walking the perinatal journey together€¦ · trauma informed care with first nation families. 2....

First Nations Families & Health Care Providers: Walking the perinatal journey together

Lucy Barney, RN, BScN, MN. Titqet Nation. Indigenous Lead, PSBC; Cultural Advisory, Pt Experience, FNHA Barbara Webster, RN, BScN, MScCNS Maternal Child Health FNHA

Acknowledgements

• Thank you to The Squamish, Musqueam and Tsleil-Waututh People for allowing us to do this work on their unceded territory.

• Thank you to everyone who is here to learn and to provide the best possible care to women and families in the perinatal period.

• Thank you to the First Nations and Indigenous Elders, community members, and professionals who helped create this path so that the women can have a safe pregnancy journey.

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Learner Objectives: 1. Recognize the importance and need to provide relational, culturally based,

trauma informed care with First Nation families.2. Recognize the impact of ACE Screening – the benefits and the potential

risks.3. Identify strategies that can be used in the clinical setting to enhance working

from a culturally safe and trauma informed perspective with Indigenous clients in the perinatal period.

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Healing & Resilient Indigenous Women: dancing a healing song

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Cultural Safety is:

an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the health care system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care.

It involves self-reflection on culture & power.It improve client experiences & leads to better care.FNHA #it startswithme Creating a Climate for Change.

Indigenous Physicians Association of Canada & Association of Faculties of Medicine of Canada. 2009; National Aboriginal Health Organization, 2009

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Cultural Humility

A life-long process of self-reflection & self-critique to understand personal biases & to develop & maintain mutually respectful partnerships based on mutual trust.

Cultural Humility Definition, First Nations Health Authority 2015

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Cultural: safety/competency/sensitivity/humility

Indigenous Physicians Association of Canada & Association of Faculties of Medicine of Canada. 2009; National Aboriginal Health Organization, 2009

Cultural Safety goes beyond:Cultural awareness –It refers to awareness of differences between cultures

Cultural Competency -is something that we strive for.

Cultural sensitivity - is about realizing the legitimacy of difference & the power of one’s own life experience can have on others

Cultural Humility is the only way we get there.

With an open heart and open mind, we can increase the space for Cultural Safety.

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Trauma informed practice • Means integrating an understanding of past and present

experiences with trauma into all levels of care and service delivery.

• It is an overall way of working, rather than a specific set of techniques or strategies.

• The goal to avoid re-traumatizing individuals and supports as well as places priority on safety, choice, and control in order to promote healing.

Trauma-Informed Practice Guideline May 2013.

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How is trauma expressed? (Poole 2015)

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Healing vs. Re-traumatization• All individuals in an organization from system planners to service

providers to support staff can make a significant positive outcomes by making services emotionally and physically safe.

• A key aspect of trauma-informed services is to create an environment where clients do not experience further traumatization or re-traumatization (events that reflect earlier experiences of powerlessness and loss of control) and where they can make decisions about their treatment needs at a pace that feels safe to them.

(Poole 2015)

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Principles of Indigenous Cultural Safety and Trauma-informed Practice in Perinatal Care

Strength based Resilience approachRelational Respectful Free of racism Response to colonial trauma

Safe Respect traditional practices and knowledge Informed choice Trustworthy Respectful of Indigenous views of women

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Role play / Case study

Role Play: You have 2 handouts for this activity: • The sheet with the 11 principles • Assessment form that will be used during the role play

During the role play mark down examples of what principles were demonstrated: • Principles of cultural safety and trauma informed care • Strengths / resiliency demonstrated • Other comments

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Role Play discussion Principles / Strengths: Allowing client to ask questionsClient giving consent ask if client Ok with doing various proceduresoffering tests so client feels she has control over whether she does them or notSafe environment established Able to tease out topics that would be in a “ACE screening” but in conversation format, client led for the information, in a safe environment, acknowledging resiliency and providing support as required.

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Healthy, self-determining and vibrant, BC First Nations children, families, communities