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Indigenous Cultural Safety, Cultural Humility and Anti-Racism standard

A new practice standard for all nurses and midwives

On Nov. 30, 2020, the Ministry of Health released findings from an independent review, led by Dr. Mary Ellen Turpel-Lafond, into the extent of Indigenous-specific racism in B.C.'s health-care system. The findings of the In Plain Sight report showed the devastating impact Indigenous-specific racism has on health outcomes for Indigenous people in B.C. The report provides evidence of the prevalence of stereotypes, discrimination, racism, and abuse experienced by Indigenous people that have created widespread fear and mistrust of the health-care system.  

The report shared personal experiences of racism and discrimination that discouraged individuals from seeking health care, reducing access to care and negatively affecting their health and wellness. It also illustrated how our current health-care system continues to limit access to medical treatment and how this disproportionately impacts Indigenous women, girls, Two-Spirit, queer and trans Indigenous people.

Specific recommendations were made to improve cultural safety in health care, within health services and in regulation.

The expectation for nurses and midwives to provide culturally safe competent care, addressing these inequities and creating a more equitable and fair health-care system for Indigenous people, will now be clarified in BCCNM's new practice standard.

A standard addressing Indigenous-specific racism

Our role is to protect clients and the public by ensuring that the professionals we regulate provide ethical, safe, quality care. The In Plain Sight report reminds us that some health-care providers continue to perpetuate Indigenous-specific racism, resulting in harm, neglect, misdiagnosis and even death of Indigenous clients.

This standard is one way we are going to begin redressing that harm by ensuring clients receive culturally safe care.

We clearly recognize there is inequity experienced by other racialized peoples; this standard for Indigenous-specific racism is in direct response to the findings/recommendations of the In Plain Sight report and it will be a part of our ongoing work to address harms experienced by other marginalized groups.

How was the standard developed?

Working together, BCCNM and the College of Physicians and Surgeons of British Columbia (CPSBC) engaged Indigenous registrants, leaders and clients throughout the health-care system along with health authority and academic partners to develop a new standard. This standard will clearly communicate the colleges' zero tolerance for Indigenous-specific racism in practice and outline key requirements on providing culturally safe care for Indigenous people in B.C.

The feedback gathered from our engagement efforts has helped us understand that learning and education for nurses and midwives will be vital to the standard's success, as registrants have varied knowledge and understanding about Indigenous cultural safety, cultural humility, and anti-racism and how to integrate these concepts into their practice.  

Together, CPSBC and BCCNM regulate over 74,000 nurses, midwives, physicians and surgeons. We have already begun work to identify and develop resources to support health care professionals, and we welcome input and suggestions from registrants.

Another theme from the feedback is that reporting colleagues is difficult—especially for registrants who have less experience or power and are therefore more vulnerable—and that further clarity on the reporting process would be helpful.

With these learnings in mind, we have crafted the standard to set out clear expectations organized into key themes (with descriptions) and direct, actionable standards.

What's next

BCCNM invited all nurses and midwives in B.C. to review the draft standard​ and provide their feedback via survey from Nov. 22-Dec. 3, 2021. ​

The BCCNM board approved the standard at its January 2022 meeting, and the standard came into effect Feb. 25, 2022

How can I prepare for the new standard?

Visit the learning resource page for your designation:

Questions or feedback?

Email us at CulturalSafety@bccnm.ca. ​​