The Right Space: The Impact of Meaningful Dialogue in Informing Culturally Safe Care in the Emergency Department in a Rural Northern Community

Abstract

This project focused on emergency department (ED) care provided in a rural northern Canadian community. It studied how supported and meaningful dialogue between health authority providers and physicians whose work is associated with the ED, and providers who work with Indigenous people outside the health authority, helped inform culturally safe care in the ED. Guided by Indigenous and non-Indigenous advisory committee members, this participatory action study created a space for dialogue that allowed the perspectives of two worlds and multiple disciplines to emerge and develop solutions. The findings demonstrated what culturally safe and unsafe care in the ED look like, identified current culturally safe practices, and described factors that challenge culturally safe care. This project, although small, was unique because of the degree of collaboration in health care improvement between those inside and outside the health authority. Supportive dialogue that is mutually negotiated to include attention to culturally safe practice may be the starting place for the creation of the right space, the ethical space, which is so crucial in moving forward. From this foundation, there are six priority suggestions on how to enhance culturally safe care within an ED setting. These recommendations, built from dialogue within a locally generated ethical space, may extend beyond the local context and may be crucial for supporting cultural safety more broadly in the health care system. The findings presented here were the result of a research project undertaken as part of a master’s degree and do not reflect the views of any other body.