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PRNU 115: Professional Practice II

Portfolio Part D: Critical Reflections

Vancouver Island University

Isabelle Friesen
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“How do my beliefs about Indigenous health needs compare to what I previously

believed?” (Professional Practice, Study Guide, LA #1 pg. 10). Before starting the Practical

Nursing Program, I had minimal knowledge and understanding when it came to other cultures

and their different requirements and preferences when it comes to receiving healthcare and

treating illness. I had never taken the time to branch out of my own cultural beliefs and consider

other cultures and the way they practice medicine. Healthcare providers need to understand these

unique health-related needs and experiences because it can help erase stereotypes and biases that

can interfere with effective care (Eliopoulos, 2022). The effectiveness of care can be largely

influenced by the initial impression made by healthcare providers, as seen in the past when it

came to the Indigenous individuals and their experiences with the Canadian health care system.

Individuals who are in the Indigenous community have become more ambivalent when it comes

to accepting healthcare services due to the negative impact the Canadian healthcare system has

had on their community (Burnett, 2019). Due to historic and ongoing settler colonialism, unequal

access to healthcare, when combined with racism and other social determinants, continue to have

an enormous and tragic effect on the health outcomes of Indigenous people” (Burnett, 2019).

Having said all of this, I have taken the time to reflect on Indigenous health needs and the

importance around educating healthcare workers on cultural differences, and what specific

factors can contribute to receiving improper care.

Something I need to expand my knowledge on is what factors affect this specific group

from receiving proper care. Racism is said to be one of the most common barriers to accessing

safe and effective medical care (Wrathall et al., 2020). Individuals are less likely to seek out care

if they do not feel safe, which results in delayed and lack of necessary treatments (Wrathall et al.,

2020). Another factor that affects this group from receiving improper care is health coverage.
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“The health care coverage and access differ for Indigenous peoples living on-reserve and off-

reserve” (Vigneault et al., 2021). Having there be a difference in the coverage of health care has

a direct impact on the health care that is provided, because if you have less coverage, receiving

any type of care may become more of a financial burden. Some studies have also shown that

there are certain barriers such as long wait times, trouble communicating and difficult

interactions with health care professionals that affect their access to receiving health care in an

acute setting (Vigneault et al., 2021). Some health care providers also hold onto the

misconception that when an Indigenous individual seeks out health care, they are only interested

in receiving drugs (Vigneault et al., 2021).

“How has this discussion about BC Laws and Practice Guidelines changed your

perspective about nursing the older adult in long term care?” (Professional Practice, Study

Guide, LA #1 pg. 8). Older adults in long-term care facilities are not always provided safe and

competent care, as seen first-hand in clinical. Something I have never heard of before was the

Residents’ Bill of Rights, which is put in place to promote the rights of adults who live in

residential care facilities (Policy and Standards, 2019). After learning about the Residents’ Bill

of Rights, I began reflecting on the experiences I had when it came to my clinical experience and

comparing the things I saw to the Residents’ Bill of Rights. There had been a handful of issues I

had witnessed that violate the rights of those in that facility, such as the rights to health, safety,

and dignity. I currently work at a long-term care facility, and I have been fortunate enough to get

to know a few of the independent living residents quite well. Something I had been curious about

was if residents knew what their rights were in the facility, so I was able to sit down with a few

of them during one of my shifts and talk to them about their Bill of Rights. I talked to one of the

residents and they were very adamite that they were very satisfied with the treatment they get
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here, and they expressed how grateful they are to be able to live in such a wonderful place where

the staff are so nice and caring. To me this is a great example of how residents should feel when

living in any type of care facility, but that is not always the case. Something I want to have more

knowledge on is what residents can do if their rights are violated by a caregiver, and what type of

resources are out there for them.

After taking some time to reflect on the Residents’ Bill of Rights, I was curious as to

what resources residents are provided with to report any violations when it comes to their rights.

I decided to look in the BC Seniors Guide where I had come across many different programs and

services for seniors to have someone advocate and support them. Seniors Abuse & Information

Line is “a safe place for older adults to talk to someone about situations where they feel they are

being abused or mistreated, or to receive information about elder abuse and prevention”

(SeniorsBC, 2015). If an older adult is unbale to seek help on their own, you can report the

situation to the designated agency in your health authority, to Providence Health Care, or

Community Living BC (SeniorsBC, 2015). Another resource for anyone with concerns about the

operation of a facility, or regarding the health and safety of resident, there is the assisted living

registry (Making a Complaint, 2022). They will assess all complaints related to the health and

safety of residents, such as abuse and neglect, unsafe environment, and staffing or other practices

or behaviours that put residents at risk (Making a Complaint, 2022). There is an abundant

number of resources out there for residents to reach out to regarding any sort of violation of their

rights.
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References

Burnett, K. (2019). Health of Indigenous Peoples in Canada | The Canadian Encyclopedia. The

Canadian Encyclopedia. Retrieved March 13, 2022, from

https://www.thecanadianencyclopedia.ca/en/article/aboriginal-people-health.

Doria, N., Biderman, M., Sinno, J., Boudreau, J., Mackley, M. P., & Bombay, A. (2021).

Barriers to Including Indigenous Content in Canadian Health Professions

Curricula. Canadian Journal of Education/Revue Canadienne de L’éducation, 44(3),

648–675. Retrieved March 13, 2022, from https://doi.org/10.53967/cje-rce.v44i3.4611.

Making a Complaint. (2022, March 8). Province of British Columbia; Ministry of Health.

Retrieved March 14, 2022, from https://www2.gov.bc.ca/gov/content/health/assisted-

living-in-bc/making-a-complaint.

Policy and Standards. (2019, July 10). Province of British Columbia; Ministry of Health.

Retrieved March 14, 2022, from https://www2.gov.bc.ca/gov/content/health/accessing-

health-care/home-community-care/accountability/policy-and-standards.

PRNU 115: Professional Practice II (Study Guide). (June 2021). Vancouver Island University.

SeniorsBC. (2015). BC Seniors’ Guide. Retrieved March 14, 2022, from

https://www2.gov.bc.ca/assets/gov/people/seniors/about-seniorsbc/guide/bc-seniors-guide-

11th-edition.pdf.

Vigneault, L.-P., Diendere, E., Sohier-Poirier, C., Abi Hanna, M., Poirier, A., & St-Onge, M.

(2021). Acute health care among Indigenous patients in Canada: a scoping

review. International Journal of Circumpolar Health, 80(1), 1946324. Retrieved March

14, 2022, from https://doi.org/10.1080/22423982.2021.1946324.

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Wrathall, D., Wilson, K., Rosenberg, M. W., Snyder, M., & Barberstock, S. (2020). Long‐term

trends in health status and determinants of health among the off‐reserve Indigenous

population in Canada, 1991–2012. The Canadian Geographer / Le Géographe

Canadien, 64(2), 199–214. Retrieved March 13, 2022, from

https://doi.org/10.1111/cag.12592.