Breaking cultural barriers

Lisa Bourque-Bearskin earns her master's degree in nursing this spring, marking yet another remarkable turn in a remarkable journey. Born of Cree and Métis decent, and having felt the sting of discrimination in the health care system, Bourque-Bearskin's capstone project fittingly deals with recruiting more aboriginal students into nursing.

Bourque-Bearskin's own interest in healing was born out of necessity. When she was just 15, her mother, a victim of domestic violence, was beaten badly and hospitalized.

Bourque-Bearskin, her grandmother and her four brothers, the youngest of whom was born with Down's syndrome, made daily treks to the hospital. The children were stricken with grief but fortified by their grandmother's knowledge of traditional healing.

"The positive side of that was I learned so much about my grandmother's traditional healing practices. I learned the value of indian medicine and its importance to healing," she said. "I saw the nurse providing physical care but my grandmother's care was all-encompassing. It was her medicine and her prayers - and I was able to see my mom heal more from that than the care she was getting and to me that was what made me want to be a nurse - seeing how effective my grandmother was."

And yet, the medical establishment objected to such treatments.

"Granny would pick her herbs and boil the herbs and give them to my mother and do a smudge and say her prayers. And we got kicked out of the hospital a bunch of times for doing that."

"We were asked to leave and we were told we were harming her, so we learned to manipulate the system so we could do what we needed to do - whether that was me watching six at the door or going out and creating a diversion somewhere else so the nurses wouldn't come to my mom's room. I didn't realize how important that experience would be to me."

Bourque-Bearskin earned her nursing degree at the U of A in 1995 and worked as a community nurse for Health Canada at the Paul Band and in the Hobbema area. She taught nursing in a pilot aboriginal nursing training program run at Hobbema and moved with her four children to Iqaluit, Nunavut, to teach nursing at the Nunavut Arctic College before returning to the U of A in 2004 to work as a sessional instructor and work towards her master's degree in 2005.

While taking U of A nursing students to field placements in Edmonton hospitals, Bourque-Bearskin again saw discrimination between health-care workers and aboriginal patients. In one case, an aboriginal AIDS patient was told he'd contracted a dangerous type of bacteria and was confined to his room, when in fact he had tested negative for the bug several times. This kind of experience brought old memories flooding back to Bourque-Bearskin.

"After that, I just thought, 'I'm going to school full time'."

Bourque-Bearskin says a graduate course she took on indigenous research methodologies through the Faculty of Education's Indigenous Policy Studies Department revitalized her interest in her culture.

One of Bourque-Bearskin's research projects, funded by the U of A-based ACADRE Network, was a study of awareness of aboriginal culture among U of A nursing students. Using a native talking circle as her format, Bourque-Bearskin interviewed 14 aboriginal and non-aboriginal students, from undergraduate to graduate student levels.

She found aboriginal students faced unique challenges in the classroom and in clinical settings. There were derogatory remarks made about aboriginals, who were stereotyped socially and physically, for health conditions they sometimes face, such as diabetes.

"The assumptions are that they've all got diabetes and their kids don't live with their moms."

Bourque-Bearskin noted that while nursing students are given case studies regarding patients with a variety of ethnic backgrounds, those studies exclude cultural issues.

"It's such a simple fix," she said. "We've got the curriculum there. And the gap is universal - it's there for all cultures. The culture is the missing piece."

Bourque-Bearskin's capstone project is a 60-page document entitled Gaining Wisdom and Enhancing Relations: the Faculty of Nursing - Aboriginal Student Access and Success Program.

"The whole project is building on the successes of other aboriginal nursing programs. So, what the Faculty of Nursing was able to do was to create a forum in collaboration with community stakeholders to gain input and develop partnerships that would enhance the recruitment and retention of aboriginal nursing students and ultimately improve the health of aboriginal communities because they will deliver health-care services that are more culturally appropriate," she said. "We need to provide culturally safe care. My whole philosophy was that we grow our own care givers."

The document outlines ways to incorporate aboriginal culture into the curriculum for nursing students. It's also clearly aimed at finding ways to increase aboriginal enrolment in the Faculty of Nursing, a goal which Dean Beth Horsburgh is actively pursuing.

It's also in keeping with Bourque-Bearskin's own concern for aboriginal nursing - she serves as director of the Alberta chapter of the Aboriginal Nurses Association of Canada.

Edmonton, Bourque-Bearskin points out, has Canada's second-largest aboriginal population, and it's growing. It is estimated that within 10 years, 44 per cent of the city's population will be aboriginal.

"We need to teach our nursing students about the aboriginal social and cultural history," said Bourque-Bearskin. "We have to stop victim-blaming - 'Oh, why don't those people just learn to take care of themselves.' People need to understand the effects of residential schooling and assimilation and the intergenerational effects it is still having before we can more on. This is important to everyone."

"I think we are at the transition point now. The future of Aboriginal health will only strengthen. It is through this learning of language of our songs and our stories that the Aboriginal voice and indigenous knowledge will be revitalized."