Navigating Cultural Safety in Newfoundland and Labrador

Katie Dicker, Senior Aboriginal Patient Navigator, St. John’s Native Friendship Centre

In 2002, our organization, along with the Division of Community Health within the Faculty of Medicine at Memorial University produced the Building Bridges Study, which was sponsored by the Strategic Social Plan.  The purpose was to look at ways to improve experiences for Aboriginal people in an urban health care setting. From the study came several outcomes, one being that there was a need to ensure the delivery of appropriate care to the province’s Aboriginal people, and another being that these individuals experience a wide range of difficulties in urban health care settings.

In 2005, the Cultural Diversity Working Group concluded that effective follow-up care for Aboriginal patients was a concern and that, according to the study, informants from Labrador reported that patients were returning home with incomplete information for follow-up care.  These two reports were the ground work that would become the basis of the Aboriginal Patient Navigator (APN) Program.

The APN Program offers support and assistance to Aboriginal patients/clients who are referred to St. John’s, NL for medical treatment.  Services and support include: navigation to appointments; arranging interpretative services in Innu Aimun and Inuktitut languages; assistance to access meals, transportation, accommodations and medical supplies; and discharge planning, liaising with internal and external agencies; as well as education and information sharing.

In our minds, the APN program is centred around enhancing cultural safety for patients. By ensuring that the physician understands the patient and by removing language barriers, an atmosphere of clear communication is created, which puts both the caregiver and individual patient at ease. Before the APN program existed, there were many situations when patients were left confused, with no understanding of the diagnosis, treatment plan or follow-up care. By providing patients with individuals who can communicate to them in terms they understand, this barrier is removed and patients are given tools to understand what the physician intended.

Through the APN program, we have learned that one of the most important factors in the longevity of programs like ours is having relevant data and showing its correlation to improved health outcomes for patients.  Since its inception, this program has assisted over 1500 patients and in the year after its pilot stage, we know that: 

* 85.7% of patients who participated in the evaluation survey felt the APN program minimized stress/anxiety;
* 64% believed that the program enhanced coordination of aftercare; and
* 57% believed the program raised awareness of cultural differences, practices and traditions.

At the end of the day, when you look at culturally based services that respond to community identified needs, it comes down to people, and ensuring that the people we provide services for get the most out of the time spent within the health care system.  It is said best by one of our previous clients in both his traditional languages and translated in English.

“Nakummek ilitsinut suliakagâtse tamâne. Ikajugatse
inûkatinet. Pitsiagusuagitse.”
“Thank you both for working here, because you are helping your people.  Keep doing the best you can.”