The Key To Tackling Chronic Disease in First Nations Communities

It’s no secret that First Nations communities face unique health challenges. Now, chronic diseases are creating further complications. While rates of these diseases are on the rise across Canada, Indigenous people are disproportionately impacted.

Consider this. First Nations individuals are 1.5 to 2 times more likely to develop heart disease than those in the general population.

People from these backgrounds are 2.7% more likely to be infected with HIV than those of other ethnicities. And in many Indigenous communities, diabetes rates are skyrocketing.

The issues that contribute to these statistics are complex. To understand them, nurses and other health care professionals need to consider a range of social and historical factors.

Looking at environment is critically important. Why is it that managing chronic disease is especially difficult in remote First Nations communities? Common problems include limited resources and geographic isolation.

Given these limitations, how can health care professionals help chronic patients? We believe telenursing is the answer.

If you’re a nurse, you’re on the frontline. You care about your patients. You probably strive to better understand and provide for their needs. Telenursing can help.

Through the right communication technologies, you can help your chronic patients manage their conditions – no matter where you are. Read on to learn how.

Unique Nursing Challenges

In remote communities, obstacles to high-quality health care are nothing new. As chronic disease rates rise, the needs of these populations are increasing.

If you’re a nurse, you are an indispensable part of the health care system. And if you work in a facility on a remote First Nation, you probably play a central role in your community. So it’s no surprise that research into the quality of care for Indigenous populations often focuses on nurses.

A recent Auditor General report provides one example. According to the report, remote nursing stations in Ontario and Manitoba are seriously understaffed. In many cases, the nurses who work in these facilities haven’t completed mandatory Health Canada training.

The fact that these locations often have difficulty retaining skilled staff is a big part of the problem. Usually, the result is very heavy workloads for nurses, which can lead to bad patient outcomes – and even tragedy.

Recently, a five-year-old boy living on an Ontario reserve died of strep throat. Residents noted that the nursing station he visited was short staffed. Leaders stressed that they can’t blame the nurses, who don’t always have the resources they need.

The health care system should provide more support – especially now.

In Canada, chronic disease rates are growing by 14% each year. As a result, patient needs are changing. And we know that many chronic diseases are occurring more frequently in Indigenous populations.

Infections (such as strep throat) can be cleared up quickly. But what about the patient with diabetes or heart disease?

More than ever before, patients in First Nations communities need ongoing support. To avoid serious complications, they need guidance to help them manage long-term conditions.

Given the current nursing shortages, how will nurses support chronic patients?

For Better Chronic Disease Management, Improve Communication

Many nurses with experience working in remote communities stress the value of communication. Those interviewed in a recent study emphasized the importance of interaction with peers and supervisors.

Health care workers learn from one another. If you work in nursing, you’ve probably become a better decision-maker by consulting with colleagues and specialist nurses.

In remote communities, finding ways to connect with outside health professionals is important. Ongoing education and consultation is critical to good practice.

Luckily, telenursing can help fill the gap. More on that in a moment.

There are other significant reasons to focus on communication. As chronic disease rates rise, interdisciplinary collaboration is becoming the norm. Patients with these conditions should benefit from the expertise of various specialists.

Here’s an example. A COPD patient who has a heart attack might be transported out of her remote community to receive care. When she returns home, her local nurse may need to consult with her pulmonologist and respiratory therapist, among others.

Regular communication between patients and various members of their health care teams can also strengthen self-management efforts.

Unfortunately, this type of collaboration doesn’t often occur in remote First Nations communities. As any nurse or doctor in one of these regions will attest, specialist care is hard to come by.

This is where telenursing comes in. By connecting patients and health care teams, videoconferencing software and other communication technologies can provide better patient outcomes.

Last but certainly not least, technology fosters communication, which means it can open dialogs across cultures.

There are so many possibilities. Indigenous and non-indigenous nurses can collaborate to improve cultural safety. And practitioners who work in remote First Nations communities can improve their skills through online education.

These types of initiatives save time and resources in the long run by helping nurses do more with less.

Why Telenursing is the Future

For a lot of health care professionals, the idea that technology is valuable isn’t new. For years, many nurses have shown a willingness to look at new ways of improving patient outcomes.

But how far has the health care system come in recent years? Are practitioners using telenursing and information communication technologies (ICTs) to their full potential? And what does all of this mean for remote First Nations communities?

In 2006, the Canadian Nurses Association (CNA) created an e-nursing strategy. It was designed to support the use of NurseONE, an interactive web-based resource for nurses.

Among other things, the strategy aimed to ensure that nurses have the information and knowledge they need to support their practice. Other objectives included connecting nursing groups and supporting new models of service delivery.

For most nurses in remote First Nations communities, these goals make a lot of sense.

In environments where workers are professionally isolated, fast access to relevant information is extremely valuable. The same is true of the ability to make real-time connections with others in the field.

When it comes to chronic diseases, supporting new service delivery models is important. Chronic patients often live in the community, which means health care organizations have had to find new ways to support them.

Unsurprisingly, the CNA document notes that ICTs have potential to improve care in remote and rural places.

But how much have things changed since 2006?

It’s fair to say that technology hasn’t revolutionized health care in remote Indigenous communities – at least not yet. Reports indicate that Canada still has a long way to go in supporting nurses – and patients – in these regions.

Luckily, telenursing still holds a lot of promise. while it’s true that video-chat and health information-sharing platforms have been around for awhile, these technologies have developed a lot in recent years. Today, they’re portable, secure, and easy to use.

As chronic disease rates continue to rise, connecting providers and patients is becoming more critical than ever more. This is especially true in remote locations.

The Bottom Line

In the years ahead, the burden of chronic disease will continue to impact remote Indigenous communities.

Government and health service providers have the chance to create a new, more accessible infrastructure. We believe that telehealth and ICTs will be a major part of this solution.

By embracing useful communication technologies in daily practice, nurses can support the use of innovation. In the end, the result will be better patient outcomes.

Feature image courtesy of chuckwaters83

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