Ethical and Leadership Challenges for Healthcare Providers in the Canadian North by Kathie Pender
The opportunity for employment in the Canadian North appeals to healthcare providers as adventurous and idyllic. The resource-challenged, independent workplace presents unique practice opportunities and tests personal and professional ethics and leadership competencies. Novice clinicians in the North may struggle to identify their role as a leader. Ethically, professionalism is challenged, safety questioned and boundaries stretched. This chapter will examine the complexities of working in the Northwest Territories from an ethical and leadership perspective.
Keywords: ethic, leadership, healthcare, clinician, Northwest Territories
The Role of Personal Support Workers in Remote Northern Communities in the Northwest Territories, Canada by Wanda Roberts
Personal support workers are integral members of the health care team in remote northern communities. They are typically Indigenous women native to the community, and often speak their first language. The scope of their role in communities is broad, and unique, when compared with the southern concept of home care services; their communities rely on them as liaisons for health care services due to their close ties with community members. This chapter will highlight some of the challenges and successes of support workers employed in remote northern communities of the Northwest Territories, Canada.
The Personal Support Worker program: A Public Health Initiative for Indigenous Women by Wanda Roberts
Colonization, racism, intergenerational trauma caused by residential schools, racist and sexist policies and legislation have had a detrimental impact on the health and well-being of Indigenous women. Through the completion of the Personal Support Worker program at Aurora College in Yellowknife, Northwest Territories, and attainment of employment, Indigenous women improve their socioeconomic and health status. They are role models for their children and communities, as well as care givers for the elders in their communities. Their enhanced knowledge of health impacts their communities and future generations. This chapter will highlight anecdotal experiences of support workers and their perceived influence within their families and communities.
Intimate Partner Violence in Northern Canada by Heather Fikowski
Intimate partner violence (IPV) in Northern Canada is a major public health issue that continues to impact women, families and communities and consistently demonstrates the highest rates in the country. A five-year study conducted between 2011 and 2016 investigated the community and frontline response to IPV in the Northwest Territories. Several dominant themes emerged that facilitated frontline worker’s sense of having their “hands tied” when trying to support women who are experiencing violence in their intimate relationships. The culture of violence and silence was identified as a theme pivotal in maintaining the social process of women shutting up about the violence. This chapter will explore the culture of violence and silence, both in terms of how it contributes to “hands tied”, as well as moving forward, towards communities that are free from violence.
Community Development in Canada’s North by Kerry Lynn Durnford, Cathy Bradbury, Susan Starks, Marnie Bell, Pertice Moffitt
Community development is an essential component of community health nursing. Community health nursing in Canada’s north is unique due to the transient nature and diverse scopes of practice of health care providers. Expectations related to interprofessional and intersectoral collaboration heighten the complexity of northern nursing practice. The rural and remote location of many communities also increases the cost of professional development and continuing competence. Particularly important is the rich diversity of northern people, but also knowledge and recognition of the legacy of residential schools and colonial practices which have created health disparities for indigenous people. Community development approaches built upon collaborative, respectful and egalitarian relationships with both indigenous people and the intersectoral team are essential to an efficient health care system. The purpose of this chapter is to discuss community health nursing competencies necessary for the practice of community health nursing in the north.
Childhood sexual and physical violence and the impact on mental health by Siv Kvernmo
Sexual and physical violence in childhood are acknowledged as major risk factors for mental and physical health in children as well as adults. As these type of assaults are associated with silence and shame, they are often underreported and, therefore, considered hard to prevent. Indigenous peoples are known to be at higher risks for several adversities such as sexual abuse and violence compared to non-indigenous populations. The knowledge of sexual and physical violence among arctic indigenous children and adolescents is sparse and in particular among the Sami. This chapter will draw a picture of sexual and physical violence in Sami youngsters and the impact on their mental and somatic health.
Cultural issues of mental health in indigenous children and adolescents by Siv Kvernmo
The risk and protective factors influencing mental health in Indigenous children and adolescents may vary from non-Indigenous peers due to their Indigenous status and upbringing in cultural different contexts. The impact of cultural factors such as Indigenous identity, cultural activities and Indigenous language competence on Indigenous children’s health is sparsely studied. In previous studies, cultural determinants accounted for significant variation in mental health in Sami high school students, and mainly for emotional problems. Later studies have broadened our knowledge of the effect of cultural issues´ impact on Sami youngsters. The aim of this chapter is to present which specific features of the Sami culture and the Indigenous status which are important to consider in the treatment and prevention of health problems in Sami youngsters.