Our Commitment to Reconciliation

Reconciliation is not simply a statement of intent, but is instead a sustained commitment to truth, accountability, and systemic change. Nursing in Canada has been shaped by a colonial history that contributed to the oppression of First Nations, Inuit and Métis Peoples, including through practices that excluded Indigenous knowledge and reinforced inequities in care. The ongoing impacts of anti-Indigenous racism in health systems make clear the urgent need for meaningful, measurable action.

Guided by Indigenous nursing leadership and shaped by engagement across the profession, CNA has committed to advancing reconciliation through concrete steps aligned with the Truth and Reconciliation Commission of Canada’s Calls to Action and the United Nations Declaration on the Rights of Indigenous Peoples.

As such, with First Nations, Inuit and Métis nurses, health leaders, and CNA partners, we co-developed The 4 Streams of Reconciliation: CNA’s Action-Oriented Framework. Grounded in an Indigenous worldview and informed by a collaborative, iterative process, the framework outlines four interconnected streams: accountability, advocacy, anti-racism and allyship. These streams guide the profession toward culturally safer care and more equitable health systems.

Access to safer nursing care and equitable health systems is a fundamental human right. CNA recognizes its ethical and professional responsibility to champion culturally safer care and to advance health systems that uphold the rights and well-being of Indigenous Peoples.

Symbolism is important. Like a river, this framework will continue to flow and overcome barriers. It will adapt to its environment, changing based on emerging knowledge, contexts and resources. What starts as a small trickle leads to larger and more impactful change, as demonstrated in the imagery. To achieve more equitable and culturally safer nursing care and health systems, CNA must act decisively “upstream” through the four streams of reconciliation: accountability, advocacy, anti-racism, and allyship. Addressing these four upstream determinants is essential to ensure that the care delivered downstream is equitable, safe and just.

Accountability

Accountability means to take responsibility for actions, decisions and outcomes, ensuring culturally safer care for Indigenous Peoples. This includes actions in the present day and the acknowledgement of the historical role that nurses play(ed) in the legacy of colonization.

Nurses are regulated health professionals who often interact first and spend the most time with those seeking care. As the national voice for all nurses, CNA must prioritize accountability for these interactions that have a direct and remarkable impact on culturally safer care provision for Indigenous Peoples.

Advocacy

Advocacy involves engaging with others and using one’s voice, recognizing the role of evidence, power and politics in driving policy decisions in the best interest of the public health system.

There are half a million regulated nurses in Canada, which equates to 1 in 57 voters. As the national voice for the profession, CNA must use its power and take meaningful and public-facing stances on Indigenous health to contribute to developing safer care and health systems.

Anti-racism

Indigenous-specific anti-racism involves practising humility by reflecting on power and privilege, and concrete actions to dismantle systems of oppression. If left unchallenged, the Whiteness of nursing and the health system will continue to default to inequitable health outcomes (Gebhard et al., 2022).

CNA must advocate for the rights of Indigenous Peoples and communities to be free of discrimination and racism, and to receive culturally safer care.

Allyship

Allyship is ongoing, requiring humility and the intentional process of unlearning and re-evaluating, whereby individuals in positions of privilege work alongside Indigenous Peoples and communities. This involves acting “with,” not “for,” and requires meaningful, respectful, and reciprocal relationships. Allyship cannot be self-declared, and recognition must come from community.

CNA must demonstrate respectful allyship through action and in partnership with Indigenous partners to advance health equity for Indigenous patients, families and communities.

Download The 4 Streams of Reconciliation: CNA’s Action-Oriented Framework. It serves as both a foundation and a call to action, supporting sustained, system-level change and a shared responsibility to advance reconciliation in nursing.

Reference

Gebhard, A., McLean, S., & St. Denis, V. (Eds.). (2022). White benevolence: Racism and colonial violence in the helping professions. Fernwood Publishing.