Reflections of a northern nurse
In preparation to write this article, I spent the summer months reflecting on my current nursing practice in the First Nations in rural northern Ontario. However, sifting through the many transformative experiences that have gratefully come my way in the past year has caused some difficulty in locating the intended focus of my message, mainly because there is simply so much to tell. Nevertheless, upon my most recent departure from Kashechewan First Nation, I had a very enlightening and encouraging conversation with two middle-aged Cree women. In discussing a few of the several health inequities First Nations women routinely face, I was encouraged by one of the women to “Speak up.” And so, it is with her blessing, and with great respect for the Aboriginal peoples whom I serve as a guest in their communities, as well as for their profoundly complex and powerful histories and traditions which I cannot capture, that I share a brief moment in northern nursing.
As a preface to what I have chosen to share, I believe it is important to disclose some of the perceived ideas about the so-called northern nurse. I’ve learned from a few of my colleagues that there exists five main reasons why nurses take their practice to the north.
They are the five M’s: missionary, mercenary, men/marital problems, mad, and misfit. As a newcomer, I was mostly ignorant to the five M’s. As a nurse acutely aware of the political nature of our profession, I was motivated to go to the north by a sincere interest in working with vulnerable populations and a growing concern for my fellow Canadians, who are, as Rudyard Griffiths poignantly remarks, “strangers in their own lands… an administrative challenge as opposed to a dynamic force in the unfolding of the country’s identity… a historical anachronism in the eyes of the dominant culture”.
I was also inspired to make a professional change after nursing in the south for a number of reasons.
Finally, and most influential, I was encouraged to join the ranks of northern nurses after having had a pivotal conversation with a nurse practitioner friend and colleague. I expressed my interest to pursue global health nursing opportunities in the developing world, with prospective plans to travel to East Africa with Medicins Sans Frontiers. Her apt reply resonated deeply with me: “You don’t have to go to Africa. Just go up north.” So, with that, I did.
And now, a year since that life-changing conversation, I am brought back to a beautiful spring day in Attawapiskat First Nation.
I’m listening to the vibrant voice of Buffy Saint Marie, while I wait for my plane to leave. I’m one of two passengers here so far, with the other yet to arrive. It’s me and the airport attendant.
As I sit and reflect on the past few weeks, I’m overwhelmed by a sense of purpose and reward that I’ve never quite experienced to this degree in my young career. I feel grateful and honoured, to have come here again, and to feel a sense of community.
It has taken some time to get here.
Each trip to the north seems to have a theme or focus for me, each incredibly challenging in its own right. My last contract was filled with young mothers and the many socioeconomic, cultural, and health issues attached to the priceless occupation. This time, I took care of several patients with severe mental health illness, two of whom had attempted to end their lives. Young motherhood and mental health are key examples of areas of health care in the north that experience extreme lack.
But for whatever reason, I seem to see more of one particular health issue each trip. That is not to say my colleagues aren’t seeing the others, that’s for certain. To be clear, there is never a shortage of patients whose various health needs present deep and complex struggle; it is not as though one of my visits illustrates the ebb and flow of the health injustices here. The tide is high.
I am filled with a bevy of emotion: reverence, hope, respect, and sadness – for all that is and came before me in this place. For the indelible mark of colonialism on our Canadian identity and its painful ugliness. For the cultural richness and resilience of the First Nations despite it all. For the tremendous weight of memory and history and stories untold.
Too-ki-ni-skoo, which is to say medicinewoman, nurse.
The terms ‘Aboriginal’ and ‘First Nations’ have become ubiquitous in recent decades. However, I would argue that non-Aboriginal Canadians generally do not have an accurate idea of what they really mean.
Furthermore, there is little understanding of and concern for the insidious consequences of colonialism, which extend to present day government policies and procedures that are “based on a philosophy of displacement and assimilation.” While there is limited meaningful discussion of our Canadian counterparts in nursing school, and we occasionally hear about ongoing social and political crises in the First Nations on the news, the realities and histories of indigenous Canadians are largely unknown. As such, much of Canadian society and the nursing community are ignorant to our national responsibility to respond appropriately to what it has in fact created - a dispossessed north.
I would urge our community, which is filled with bright, caring, intelligent nurses, to think more critically and empathetically about our northern communities, as well as demand more from nursing institutions and the national sociopolitical consciousness at large. Pick up a relevant book, attend a talk, visit a friendship centre, enter a constructive dialogue, actively listen, and, should the opportunity present itself and the cause compel you, speak up and head north.
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