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Indigenous nurse overcomes racism, focuses on ‘cultural respect’ to deliver holistic care
Aug 30, 2021, By: Laura Eggertson
Canadian Nurse True North Series Juliet Bullock
Courtesy of Juliet Bullock
Indigenous nurse Juliet Bullock uses open-ended questions to build relationships with her patients. “I always start with ‘What brings you here today, and how can I help you?’” she says.

Editor’s note: this profile of Juliet Bullock is part of the Canadian Nurse True North series , focusing on the stories and practice of nurses who work in northern Canada under some of the country’s most challenging conditions.

Open-ended questions are Juliet Bullock’s favourite way to build culturally sensitive and safe relationships with patients.

Bullock, who is Gwichy’a, has been working as a public health nurse in Nunavut for the past three years. She flies in and out of communities such as Cambridge Bay and Kugluktuk from her home in Heriot Bay, on B.C.’s Quadra Island.

Although her First Nations culture is distinct from that of her Inuit patients, Bullock’s upbringing in Inuvik, N.W.T., and her time as a student at the Grollier Hall residential school have built a bond of shared resilience.

She understands the trauma at the heart of many health conditions.

She knows the reason people book an appointment often isn’t the only issue they need to discuss.

“I always start with ‘What brings you here today, and how can I help you?’” says Bullock.

Bullock makes time to hear people’s stories, whether it is a parent she works with during the well-baby home visiting program she started or a teenager she is vaccinating against COVID-19.

Safe space

“There was always the underlying idea that being Indigenous was a barrier to accomplishing the goals I felt were important.”

Creating a safe space for the people in the communities where she works is a vital part of her job, she says.

The key is taking time to listen. Listening is an antidote to the “hurried sickness” besetting health-care professionals, she says, where the goal seems to be “getting people in and out as fast as possible.”

“We forget the essence of sitting and listening to their story. That’s part of building the relationship. It’s really about opening the door.”

Bullock’s approach holds space for people to tell her what they really need, like the patient who asked for a bandage for his cut finger and stayed to talk about the violence within his family.

“That little cut on his finger was a way for him to say ‘I need help,’” Bullock says.

Understanding the roots of that violence, and of the substance use and mental health issues she encounters, comes from Bullock’s own experience with the racism directed at her as an Indigenous woman, a northerner and an Indigenous nurse.

Bullock was seven or eight when her Brownie leader in Inuvik unplaited the long dark hair Bullock’s Gwichy’a mother had carefully braided. She told Bullock she looked “too much like an Indian.”

That was just one example of the racism that undermined Bullock’s self-esteem. The same sense of being “less than” permeated her experience at Grollier Hall, which in 1997 was one of the last residential schools to close in Canada.

Racist attitudes

“I was never nurtured to pursue my dreams,” she says of her time in residential school, unlike the support she got at home.

“There was always the underlying idea that being Indigenous was a barrier to accomplishing the goals I felt were important.”

Nursing leaders also directed racist and colonial attitudes toward Bullock during her professional and academic career, she says.

Now 62, she recalls her evaluation at the end of a program to obtain her licensed practical nursing certificate, her first post-secondary course. Her instructor asked her about her plans.

Bullock told the instructor she would work for a while, and then earn her registered nursing credentials.

“She looked at me and she said, ‘I don’t think you have what it takes,’” Bullock remembers. “I said, ‘Watch me,’”

Bullock became a registered nurse in 1994, earning her diploma from the University College of the Caribou (now Thompson Rivers University). She graduated as her class valedictorian. Three years later, she received a bachelor of science in nursing from the same institution.

She’s currently pursuing her master’s degree in nursing leadership at the University of Victoria.

Despite those accomplishments, Bullock encountered resistance to the idea she could succeed.

Admitted prejudice

In the 1990s, she was enrolled in a nursing mentorship program as part of a territorial nursing initiative. Bullock’s nurse manager belittled her, spoke badly of her to others and behaved insensitively and unethically toward Indigenous patients, Bullock says. Her experience was “deeply problematic” given that the majority of the patients were Indigenous.

Bullock recorded her interview during the final evaluation. She confronted the nurse manager about the racism the manager displayed.

“I said, ‘Are you prejudiced?’” Bullock remembers. “She said, ‘Yeah.’ I was dumbfounded. I still have that recording.”

Rather than making her bitter, Bullock’s experiences stoked her efforts to educate her colleagues in cultural sensitivity.

She turns the incidents of racism she’s seen on the job into teaching opportunities.

“When you become angry and confrontational, you put up a barrier right away. My approach to nursing is to be transparent: to share ideas around cultural respect,” she says.

Dangerous assumptions

Seven years ago, while working as an Aboriginal nurse liaison at a B.C. hospital, Bullock observed an Indigenous man stagger into the emergency department.

Other nurses assumed he was intoxicated and tried to get him to leave.

“When I approached the patient, I realized he wasn’t under the influence of alcohol; he was having a seizure. Right away, we were able to bring him into the trauma room and provide the care he needed.”

If Bullock hadn’t been there, the patient’s outcome could have been “very serious,” she says.

She later debriefed the other nurses, using the incident to teach them about trauma-informed practice.

But these accounts are all too familiar in Canada’s health-care system, Bullock says. She points to the 2016 death of Inuit elder Hugh Papik.

The 68-year-old man suffered a stroke, but staff at his elder’s home and Aklavik health centre refused to treat him because they believed he was intoxicated. A coroner’s inquest later recommended cultural safety training for all health-care workers in the Northwest Territories.

“We never know what people’s experiences are, but we know the devastating impact of residential schools, and as nurses, we become the keepers of their stories,” she says. “Once you know that, the plan of care changes, the attitude changes.”

Bullock’s holistic approach to nursing addresses her patient’s physical, mental, emotional and spiritual needs: the four aspects of the medicine wheel.

She also applies that care to her own life. When encountering racism, discouragement or her own physical challenges, she has learned to take care of herself.

Drawing strength

She walks, grounds herself in her culture, and spends time with her daughters Crystal and Wanaao and granddaughter Quinn.

Her daughters were instrumental sources of strength in 2009, when Bullock was diagnosed with uterine cancer. For three years, she had to stop nursing as she underwent chemotherapy and struggled her way to wellness.

Drawing strength from powerful women is a lesson Bullock learned from mentors, including Sarah Jerome, a Teetl’it Gwich’in elder in Inuvik who is the former NWT languages commissioner.

“She taught me through her personal journey and her lived experience that whatever has happened in the past, you can use it in a very positive way to grow and develop into the person you want to be,” Bullock says.

Surviving cancer taught Bullock that she is stronger than she knew. It also gave her the courage to follow her dream of returning to the North, taking the public health job with the Government of Nunavut.

Today, Bullock hopes sharing her story could help Indigenous nurses who are beginning their careers.

“Reach for your dreams,” she tells them. “We’re all faced with barriers. It’s how you overcome those barriers in a positive way that matters.”

Laura Eggertson is a freelance journalist based in Wolfville, N.S.