Show:
Substance use
LGBTQ
Indigenous health care
Indigenous care pt. 2
Epidemio-logy
100

What are reasons that people use substances?

  • To relax and be social, 
  • to enhance performance, 
  • out of curiosity, 
  • to rebel, 
  • to feel good, 
  • to not feel bad (numb feelings), 
  • for celebration,
  • for self-expression,
  • for escape, 
  • for sleep, 
  • to treat pain and trauma (physical or emotional), 
  • for religious or spiritual traditions…
100

What is normativity?

Designating something as socially ‘normal’


Leads to a lot of assumptions, and expectations

        - getting married

        - have a boyfriend/girlfriend

        - when are you having kids

100

What terms should you use when talking about Indigenous communities and members?

  • Aboriginal + Indigenous is an umbrella term
  • ‘Indian’ is legal reasons
  • First nations is a group – specific band
100

What were Indian day schools?

- Similar to the residential school but did not stay over night.


- Cheaper


- Used to assimilate the community

100

What is epidemiology?

The term epidemiology stems from three Greek terms:

  • Epi - upon or among
  • Demos - people
  • Logos - to study or the study of


“The study which befalls people.”

200

What are the harms of substance use disorders?

Health harms:

  • Anxiety, depression, psychosis, suicidal thoughts
  • Overdose death
  • Brain injuries
  • Early death
  • Infections-Hepatitis C, HIV,
  • Poor Nutrition
  • Cancers

Social Harms:

  • Job loss
  • Crime and legal consequences
  • Difficulties in school 
  • Homelessness
  • Relationship/family dysfunction
  • Social Isolation
  • Grief and loss on family, friends
  • and community
200

What is transitioning?

when an individual seeks congruence in their gender.

  • Somewhat misleading term as the person is not actually changing but seeking harmony in how everything lines up for them.
  • It is actually the rest of society that experiences the transition – in how they view that individual.
  • With this shift there may be an expression or public declaration, may be a change in name and pronouns.
  • Honouring this change is a sign of deep respect and critical way to show support.
200

What did pre-contact look like? (before 1500s)

  • Holistic view of health, illness and treatment consist of physical, emotional, mental and spiritual dimensions.
  • Research indicates Indigenous People were generally very healthy, well nourished.
  • Minimal diseases
  • Death through accidents, injury, warfare.
200

Nursing considerations - RTS

Respect

  • Acknowledge & appreciate others actively & authentically
  • Listen, try to understand, explain, allow autonomy

Trust

  • Allows vulnerability, dependency and risk taking
  • Indigenous – tend to relationship first, keep word, be confidential, reliable, kind and nonjudgmental

Spirituality

  • Not all indigenous people follow Indigenous ways
  • Allow clients to practice spirituality as completely as possible 
200

Infection Control

Breaking the chain


A two-tiered approach

  1. Routine/Standard precautions
  2. Additional/transmission based precautions
300

What are the 4 C's -- Substance use disorder

  1. Compulsion-an overpowering urge to use
  2. Cravings-it feels like it’s vital for survival
  3. Consequences-can’t stop using even though it’s causing problems in your life
  4. Control-using more than intended or trying to stop but being unable to
300

How to provide respectful nursing care with the LGBTQ community?

  • Do not assume anything
  • Consider terminology
  • Ask for preferences (with name and pronouns)
  • Be ok with making mistakes and being corrected
300

What are the residential school impacts today?

  • Loss of self identity
  • Alcohol abuse as a coping strategy …alcoholism
  • Significant health disparities
  • Educational disparities
  • Income disparities
  • Children also developing addictions (cycle)
  • Children also developing abusive behaviours (cycle)
300

Colonization purpose and effect?

  • Displace Indigenous people from traditional lands


  • Everything they learned as a child was taken away


  • Goal to Isolate and assimilate


  • Residential Schools, Indian Day Schools, Indian hospitals

  • Depleted resources diminishing livelihoods.

  • Diseases are introduced: small pox, TB, measles

  • Alcohol introduced

  • Malnutrition, starvation

  • Hudson’s Bay Blanket

    • Had small pox in the blanket
    • 1700/s trading posts
300

Non-Communicable Disease

  • A disease for which evidence is lacking that transmission from individual to individual is possible 
400

What is Trauma informed care?

  1. Resiliency and recovery
  2. Understanding trauma and stress
  3. compassion and dependability
  4. Cultural humility and responsiveness
  5. Safety and stability
  6. Collaboration and empowerment

400

What are the impacts on the LGBTQ community?

  • Psychosocial stressors
  • Anxiety, depression, stress, ED's, homelessness
  • Cardiovascular health
  • Increased tobacco use
  • Higher BMI
  • Gender-affirming hormones increase CVS health
  • Increased incidents of STI's
  • Violence
400

Indigenous child welfare

  • 1960’s-90’s – Sixties Scoop – Indigenous children apprehended on slightest pretext, placed in non –Indigenous homes (continuation of assimilation process)
  • Indigenous children are over-represented in the welfare system
  • Lost culture and often experienced abuse
  • Currently represent over 50% of foster care children

  • There were not services- child welfare, on reserve so kids were just taken.

  • Government pay outs does not compensate 

400

How to make progress in healthcare?

  • Nurse will play key roles
  • Examine Indigenous health challenges, develop appropriate responses
  • Implementing knowledge and action through understanding
  • Advocate for health equity and social justice.
  • Assist indigenous communities to build capacity
  • Re-orientation of health systems to benefit Indigenous populations
  • Nursing schools
  • Allyship 

*Accurate and culturally translated health care information can lead to patient empowerment and better health and outcomes.

400

What are transmission-based precaution types?

  • Contact
  • Contact plus
  • Droplet
  • Droplet and contact
  • Airborne
  • Airborne and contact
500

Addiction and nursing care?

  • Consider client risks for substance use disorder and barriers –SDOH- for accessing supports
  • Understanding client tolerance
  • Knowing personal bias
  • Recognizing potential client fear


500

What is inclusive language?

  • Avoiding derogatory language


  • Avoiding language that reinforces harmful notions about bodies/identities
    • Associating certain identities as good/bad or normal/abnormal
    • Defaulting to language that assumes a person’s identity


  • Using person-centered language
    • Person-first language – client who has diabetes
    • Identity-first language


  • Using language people can understand
500

Indigenous: justice system

  • Indigenous population over-represented (about 35% and 40% of women).
  • Residential schools, intergenerational trauma and poor legal counsel has resulted in high numbers.
  • Gladue Report
500

Truth and Reconciliation

  • In 2005 over 18,000 Residential school filed lawsuits
  • Royal Commission on Aboriginal Peoples (RCAP) was established (1996)
  • Full chapter on residential schools
  • Federal response: Action plan includes apology & healing fund
  • Aboriginal Healing Foundation (AHF)- apology and healing fund
500

What is immunization?

  • A person becomes protected against a disease through exposure to immunizing agent (i.e. a vaccine)


  • A vaccine is a biologic product designed to induce a protective immune response
    • Classified according to type of antigen


  • The ideal vaccine
    • Minimal adverse effects
    • Lifelog disease protection after a single dose administered at birth
    • Inexpensive
    • Stable for shipment
    • Easy to administer