On Nov. 30, 2020, the Ministry of Health released findings from an independent review 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.
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.
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.
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 clearly communicates the colleges' zero tolerance for Indigenous-specific racism in practice and outlines 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. These new educational videos are one way we are supporting registrants in their cultural safety and humility journey.
Update: Jan. 5, 2023. Some registrants and members of the public have raised concerns about BCCNM's reliance on the In Plain Sight Report, given the recent questions about one of its key authors, Dr. Mary Ellen Turpel-Lafond.
The In Plain Sight team was comprised of a number of recognized Indigenous advisors and leaders. While Dr. Turpel-Lafond was the chair of the investigation, the investigation as a whole is larger than her. The report and its recommendations are a summation of the experiences, stories and facts of thousands of Indigenous people highlighting their experiences within the B.C. health care system. The information, data, facts and recommendations from the report are not contestable. Indigenous specific racism is prevalent throughout B.C.'s health care system and it has its origins in the province's history of settler colonialism.
It is important for us to continue to recognize and honour the contributions of these individuals to the report, and to use their shared knowledge and guidance to improve the health care system. The work stands on its own merit and we value the evidence it has provided as we work to meet our obligations and commitments as a regulator, to minimize the harms caused to Indigenous people by systemic racism within the B.C. health care system.
The Indigenous Cultural Safety, Cultural Humility, and Anti-racism Practice Standard Companion Guide was created to help nurses and midwives understand and apply the new practice standard. It incorporates Indigenous experiences to help nurses and midwives learn about culturally unsafe care and reflect on their own practice.
Download the guide now
Our two colleges continued our partnership and have created a series of educational videos, to support nurses, midwives, physicians and surgeons to understand and apply the new standard.
Introduction to the New Standards
Building Knowledge Through Education
Creating Safe Health-care Experiences
Strengths-based and Trauma-informed Practice (Looking beneath the surface)
Self-reflective Practice (It starts with me)
Anti-racist Practice (Taking action)
Person-led Care (Relational care)
Email us at CulturalSafety@bccnm.ca.