medicine_wheel_teachings.htm
- The Circle lies at the centre of First Nation's spirituality; it is simple logic, actually, as everything in the Universe is round. Father Sky is a great blue bowl, the Planets and Stars are round. Mother Earth and all that live upon her are round, i.e., the plant world has four circular parts, roots, stems, leaves and fruit. Air swirls, and water bubbles in circles. The human body is circular. In other words, the circle is integral to an understanding of the sacred and equal connections of all living beings. There is no beginning and no end in the cycle of life; it is an endless, respectful continuity from the past, to the present, to the future and to the plenitude of life. Mother Earth is often referred to as a Medicine Wheel, Copper Shield or Sacred Hoop because she is circular and she also turns in a circle.http://www.shannonthunderbird.com/medicine_wheel_teachings.htm
- 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 Picture is from Yellowknife
- 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.
- Picture, Saskatchewan, on the road to Saskatoon
- The giving of a Star Blanket is a tradition that honours individuals for reasons of generosity and blessings. When the buffalo became scarce and communities became isolated, First Nations men were not allowed to leave the reservations to hunt, hides became hard to come by to make robes or clothing, so women turned to making quilts and Star Blankets were especially valued. Fabric is very important and holds special meaning in the First Nations cultural and spiritual life. Swatches of cloth are often used in ceremonies, and when the fabric moves in the wind, it is believed that an individual’s prayers would be carried to the Creator. Quilts are used for warmth and protection, and young men traditionally would wrap themselves in a quilt while awaiting a Vision on some secluded high place. For the recipient of a Star Blanket, it indicates that the giver holds you in very high esteem for your generosity and accomplishments. The star design does not represent one thing but can refer to the sun or the Creator. To give a Star Blanket is to show ultimate respect and honour.
- A buffalo rubbing stone sits amid the great expanse of 6,000 years of Northern Plains tribal history that is today known as Wanuskewin Heritage Park in Saskatchewan, Canada. Read more athttp://indiancountrytodaymedianetwork.com/2014/01/19/wanuskewin-heritage-park-6000-years-northern-plains-history-153171To date, archaeologists have discovered 19 prehistoric and two historic campsites, several tipi circles (rings of stones that were used to secure the covers of tipis) and a medicine wheel (a central cairn surrounded by a peripheral ring of stones analogous to the hub and rim of a wheel). Smaller stone cairns lie outside the peripheral ring. This structure is about 1,500 years old and is the most northerly medicine wheel on the Northern Plains.Read more athttp://indiancountrytodaymedianetwork.com/2014/01/19/wanuskewin-heritage-park-6000-years-northern-plains-history-153171According to Hart, “First, knowledge is holistic, cyclic, and dependent upon relationships and connections to living and non-living beings and entities. Second, there are many truths, and these are dependent upon individual experiences. Third, everything is alive. Fourth, all things are equal. Fifth, the land is sacred. Sixth, the relationship between people and the spiritual world is important. Seventh, human beings are least important in the world” (2010, p. 3).
- Ryan WunschphotographyI feel the sky is Saskatchewan is much like the oceans surrounding Canada.