https://www.cna-aiic.ca/fr/blogs/ic-contenu/2026/06/19/laiic-publie-un-cadre-de-reconciliation-oriente
June 19, 2026 (Ottawa, Ontario) — Today, the Canadian Nurses Association (CNA) released The 4 Streams of Reconciliation: CNA’s Action-Oriented Framework, a practical framework designed to guide CNA’s journey to reconciliation and support nurses, nurse practitioners, nursing organizations, and health-system partners in taking measurable action toward safer care and health systems for First Nations, Inuit and Métis Peoples and communities.
The framework development was informed by a national engagement approach that uncovered an urgent gap between nurses’ awareness of reconciliation and their ability to consistently provide culturally safer care. Engagement participants emphasized that barriers are not simply matters of individual intent. They are rooted in systems, policies, education gaps, and infrastructure that do not equip nurses with the knowledge they need. Key findings include:
- 91.7 per cent of survey respondents said they are familiar with reconciliation, but only 65 per cent said they feel confident providing culturally safer care.
- The highest confidence levels were reported by nurses in British Columbia (81.6 per cent) as compared to the lowest in Nova Scotia (50 per cent).
- Urban nurses — the majority of the profession — have the lowest levels of formal training on Indigenous health and cultural safety.
- Respondents identified systemic racism, lack of education and training, and lack of infrastructure and support as the top barriers to delivering culturally safer care.
- Nurses who had received formal training on Indigenous health and cultural safety reported significantly higher confidence in delivering culturally safer care than those who had not (74 per cent versus 43 per cent).
Throughout the engagement process, participants were clear that reconciliation in nursing must move beyond symbolic gestures. They emphasized that naming nursing’s history is necessary, but not sufficient — structural change is the work that must follow. Participants also pointed to the need for stronger education, infrastructure, leadership, and organizational accountability to help nurses provide culturally safer care consistently.
“Advancing Indigenous health equity requires sustained action across health systems, all levels of government, and the nursing profession,” said Dr. Valerie Grdisa, CEO of CNA. “CNA’s framework creates a practical foundation for collaboration — including education that addresses anti-Indigenous racism, support for Indigenous nursing leadership and research, and action to address the systemic barriers that continue to affect culturally safer care.”
The framework acknowledges that nursing, as part of the colonial health system, has a history inseparable from the oppression and harm experienced by First Nations, Inuit and Métis Peoples. Nurses worked in residential schools, Indian hospitals, and other institutions where neglect and abuse occurred, and nursing practice contributed to the exclusion of Indigenous knowledge and healing practices, anti-Indigenous racism, and mistrust of health systems.
“Reconciliation is an ethical and professional responsibility for nurses and nursing organizations,” said Dr. Tracie Risling, president of CNA. “CNA’s framework helps translate that responsibility into action by focusing on accountability, advocacy, anti-racism and allyship — and by ensuring this work continues to be guided by Indigenous nursing leadership.”
CNA is also calling on the federal government to act. The association is urging federal action to expand access to culturally relevant education and anti-Indigenous racism training, renew and expand the Indigenous Research Chairs in Nursing program, and strengthen the Indigenous health workforce through sustained, distinctions-based investments that address systemic barriers and support long-term participation across roles and settings.
The 4 Streams of Reconciliation was co-developed through Indigenous nursing leadership and broad engagement with First Nations, Inuit and Métis nurses, Indigenous-led organizations, nursing partners, and health leaders. It focuses on four areas: accountability, advocacy, anti-racism and allyship. Together, these streams provide a structure for CNA’s ongoing work and emphasize the importance of acting “upstream.” This framework also serves as a practical guide for nurses in all roles, settings and regions to contribute to reconciliation through their practice, leadership, education, policy and advocacy.
“This is the beginning of sustained work,” said Dr. Grdisa. “Credibility will be earned through implementation, public accountability, continued partnership, and measurable action.”
The framework is available at https://www.cna-aiic.ca/en/about-us/who-we-are/our-commitment-to-reconciliation
The Path: Your Journey Through Indigenous Canada, CNA’s reconciliation education program, is available at https://www.cna-aiic.ca/en/about-us/who-we-are/our-commitment-to-reconciliation/nursings-call-to-truth-and-reconciliation
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About the Canadian Nurses Association
The Canadian Nurses Association (CNA) is the national and global professional voice of Canadian nursing. Our mission is to advance the nursing profession to improve health outcomes in Canada’s publicly funded, not-for-profit health system. CNA is the only national association that speaks for all nurses in all sectors and practice settings across all 13 provinces and territories. We represent unionized and non-unionized nurses, retired nurses, nursing students, and all categories of nurses (licensed and registered practical nurses, nurse practitioners, registered nurses, and registered psychiatric nurses).
Media contact
Kerri-Anne Finn
Media and Communications Coordinator
Canadian Nurses Association
kfinn@cna-aiic.ca
613-282-7859
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