Background: Although the Emergency Department (ED) acts as an entry point into the acute healthcare system, it is often a source of anxiety and uncertainty for Indigenous patients. Racism and discriminatory practices in the ED, resulting in Brian Sinclair’s untimely death at Winnipeg’s Health Sciences Centre in 2008, and Joyce Echaquan’s viral plea for help before she died in a Quebec hospital in 2020, show the need for increased patient advocacy. The literature surrounding the use and role of a patient advocate in the ED is limited. However, the few hospitals that have utilized a designated ED patient advocate have reported higher patient satisfaction. With this in mind, this study examines the potential for an Indigenous patient advocate patients in the ED. Objectives: The objectives of this thesis were to examine (1) why culturally unsafe care continues to persist for Indigenous Peoples in ED environments and (2) the feasibility of a newly imagined Indigenous patient advocate role in the ED.
Methods: In this qualitative study, eight semi-structured interviews were conducted with Indigenous and non-Indigenous healthcare professionals who have worked or currently work in advocating for Indigenous patients to ensure greater cultural safety generally and in the ED of a major tertiary care hospital in Winnipeg, Manitoba (Canada). Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Results: Results indicate that high-pressure situations, specifically in the ED, are where racist incidents are likely to transpire. Participants identified the dangers the Indigenous patient advocate might encounter in the health care system and recommended how to improve the Indigenous patient experience. Conclusion: The findings reveal that cultural safety training and system wide policy changes are required to heal the ED, namely creating an environment where an anti-Indigenous racism agenda is reflected in all emergency medicine workings and system operations.