Committing to a journey of learning and reconciliation in registered nursing regulation

Background and Context

As the regulatory body for registered nurses in Manitoba, the College of Registered Nurses of Manitoba (the College) is mandated to govern the profession in a manner that serves and protects the public interest. Our statement of commitment is a concrete step to advancing cultural safety and humility in registered nursing regulation and among registered nurses involved in the delivery and administration of health services for Indigenous peoples in Manitoba. We see this as a core aspect of our public interest mandate.

Evidence of the urgency of this issue abounds. Dating as far back as the Royal Commission on Aboriginal Peoples in the 1990s, through to the more recent publication of the final reports of the Truth and Reconciliation Commission and the National Inquiry into Missing and Murdered Indigenous Women and Girls, the horrible legacy, abuses and trauma that resulted from damaging and discriminatory colonial policies, legislation and structures in Canada, including systemic discrimination and inequality in health care, are clear. Closer to home, the Southern Chiefs’ Organization’s Survey on Experiences of Racism in the Manitoba Health Care System shows there is much work to be done to address the systemic racism and gaps in health equity experienced by Indigenous peoples in Manitoba.

The Truth and Reconciliation Commission defined reconciliation as an ongoing process of establishing and maintaining respectful relationships, underpinned by repairing damaged trust and following through on concrete actions that demonstrate real societal change. We understand that the College has a role to play in building and repairing trust, and that we can and must take significant and meaningful steps, guided by respectful engagement with Indigenous communities, Elders, Knowledge Keepers, and leaders to advance reconciliation, respond to the Calls to Action and Calls for Justice, and to integrate these learnings into our regulatory work and the essential expectations of registered nursing practice in this province.

Our statement of commitment

We are committed to a journey of learning and reconciliation, together with Indigenous Knowledge Keepers, Elders and community members. While we are early in this journey, we dedicate ourselves to engaging respectfully and in a spirit of partnership to:

understand the impact of residential schools and colonization on the health of Indigenous peoples of Canada,
participate in developing meaningful actions to address the gaps in equity of health and social outcomes for Indigenous peoples,
recognize the value of the healing practices of Indigenous peoples through collaboration with Elders, Healers and Knowledge Keepers, and
assure current, and future registered nurses have education in intercultural competency, conflict resolution, human rights and anti-racism.

We pledge to enact the mandate of the College to serve and protect the interests of Indigenous peoples through equitable, fair and transparent practices and policies.

Land acknowledgement

The College is located on the original lands of Anishinaabeg, Ininew, Anisininew, Dakota Oyate, and Denesuline peoples, and on the homeland of the Red River Métis. Our drinking water comes from Shoal Lake 40 First Nation, in Treaty Three Territory. We respect the Treaties that were made on these territories, we acknowledge the harms and mistakes of the past, and we dedicate ourselves to move forward in partnership with Indigenous communities in a spirit of reconciliation and collaboration.

Definitions

Within this context, we rely on the following definitions of cultural humility and cultural safety as currently described in the Entry-Level Competencies for the Practice of Registered Nurses:

Cultural Humility is a process of self-reflection to understand personal and systemic biases and to develop and maintain respectful processes and relationships based on mutual trust.

Cultural Safety is an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the healthcare system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care. (College of Registered Nurses of Manitoba, 2019)

Next Steps

As we move forward in this journey, the College is working to establish a steering committee that includes Indigenous voices and perspectives that will guide our work and engagement efforts. We will provide regular updates on our work, what we’ve heard, and how Indigenous community members, members of the public and members of the registered nursing profession can contribute to advancing our understanding and capacity to enable, implement and sustain change.

We welcome your comments and your insights as we move forward in this journey.

Sincerely,

Deb Elias, RN MN
CEO/Registrar

Noah Gatzke, RN(NP) MN
Council Chair

References

College of Registered Nurses of Manitoba. (2019). Entry-level competencies for the practice of registered nurses. https://www.crnm.mb.ca/resource/entry-level-competencies-elcs-for-the-practice-of-registered-nurses/

National Inquiry into Missing and Murdered Indigenous Women and Girls. (2019a). Reclaiming power and place: The final report of the National Inquiry into Missing and Murdered Indigenous Women and Girls. https://www.mmiwg-ffada.ca/final-report/

National Inquiry into Missing and Murdered Indigenous Women and Girls. (2019b). Calls for justice. https://www.mmiwg-ffada.ca/wp-content/uploads/2019/06/Calls-Web-Version-EN.docx

Royal Commission on Aboriginal Peoples. (1996). Highlights from the report of the Royal Commission on Aboriginal Peoples. https://www.rcaanc-cirnac.gc.ca/eng/1100100014597/1572547985018

Southern Chiefs’ Organization. (2021). Survey on experiences of racism in the Manitoba health care system. https://scoinc.mb.ca/wp-content/uploads/2021/07/SCO-Racism-Report-final-WEB-wcag-1.pdf

Truth and Reconciliation Commission of Canada. (2015a). Calls to action. https://ehprnh2mwo3.exactdn.com/wp-content/uploads/2021/01/Calls_to_Action_English2.pdf

Truth and Reconciliation Commission of Canada. (2015b). Honouring the truth, reconciling for the future: Summary of the final report of the Truth and Reconciliation Commission. https://ehprnh2mwo3.exactdn.com/wp-content/uploads/2021/01/Executive_Summary_English_Web.pdf