Indigenization of nursing education programs in Saskatchewan: A critical discourse analysis

Abstract

The nursing academy, motivated by the release of the national Truth and Reconciliation Commission’s (TRC) Calls to Action in 2015, has unequivocally declared support for and commitment to Indigenization. However, the way Indigenization is defined and operationalized in the nursing academy is varied and sometimes contested. Situated within the context of colonialism in the Canadian healthcare system and nursing education, this study aimed to unpack the conceptualization of Indigenization using the undergraduate nursing programs in the province of Saskatchewan as a focus of the research. To conceptualize Indigenization in the nursing programs, I explored the following three questions: How do the strategic plans of these undergraduate nursing programs conceptualize Indigenization? What are the experiences or practices of nursing program staff in implementing Indigenization within their programs? How do the discourse found in texts and staff experiences or practices sustain, reproduce, or transform existing power structures in the programs? Using Spivak’s (2009) theory of the deconstruction of marginality as the overarching framework, I examined the strategic plans of the three undergraduate nursing programs in Saskatchewan including their parent institutions—University of Saskatchewan, University of Regina, and Saskatchewan Polytechnic. I also interviewed a total of seven nursing staff members from the three programs to gain an understanding of their practices of Indigenization. I analyzed the strategic plans and interviews using a qualitative analysis approach informed by Lune and Berg (2017) and Fairclough’s (2016) dialectical-relational approach to critical discourse analysis. Through the study, I establish that the discourse of the strategic plans of nursing education programs in Saskatchewan consists of four constructs of Indigenization: Indigenous inclusion, relationship, reconciliation, and decolonization. Indigenous inclusion consists of creating space, i.e., making the learning environment physically and culturally welcoming; incorporating Indigenous ways of knowing; and supporting Indigenous students, faculty, and staff. Relationship is characterized by mutuality and reciprocity, Treaty land acknowledgements, and collaboration and engagement with Indigenous communities. Reconciliation is manifest in institutional declarations that all members of the community, especially non-Indigenous ones, bear responsibility to take up the TRC’s Calls to Action. Decolonization is defined in the strategic plans; however, the plans do not describe how to achieve it. The findings show that when the four constructs are presented as interchangeable processes, nursing education programs run the risk of de-emphasizing each of these constructs as unique—albeit interrelated—processes to achieve the overall goals of Indigenization. The study shows that the nursing program staff tend to favour Indigenous inclusion and building relationships over reconciliation and decolonization. The practices of nursing program faculty and staff also reveal conditions that foster Indigenization as well as its benefits and challenges. The research further shows how the nursing programs are addressing the ongoing impacts of colonization by centering marginalized Indigenous Knowledges and systems. However, it also reveals tensions and contestations including the fact that not every nursing program faculty and staff are receptive to Indigenization. I conclude by discussing implications of the research—the importance of explicitly defining Indigenization and its goals for deconstructing politics and practices in the nursing programs, and for examining racism as an ongoing problem in nursing education. Through this study, I invite members of the nursing academy to take a deconstructive lens to their everyday practices of Indigenization. Keywords: Indigenization, decolonization, reconciliation, colonialism, nursing, racism