Tangled pasts, healthier futures: Nursing strategies to improve American Indian/Alaska Native health equity

Pool, Natalie; Stauber, Leah

doi:10.1111/nin.12367

Cited by 7 publications

(9 citation statements)

References 41 publications

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“…While available research provides evidence that the literature on AI/AN students is expanding, it is also clear that we need more empirical research that examines the structures, policies, and practices and how these influence AI/AN students' access and success 18–21,23–25. A growing body of literature suggests workforce diversification is critical to improving health care in the United States in 2 ways 26,25. First, increasing the number of AI/AN nurses may help address provider shortages in rural and remote areas and is a recommended strategy for implementing high-quality primary care 4.…”

Section: Resultsmentioning

confidence: 99%

“…[18][19][20][21][23][24][25] A growing body of literature suggests workforce diversification is critical to improving health care in the United States in 2 ways. 26,25 First, increasing the number of AI/ AN nurses may help address provider shortages in rural and remote areas and is a recommended strategy for implementing high-quality primary care. 4 Second, the presence of an AI/AN workforce is critical in addressing both chronic health disparities and community crises such as the COVID-19 pandemic.…”

Section: Implications For Policy and Practicementioning

confidence: 99%

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The Caring for Our Own Program

Larsson

Johnson

2022

Nurse Educ

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Background: Research has identified workforce diversification as influential in improving health outcomes. The Caring for Our Own Program (CO-OP) set out to achieve classroom and workforce parity for rural Native American nurses and communities. Purpose: In this study, we report quantitative results of the first 20 years of the CO-OP and explore the extent to which the CO-OP model influenced degree completion for Native American students. Approach: The CO-OP employs a 4-pillar program model where sense of place, financial security, academic readiness, and social connection empower students as they progress. One hundred twenty-one Native American students have earned nursing degrees since inception. In addition, more than 10% of CO-OP undergraduates have returned to become nurse practitioners. Conclusions: The CO-OP model replicated elsewhere may also succeed by adapting key concepts in that context to achieve health equity.

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Section: Resultsmentioning

confidence: 99%

Section: Implications For Policy and Practicementioning

confidence: 99%

The Caring for Our Own Program

Larsson

Johnson

2022

Nurse Educ

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“…In Australia, cultural safety is embedded in professional nursing’s regulatory framework ( Australian Nursing and Midwifery Accreditation Council, 2019 ; Nursing and Midwifery Board of Australia, 2018 ) and is also reflected in New Zealand and Canadian Nursing Council’s standards and competencies ( Canadian Nurses Association, 2022 ; Nursing Council of New Zealand, 2011 ). However, cultural safety is not embedded in American nursing professional standards, which remains a barrier for improving health equity, especially for American Indian and Alaskan Native peoples ( Pool & Stauber, 2020 ). In keeping with the principles and practice of the cultural safety model ( Cox et al, 2021 ), health professionals and systems need to acknowledge their part in genocide, colonization, and neo-colonization in concert with other agents of the state, such as police, welfare, and education systems.…”

Section: Discussionmentioning

confidence: 99%

Elements of Long-Term Care That Promote Quality of Life for Indigenous and First Nations Peoples: A Mixed Methods Systematic Review

et al. 2022

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Background and Objectives Little is known about elements of long-term care (LTC) that promote quality of life (QoL) for older Indigenous and First Nations peoples. This systematic review aimed to extend understanding of those deemed most important. Research Design and Methods Following PRISMA guidelines, systematic database and hand-searching were used to find published and unpublished qualitative studies and textual reports. A convergent integrated approach was used to synthesize data, according to the Joanna Briggs Institute methodology for mixed methods systematic reviews. Results Included papers (11 qualitative; 7 reports) explored views and experiences of Indigenous residents, families, and LTC staff from North America (8), South Africa (1), Norway (1), New Zealand (1), and Australia (7). Elements of care included: i) co-designing and collaborating with Indigenous and First Nations communities and organizations to promote culturally safe care; ii) embedding trauma-informed care policies and practices, and staff training to deliver culturally safe services; iii) being respectful of individual needs, and upholding cultural, spiritual and religious beliefs, traditional activities and practices; iv) promoting connection to culture and sense of belonging through sustained connection with family, kin and Indigenous and First Nations communities. Discussion and Implications This review identifies elements or models of care that promote QoL for Indigenous and First Nations peoples in LTC. While included papers were mostly from the United States and Australia, the congruence of elements promoting QoL was evident across all population groups. Findings may be used to inform standards specific to the care of Indigenous and First Nations peoples.

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“…While cultural competence and cultural humility are required components in nursing curricula in the U.S., cultural safety has not been mandatory. Pool and Stauber (2020) provide a 'call to action' to embed cultural safety into the nursing curricula. Incorporating a process of critical self-reflection and addressing the power differential between the nurse and patient are necessary for cultural safety and can lay the path for improving health equity, specifically for American Indian/Alaska Native peoples.…”

Section: The Aacn Published the Essentials Of Baccalaureate Education...mentioning

confidence: 99%

“…Students' reflexive blog posts provide evidence of some of the key aspects of cultural safety. These aspects include critical consciousness; providing a 'safe place' for care; seeking to understand historical trauma; and acknowledging power imbalances (Curtis et al, 2019;Richardson & Williams, 2007;Mkandawire-Valhmu, & Doering, 2012;Pool & Stauber, 2020).…”

Section: Reflectionmentioning

confidence: 99%

Fostering Cultural Safety in Nursing Education: Experiential Learning on an American Indian Reservation

Mattingly

2021

Contemporary Nurse

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Background: To improve health equity, especially for American Indian/Alaska Native peoples, cultural safety must be included in the nursing education curricula. Cultural safety requires self-reflection with an examination of one's own culture and an ongoing analysis of biases and power imbalances Methods: Using a case study approach, a description and discussion of an ongoing Baccalaureate nursing clinical immersion experience on an American Indian Reservation is presented. With travel to the Pine Ridge Reservation, nursing students offer health promotion at community events and partner sites, with a focus on prevention of heart disease, diabetes, and unintentional injury. Transformative Learning Theory provides the foundation for the nursing clinical immersion experience at the Pine Ridge Reservation. Nursing students reflect throughout and after the Pine Ridge clinical experience via blogging.Results: Cultural safety themes identified in nursing student reflections include critical consciousness; providing a safe place; seeking to understand historical trauma; and acknowledging power imbalances. Satisfaction surveys are completed by Lakota screening participants, and results provide further evidence of emerging cultural safety.Impact Statement: A clinical immersion experience at an American Indian Reservation can foster cultural safety while also encouraging transformative learning. Conclusions:Nursing educators should consider clinical experiences focused on American Indian/Alaska populations. With a service component, the clinical immersion at the Pine Ridge Reservation requires that participants reflect on their experiences. A transformative change in perspective, required for cultural safety, is often the end result for nursing student participants.

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Tangled pasts, healthier futures: Nursing strategies to improve American Indian/Alaska Native health equity

Cited by 7 publications

References 41 publications

The Caring for Our Own Program

The Caring for Our Own Program

Elements of Long-Term Care That Promote Quality of Life for Indigenous and First Nations Peoples: A Mixed Methods Systematic Review

Fostering Cultural Safety in Nursing Education: Experiential Learning on an American Indian Reservation

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