Going full circle: An Indigenous nurse's journey of nursing practice and leadership

Talk Tuesday - August 11, 2020

Presenter

Chief Karen Batson, R.P.N., B.Sc.M.H., B.G.S., M.Ed 
Pine Creek First Nation

Karen Batson is a member of the Pine Creek First Nation and the first female Chief. Karen’s education and work experience has focused in the area of health, specifically in mental health in both government and private practice settings. In her role as Chief, Karen has been involved in facilitating many community development initiatives resulting in positive changes in her community including increases in housing, employment, infrastructure, elder housing and improvements to the overall health and wellness of the community.
 
In 2018, she was appointed as the chair of the Chiefs Health Action Table at the Southern Chiefs Organization. The focus of this initiative is the transformation of health services for 36 First Nations communities in Southern Manitoba. Karen is also on the Assembly of Manitoba Chiefs Women’s Committee, Chiefs Standing Committee on Child Welfare, Chiefs Committee on Education, West Region Child & Family Services Board, Collaborative Leadership Initiative and the Chiefs Committee on Charter Renewal with the Assembly of First Nations.
 
Prior to becoming Chief, Karen worked in academia, where she has taught at both Assiniboine Community College and Brandon University with a focus on community development with Indigenous communities and most recently teaching in the Department of Psychiatric Nursing with the Faculty of Health Studies.

Summary

The Association hosted Chief Karen Batson, a registered psychiatric nurse (RPN) who holds a Bachelor of Science in Mental Health, a Bachelor of General Studies, a Masters of Education, several community roles and serves as the Chief of Pine Creek First Nation. 

Chief Batson shared her journey with us, from leaving her home community and family at 18, through attending university, working in various clinical areas and while she was getting married and starting a family. This period was a time of dramatic change in how mental health care and mental health nursing were conceptualized and practiced. Chief Batson and her husband, also an RPN, started a private practice providing mental health services to First Nations communities. They worked alongside their regulatory college to create the services needed to support private practice which hadn’t existed in Manitoba before they started Healing Spirit Counselling. 

Chief Batson shared some details about her academic and teaching career and the two requests to run for chief of her community. The first she declined because of her own circumstances at the time but she was approached again in 2016. After visiting the community, seeing the living conditions, speaking with people and seeing the need, she connected with her family who agreed to support her. She ran and won.

After speaking about her own background, Chief Batson outlined some of the historical issues affecting First Nations people today. She spoke about initial relocation to reserves; the Indian Act; residential schools and their impacts; and other harmful policies. Social determinants of health were detailed in general and specifically those that impact the health of Indigenous people and children and the dramatic disparities in health outcomes. 

Chief Batson ended her talk with discussion of the current and future role of RPNs and then took us on a tour in pictures of her community, Pine Creek First Nation. 

Question and answer

1. How does the Association plan to increase the number of Indigenous mental health providers?

  • Mary Smith, executive director, shared that the Association will work collaboratively with professional partners in all nursing disciplines, especially to share presentations like this. The Association’s plan is to establish good strong relationships and to identify priority issues to work together on.
  • Chief Batson said there certainly are more mental health practitioners now than when we first got started and more professions too. Still, psychiatric nurses have those more specialized skills, they can do assessments, know about medications etc. We need to track more Indigenous people into the profession. There aren’t a lot of Indigenous psychiatric nurses but the young Indigenous population is growing and that’s the next generation who will work and take up these careers. This is a great opportunity to promote psychiatric nursing and other kinds of nursing.
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2. Can you talk about mental health issues as they relate to the First Nations culture?

  • One way we could incorporate a cultural aspect would be to utilize traditional healers. Some people trying to find their way identify wanting to incorporate other ways of healing including using teachings, culture and ceremonies from elders.
  • When we were in private practice, we had background knowledge and exposure to ceremonies and teachings so we were able to understand when people spoke of these things. When they came and had a counselling session and they talked about those things it wasn’t foreign to us. Knowing that the counsellor understood what you meant or wasn’t shocked, helped make people more comfortable. People are trying to find different ways of healing and we need to be open to that.
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3. Can you speak to your experience as a woman in leadership in a patriarchal structure?

  • I am the first woman chief for my community. I guess it was a big step for them, I remember them talking about it. That was my campaign motto, “Creating Change.” Maybe for some ppl it was a gender thing, that they wanted to see what a woman could do. I think I've made a lot of positive changes.
  • It is a bit more challenging as a woman. There are 11 women chiefs now in Manitoba so we’re still a minority at the table but that doesn't mean we shy away. We’re a very vocal group and have our own women's committee.
  • There have been times when I’ve had to deal with some of the patriarchal values that exist but I just speak to it. I don’t just let it happen and not say anything. I use my voice and make sure they know what they’ve said or done is inappropriate. It’s 2020! Women need to take back roles that were taken from them in some cases. Maybe those roles were never lost but we’re making changes.
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4. What do you think are appropriate steps to decolonize nursing education?

  • We’ve talked about trying to have more Indigenous students but it’s also having more Indigenous, Metis, Aboriginal, First Nations instructors as well. Having that Indigenous perspective in the classroom allows them to be integrated into the curriculum. I would always teach from my own perspective and one of the comments I got back on an evaluation was something like, “I didn’t know this was an Aboriginal course” and that was because I, as the professor, spoke about Aboriginal issues. I can’t change my identity or the experiences I’ve had and witnessed and those are part of how I teach and I think we have to.
  • If we can’t have people come and teach in the universities we need to get the students in different clinical settings that are run by or serve Indigenous populations.
  • Having a course on Aboriginal health where students are exposed to and learn that history. It’s not to shame and blame anyone, but it’s important for nurses to understand that background so they can understand why an Indigenous person might present in a certain way.
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5. Have there been discussions on how to implement a different kind of healthcare that is not medical model based?

  • Yes! And those discussions are ongoing. These are very early stages and it’ll be years at least before we can have a healthcare system for Indigenous people. I think a lot of it is about looking at different ways of doing things, looking at the history and at ways we can incorporate cultural aspects into everyday care. Not just a smudge room at a hospital but being truly inclusive, that’s where traditional healers can come in.
  • I went to Alaska to look at their healthcare system, which the Alaskan Native people took over. It was a 15-20 year process. It was fascinating. It had medicine of course, but not the hierarchy of medicine. They had pods where the doctors, nurses, social workers, dieticians and everyone all worked together in a big room. They had traditional healers involved and a garden where they grew traditional medicines. The whole building was immersed in the culture – carvings, art and most of the staff. That’s what I envision. It will be important for us to include elders and traditional healers in the process because they are the knowledge keepers. There will have to be a balance but I think the sky is the limit.
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6. What do you find is the most effective way to change Indigenous health issues? Policy? Government?

  • It is policy and government. Moving away from the Indian Act as much as we can and becoming self-reliant. Some communities are self-governing now. Regulations are a big stumbling block for economic development. For example, our community has some land in Dauphin that we’re hoping to develop, to have business and build some economy and bring in money to improve even more but it’s very challenging. The Indian Act is very restrictive. This is why it's taken so long for Indigneous communities to develop economically. We have to work through the Indian Act if we want to make it an urban reserve, if we don’t want to do that then it’s just like any other regular business.
  • There are a lot of funding issues. Communities are very underfunded, I was very surprised at the level of funding. You're expected to run a whole community with that. Fix all the roads, provide all the services, keep your buildings in tip-top shape, keep a water treatment plant going, garbage pick-up, pay your staff, keep trucks on the road. You're a government but have maybe 25 staff to run a whole community.
  • Thinking about social determinants of health (SDH) – people need good safe houses to live in like any other Canadian. People living on reserve on social assistance get $220 a month to live on! They can’t afford a car with that so if they need to leave the community, they have to pay $30 - 50 and then don’t have much left for food and clothes and personal items.
  • There is a perception that people living on reserve, they’re given everything. Even education is challenging. We might only have funding for 35-40 students per year, not all for free.
  • So we need policy changes, more funding, good leadership in communities. I’ve been lucky to have a good team working with me since I came on board. We spent the first 14 months getting out of the co-financial management that the community had been under for 15 years. Now that we’re independent we can get projects started and move forward. A big part of that is writing proposals for the projects, much of the funding is obtained through proposal’s that compete with the 63 First Nations in Manitoba so a lot of it is who can write the best proposal.
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7. Why isn’t nursing at all concerned that there is a genocide currently being committed against First Nations and what is behind this denial?

  • Well, it took the government how many years to apologize for residential school and the harms.
  • I don’t know. It could be a lack of awareness, that's why it's good to have these presentations and discussions. It’s hard for people to hear about it. Like when I brought presenters into my classroom to present the reality of First Nations people who are still working with the intergenerational impacts of various policies and actions.
  • One important thing is there are 11,000 Indigenous children in CFS care who were taken away from their family and their community. What kind of trauma are they experiencing and what kind of healing will they need? They’re aging out of care and ending up on the streets homeless or vulnerable to detrimental lifestyles. That cycle is still happening and we have to open the eyes of our students to it so they know that these traumas aren’t just in the past but are ongoing.
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8. What can you say about Indigenous nurses in Manitoba and racism?

  • The whole impetus behind having this new healthcare system for First Nations people is because of the systemic racism First Nations people experience in the healthcare system and that includes care not being provided in their communities. People don’t like to travel out of their home communities especially when they’re unwell and may never have left before. In Canada, people should be able to have services in their own communities. Patients on dialysis have to travel sometimes three and a half hours one way, seven hours there and back, three times a week because they can’t have dialysis in their community.
  • People in urban centres experience racism in healthcare too and in the education, justice and CFS systems. When we look at education, Indigenous people have already said, “Well, enough” - that didn’t work for us, it traumatized us, first residential schools, then day schools. We want to take over our own education, and we did. This will be the same for healthcare. It’ll be a long process but our minds are set, we have good examples and good advocates. We need to create a system to heal people in the way they want to be healed. In BC First Nations people took control of health, why couldn’t we do that here in Manitoba? It’s an exciting endeavor for sure.
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