Indigenous Component

In this section, we report on our findings related to access to care for Indigenous patients. We are very grateful to the Indigenous patients and patient supporters who took the time to discuss their concerns so frankly with us. They were quite clear that the path for Indigenous patients receiving care at Eastern Health is one that is defined by the broader experience of systemic racism in the province in general. Moreover, they conveyed a strong perception that there is an ongoing and troubling lack of awareness by staff of the experience of being an Indigenous patient at Eastern Health. Here, we review the main challenges raised by patients, patient supporters, and staff, focusing on: the logistics of travel from Labrador posing undue hardship on patients and their travel escorts; communication barriers posing risks to patients in terms of care as well as informed consent; cultural differences exacerbating the lack of trust by patients in the health care system; racism and marginalization shaping the experience of care; and settler-Indigenous power relations more generally shaping mistrust in the system. An important positive finding was that the APN program effectively responds to the needs of patients at Eastern Health. The program was described by patients, patient supporters, and health care providers in an overwhelmingly positive light.

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