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 First Nations, Inuit and Métis 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 First Nations, Inuit and Métis 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 First Nations, Inuit and Métis communities, Elders, Knowledge Keepers, and leaders to advance reconciliation, respond to the Calls to Action and Calls for Justice, to understand and uphold Indigenous rights as articulated in the UN Declaration on the Rights of Indigenous Peoples (UNDRIP) and to integrate these learnings into our regulatory work and the essential expectations of registered nursing practice in this province.

Land acknowledgement

The College of Registered Nurses of Manitoba (College) respectfully acknowledges that our offices, our registrants, and the public we serve reside and work on the traditional territories and ancestral lands of the Anishinaabeg, Ininewak, Anisininewuk, Dakota Oyate, and Dene, and on the national homeland of the Red River Métis.  

The College recognizes the historic and ongoing impacts that colonization and systemic discrimination have on the health of First Nations, Inuit and Métis peoples, and that we must take continued, meaningful actions to advance reconciliation and affect change in the regulation of registered nurses.  

We respect the Treaties that were made on these territories, and we are committed to moving forward in partnership with First Nations, Inuit and Métis 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)

Ongoing Work and Next Steps

The College has been working diligently over the past three years to build relationships and support engagement through a grassroots, comprehensive and distinctions-based approach. Through this work, we have been growing our understanding of how we can meaningfully contribute to reconciliation in health care, to supporting First Nations, Inuit and Métis nurses and community members, and to move forward in good ways as a true partner for needed change. We are seeking to build relationships with, and better understand key priorities for First Nations, Inuit and Métis nurses and community members vis-a-vis health care, nursing/professional practice, as well as productive integration of traditional knowledge in these and related areas.

We formed an Indigenous Advisory Group comprised of First Nations, Inuit, and Métis nurses and community members as a collaborative circle for reconciliation action planning and to help facilitate the integration of Indigenous perspectives into our work in a more fulsome way. The College plans to deliver a formal apology in the spring of 2026 for its role in the systemic discrimination and generational harms that were and continue to be experienced by First Nations, Inuit and Métis in health care. As the largest health care profession in Manitoba, registered nurses have been part of the problem, and must be part of the solution in ensuring safe care for everyone who accesses care in our province.

In tandem with this work, the College has undertaken substantial internal learning and knowledge building work to bolster cultural humility in delivery of our regulatory mandate and we have implemented a range of learning modules and updates to our Code of Ethical Conduct as productive first steps in addressing Indigenous-specific racism.

The outcomes of these efforts and what we have learned will be developed into a reconciliation action plan that will be finalized and begin implementation by the end of 2026. We believe the implementation of the reconciliation action plan is part a long-term process of learning, understanding, and continuously improving how we move forward in good ways.

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

Sincerely,

Deb Elias, RN MN
CEO/Registrar

Kenneth Molloy
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