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Cultural safety and humility

Making the health system more culturally safe for First Nations and Aboriginal people

Systemic racism and discrimination towards First Nations and Aboriginal people continues to be a major problem in many contemporary health care settings, often resulting in inappropriate treatment and barriers to accessing health care. 

BCCNM's commitment

In 2017, the previous B.C. nursing and midwifery colleges were four of 22 B.C. health professions to pledge their commitment to making our health system more culturally safe for First Nations and Aboriginal people. BCCNM continues this commitment. ​

The In Plain Sight report

On Nov. 30, 2020, Health Minister Adrian Dix released findings from an independent review, led by Dr. Mary Ellen Turpel-Lafond, into the extent of Indigenous-specific racism in BC’s health-care system. The findings released in this report, titled In Plain Sight, showed the devastating impact Indigenous-specific racism has on health outcomes for Indigenous people in BC.

Prior to the release of the report, BCCNM had taken initial steps to integrate the principles of cultural safety and humility into our organizational culture, our brand identity, as well as our strategic and operational plans. We encouraged registrants, staff, Board, and committee members to undertake cultural safety training. We had also begun the work to embed the voice of Indigenous peoples into our governance structures and had engaged a First Nations Knowledge Keeper to be a guide and resource to our Board and staff.

Following the report’s release in November 2020, BCCNM prioritized several actions relating to the report’s recommendations, by:

  • Issuing an apology to Indigenous Peoples and communities who have experienced racism while engaging with BCCNM, our fellow health regulatory colleges, and with the health professionals we regulate. ​ ​

  • Creating a statement of intent that commits us to developing new standards for culturally safe and humble and responsive care. This includes seeking participation from BC First Nations and other Indigenous peoples from across the province to ensure these standards are meaningful and relevant, and recognizing that consulting about improving health care will require significant care, effort, commitment, and sensitivity.

  • Developing, in collaboration with the College of Physicians and Surgeons of British Columbia, a new standard that explicitly articulates the requirements of culturally safe, humble, and responsive professional practice.

  • Providing training and education in cultural safety and humility, unconscious bias and/or trauma-informed care for all staff, Board and committee members.

  • Striving to consistently apply the lens of cultural safety and humility to our decision-making, by broadening Indigenous participation on BCCNM’s board and committees, and by investing in supports to ensure that Indigenous people do not feel isolated or unsafe when engaging in this work. To this end we are actively recruiting Indigenous committee members and have appointed five additional Indigenous individuals to BCCNM committees so far this year. We have also, in collaboration with the other health profession regulators in B.C., established an Indigenous-led Community of Practice support network for Indigenous board and committee members.

  • Working with advisors to develop a strategy and approach for engaging BC First Nations and other Indigenous peoples in our regulatory work. This includes supporting and accessing the BC Public Advisory Network, which has been established in collaboration with other health profession regulators and includes Indigenous community members.

  • Evaluating our complaints process to identify ways to make it more accessible, meaningful, safe, and effective for Indigenous people. We are developing a plan to engage external reviewers to assist us in identifying and implementing changes.

We recognize that this work is just beginning. Cultural safety and humility is a journey and an ongoing process to unlearn, learn, and relearn. We look forward to continuing this work, in conversation with our registrants and other partners, in the months and years to come.

How can nurses and midwives help make the health system more culturally safe?

Increasing the level of cultural safety in the health care system through approaches such as cultural humility, cultural safety, health literacy and relationship-based care will assist in improving the quality of health services for First Nations and Aboriginal people. Nurses and midwives are well-positioned to make a difference.

BCCNM encourages you to: 

Collaborating with First Nations Health Authority

In partnership and collaboration with the First Nations Health Authority (FNHA), BCCNM is supporting the collection of data about current and future BC First Nations and other Indigenous health professionals in B.​C. Registrants will have the option of answering three questions on their registration renewal application.​​​

What will r​egistrants be asked?

Do you identify yourself as an Indigenous person, that is, First Nations, Métis, or Inuk (Inuit)?

  • Yes​
  • ​​​No
  • Prefer not to answer

If you identify as an Indigenous person, are you:

  • First Nations
  • Métis
  • Inuk (Inuit)

If you identify as an Indigenous person, which specific Indigenous nation, community, and/or band are you a member of/do you identify with?

  • A free-form field will be provided so registrants can enter the name of more than one nation, community and/or band.
Why is this information being collected?

​B.C. First Nations have a health governance partnership with the province of B.C. In 2006, the parties identified “practicing certified First Nations health care professionals” as an indicator of progress of the Transformative Change Accord: First Nations Health Plan. This data will be used to inform reporting on this indicator. ​​

How will this information will be used?

​Any data collected will be shared in aggregate form with FNHA.

Is answering mandatory?

​No. Answering these questions is optional. Your eligibility for renewal of your registration will not be impacted by your responses or your choice not to respond.​

Need more information?

If you have questions or concerns about how this information will be used or why it is being collected, we encourage you to contact the First Nations Health Authority​.​​​​​​​​​​​​​