Sitting on an island: nurses in the Canadian North

Abstract

<p>The nature of the practitioner/patient relationship has profound effect on the quality of health care. If this relationship is poorly managed (i.e. is susceptible to misunderstandings, tension and breakdowns), health care will be socially, psychologically, and sometimes even medically, inadequate and/or inappropriate. Intercultural health care is especially vulnerable to this problem, as practitioner and patient often interpret events or situations in different ways, according to their own cultural background.</p> <p>This paper is concerned with one such case of intercultural health care. In the Canadian north, health care is almost always controlled and distributed by nonnative doctors and nurses from the south. These people may have good intentions towards their native patients, but they are usually unable to communicate these attitudes to their patients and/or actualize them as behaviour. As a rule, natives and non-natives view and treat one another in terms of stereotypes rather than as individuals.</p> <p>Northern nurses are expected to be empathetic "comforters" as well as curers, but the structure of native/white (Le. non-native) relations in the north makes this very difficult. Both interactional and network theories will be used to analysize the manner in which most nurses relate to their patient population. The Quality and quantity of a nurse's relations to the community around her strongly influence her tenure in the north and how she is evaluated by others.</p> <p>A great many northern nurses retreat to the "total institution" of the nursing station or hospital and have few informal or personalistic encounters with native people. It will be argued that this behaviour is largely a response to the double bind inherent in northern society as to how nurses should interact with their native patients. Many of the problems exhibited in northern health care stem not from indifference or negligence, but are created by the poor quality of crosscultural communication currently typical of white nurses and native patients.</p>