Indigenous health and cultural safety in nursing: ask, listen, make room
A client asks to smudge before surgery. How a practical nurse asks, listens, finds a safe way, and writes the practice into the plan of care.
- The client is the expert on her own practice.
- A safety limit changes how you arrange a practice. It is not a reason to refuse it.
- Write it into the plan of care, so she never has to ask twice.
When an Indigenous client asks for a traditional practice, you ask what she needs, listen, and find a safe way to make room for it. Her practice is part of her care. This guide follows one request to smudge before surgery.
A request to smudge before surgery
Your client is a First Nations woman who has surgery tomorrow. She says: “I'd like to smudge before my surgery. My aunt is bringing sage tonight.” Smudging is the burning of a sacred plant such as sage. It is part of how she prepares for something hard.
She shares her room with a client who is on oxygen. It would be quick to say that it is not allowed here. You do not say that, because your part is to find a safe way.
Ask first, then listen
You ask something like: “Tell me what you need for it.” Then you listen, because she is the expert on her own practice. She answers: “Just ten quiet minutes this evening, with my aunt.”
Find a safe way
- Burning sage near oxygen is unsafe, so the bedside will not work.
- Tell her that plainly.
- Tell her that you will find a place.
- Take her request to your charge nurse and the Indigenous health liaison, and find a room together.
Write it into the plan of care
At 19:00, she and her aunt have a quiet room. You write it into the plan of care and you hand it over, so that she never has to ask twice. She tells you: “Thank you for asking.”
Never guess, ask
First Nations, Inuit and Métis peoples are distinct, and practices differ between nations and between people. So with your next client you never guess. You ask what matters to them, and who they want with them.
Policies on practices such as smudging differ between employers. Follow your agency's policy, and see the whole shift in client advocacy and confidentiality in nursing.