The How and Why of Indigenous Nurse History

How do you write a history of Indigenous nurses? Several stories coincide: stories about education, about colonialism in health care, about Indigenous women and work, and about racism in the nursing profession, for example. But one starting point is the founding of the Registered Nurses of Canadian Indian Ancestry (RNCIA) in the mid-1970s, an important professional and political organization for Indigenous nurses in Canada.

Most of the original goals of the RNCIA had to do with moving into a central position within the federal Indian health system and extending Indigenous people’s self-advocacy and authority. RNCIA nurses also sought to re-write the standard curriculum in Canadian nursing schools and insisted on Indigenous representation in workplaces serving Indigenous people.

Their objectives were practical and reasonable: to improve Indigenous health by fostering education, data collection, and Indigenous nurse participation in health care programming and provision.

But in the historical context of both the twentieth century Indian health system in Canada and inequity in the health status of Indigenous people, these goals were, in fact, revolutionary. The RNCIA wanted to transform the very nature of the relationships between Indigenous people and governments, and to reject the colonization of Indigenous health.

And you can’t beat that for a fascinating topic of history to study.

Let’s take a look at one of the RNCIA’s objectives to see what we can learn about Indigenous nursing history: It reads that the RNCIA aimed, “To act as an agent in promoting and striving for better health for the Indian people, that is, a state of complete physical, mental, social and spiritual well-being.”¹

This goal is significant for a number of reasons. The RNCIA was the first group of Indigenous professionals in Canada to organize as an association. Most professional associations form in order to improve wages and working conditions. Instead, the RNCIA spoke about the health of Indigenous people and their goal to help to improve it.

This objective, moreover, was about action on the part of Indigenous nurses — “promoting and striving for better health.” Putting Indigenous nurses and their work at the core of the analysis is key to writing this history.

Third, this objective insisted upon a definition of health that suited Indigenous epistemologies and defined health as a state of complete physical, mental, social and spiritual well-being. As such, it also spoke to a different approach to or ethic of nursing.

This objective also addresses the historical conditions of colonization. Indigenous standards of health fell enormously during and after contact. The appropriation of land and resources, successive military and cultural invasions, as well as policies that served to weaken Indigenous people, communities, and nations, all resulted in widespread poverty and dislocation. These conditions not only fostered ill health and the suppression of Indigenous medicine, but also a health care system which did not by and large serve Indigenous people very well.

The Value of Writing, Studying, and Teaching Indigenous Nursing History

Once you spend some time with this history, you can never look at Canadian history or Indigenous history the same way again. An understanding of Indigenous nursing history, indeed, changes the nature of Canadian and Indigenous history as a whole.

For example, Indigenous women have a vibrant modern history, but it is a history that has for the most part been forgotten or written out of accepted mainstream accounts.² Indigenous nursing history insists on the vital participation of Indigenous people in education, work, and health care provision — and in shaping our modern history more generally.

It is still often assumed that the trajectory of health history in Canada has been one of straightforward progress through time. In terms of Indigenous people’s health history, the assumption was that prior to the advent of Europeans in this part of the world, there was no knowledge of health and medicine of significance today, that Indigenous medical practices merely constituted “suspicion” and that medicine was practiced by “charlatans.” Histories of medicine in North America regularly begin with the work of European missionaries, traders, nurses, and doctors to alleviate sickness among Indigenous people. This narrative of our health history also regularly fails to acknowledge the colonial context in which epidemics and non-Aboriginal healers prevailed. Further, it ignores Native and Inuit concepts of health and healing, and it casts Indigenous people in reactive, passive, and even dependent roles.

The existence of a critically engaged Indigenous nursing workforce has resulted in not only a professional challenge to inherent inequities in healthcare, but also to some of the most vehement and longstanding stereotypes about Indigenous people. In addition, Indigenous nurse history forces a discussion of the colonial nature of the health system in Canada. Many Indigenous nurses worked within the limited, hierarchical, and non-local medical and nursing services run from the nation’s capital as a “moral obligation” rather than as a treaty responsibility.

Finally, one of the great contributions of Indigenous nurse history is that it puts Indigenous displacement and resistance at the center, rather than the periphery of, national history and the history of state formation. Critically, this centers racism and inequality in discussions of federal education, health and employment policy. For example, many Indigenous nurses in Canada had a compromised educational background at segregated federal Indian schools, be they residential or day schools. Until after the 1940s, they faced color bars at Canadian nursing schools, as well as a number of other substantial barriers long after. In employment, Indigenous nurses faced assumptions about their abilities and their competence as Indigenous nurses. Any successes were attributed to assimilation. The persistence of Indigenous expertise in nursing in spite of this is nothing less than heroic. Ultimately, learning about the impact of racism on Indigenous nurses, as well as some of their strategies for building anti-racist nursing and healthcare practices is invaluable to those of us who also work in underrepresented fields.

Notes

1. RNCIA Objectives, 1975. Library and Archives Canada, Record Group R11504, Aboriginal Nurses Association of Canada, Volume 1 File 1-8, “History.” See also: Mary-Ellen Kelm and the Aboriginal Nurses Association of Canada, 30 Years of Community: Aboriginal Nurses Association of Canada (Ottawa: Aboriginal Nurses Association of Canada, 2005). Return to text.
2. McCallum, Mary Jane Logan, Indigenous Women, Work and History, 1940-1980 (Winnipeg: University of Manitoba Press, 2014), see especially Introduction. Return to text.