Toward a Decolonized Future in Nursing

Seven of the 94 Calls to Action to redress the legacy of residential schools and advance the process of reconciliation are specifically about healthcare reform and one in particular—Call to Action #24—addresses the changes needed at nursing and medical schools. Over the past few years, the community of scholars and learners at York University’s School of Nursing within the Faculty of Health have heard the call and are starting to do the work.

“The goal is to better align the school of nursing with the Truth and Reconciliation calls to action,” explains Kate Dunn, Assistant Professor and an Anishnaabe scholar at the School of Nursing within the Faculty of Health. “The challenge is how to do this respectfully, tactfully and carefully, while maintaining requirements of the accrediting bodies.”

Dunn, who has worked on liver wellness and hepatitis C elimination in Indigenous communities, is a new appointment, who, in January, will teach Introduction to Social Justice and Advocacy in Nursing Practice. This is a second-year course in the process of being revised to come closer to meeting the central call in Action #24—a mandatory course in “Aboriginal health issues” including the history and legacy of residential schools.

This isn’t the only course at the School of Nursing that acknowledges the history of settler colonialism in Canada. Associate Professor Archana Paul says that, in her second-year course, Mental Health Across the Lifespan, the first two weeks are focused on the history of Indigenous people being harmed by institutions (including psychiatry), stigma as a source of discrimination, as well as trauma-informed care. Paul, who received the 2024 Council of Ontario University Programs in Nursing (COUPN) Award for excellence in teaching earlier this year, takes care to ensure the conversation is threaded throughout the rest of the course, with a goal to help future nurses become better patient advocates.

Vanesa S., a BScN Nursing student, says that Paul’s use of real-life examples of people harmed by the healthcare system, such as Brian Sinclair, who, in 2008, died in the waiting room of a Winnipeg hospital after not being seen for 34 hours, had a big impact.

“It was a case I wasn’t aware of and it really made me resolve to be sure to have my own reflective practice and check my own bias,” she recalls.

It also inspired her to research the systems in which medical trauma has been—and still is—inflicted on Indigenous people, such as pregnant women who are forced to leave remote communities to give birth, even when they are low-risk. Vanessa adds: “With everything that’s happened with the forced sterilizations and forced birth evacuations, it’s so important to be mindful not to retraumatize patients.”

“Supporting the calls that Indigenous communities continually ask for involves, not only learning about the historical and contemporary issues, but also has to have a connection with activism.”

— Associate Professor Ruth Rodney

In Health and Healing: Global Context of Nursing, a fourth-year class with three sections taught by three different educators, Ruth Rodney, Ivona Mostarac and Sandra Peniston, their shared goal is to delve into the history and current reality in a way that doesn’t tokenize the subject matter and takes exercises beyond merely performative gestures.

When it comes to land acknowledgements, for example, Rodney asks students to reflect on them in various ways by bringing in resources such as the “Alternative Campus,” a Faculty of Environmental and Urban Change project that invites people to think critically about the land York is situated on.

“I think that, if we are really serious about it, there always has to be an action component,” says Rodney. “Supporting the calls that Indigenous communities continually ask for involves, not only learning about the historical and contemporary issues, but also has to have a connection with activism.”

Sandra Peniston challenges her students to consider the role nursing has played in settler colonialism.

“We, as nurses, we were there in those residential schools, we were part of this,” she says. “We’ve kind of whitewashed our nursing history but, whether it was in Canada, the United Kingdom or across Africa, we shaped colonialism as well. We need to own that.”

Students enrolled in The Canadian Health Care System—a third-year course taught by Mohammed Anwar Majid that examines residential schools, trauma and violence against women, including the national inquiry into Missing and Murdered Indigenous Women and Girls—are also encouraged to take action with an exercise that sees them write letters to the Minister of Health.

“My expectation was for students to provide some general recommendation but, instead, students have committed themselves to continuously exploring Indigenous history and culture, volunteering with Indigenous elders and knowledge keepers and advocating for Indigenous rights,” says Majid. “I am humbled to be in the presence of these future leaders and they are helping me become a better person.”

Often as not, students seem to be ahead of the curve when it comes to wanting more Indigenous content. Vanessa S., for example, would like more material about traditional medicine in the curriculum and more emphasis on different conceptions of well-being and ways of knowing.

Similarly, first-year nursing student, Jessica Houf, would like to see more of a strengths-based approach when it comes to learning about Indigenous health issues.

“We often talk about Indigenous health primarily in terms of disparity and framed as a problem,” says Houf. “I’d like to see more about possibilities for improving health overall by incorporating Indigenous practices and Indigenous thinking.”

Houf adds that she’s begun exploring these topics for her own research papers and independent work, which she sees as part of the job of being a student as well as working on decolonization.

“For so long, we talked about the harm,” says Karen Campbell, who teaches Qualitative Research Methods in Nursing. “And we need to talk about that. We need to continue to talk about cultural genocide and to understand the legacy of colonialism. And then we need to say, ‘Okay, now what?’”

“Some students are afraid to research within Indigenous populations because Indigenous populations have been harmed by researchers,” Campbell adds. “But now we have to look at some ways that we can work with and collaborate with these groups.”

Associate Professor Lisa Seto Nielsen, who teaches a different section of Qualitative Research Methods, says it’s important to avoid burdening Indigenous colleagues by asking them to be responsible for educating settlers. “A colleague pointed out that the work of decolonizing isn’t the work of Indigenous academics and scholars in the community,” Nielsen notes. “It's really our job to decolonize.”

And we’re only just getting started on the hard work, says Kate Dunn.

“There’s pressure to do things quickly, of course, but it’s been 150 years of colonizing education and you can’t just decolonize and re-indigenize in a few months,” she points out. “It’s a big process.”

“I think the greater conversation might even be, ‘How do we all take part in this process?’”