Little is known about Registered Nurses (RNs) and their work in northern Canada and the care of older adults with dementia in this setting. As the prevalence of dementia is predicted to increase over the next 30 years, the purpose of this project was to discover key concepts that depicted salient issues in dementia care in northern Saskatchewan from the perspective of RNs working in northern health care facilities. A sequential exploratory mixed method design was chosen for this study with a qualitative lead complemented by a secondary analysis of quantitative data. <p>Interviews were conducted with 14 RNs, employed in small northern Saskatchewan communities, about their experiences with dementia caregiving and their perceptions of dementia care resources. The grounded theory method used in analysis of the interview data resulted in the construction of the theory, Insulating and Expanding the Awareness of Dementia in Northern Nursing. The study identified three categories of conditions that influenced awareness of dementia: Dementia Care and Community Caregiving, Characteristics of the Northern RN, and Northern Nursing Worklife. The quantitative secondary analysis, using a north-south comparison of data from the national survey (Stewart et al., 2005) in the multi-method study The Nature of Nursing Practice in Rural and Remote Canada (MacLeod et al., 2004), was used to explore contextual elements identified in the grounded theory analysis. The comparison of nursing practice in northern (n = 597) and southern (n = 2154) rural and small town communities found that fewer RNs in northern Canada reported dementia as a client characteristic, worked in long-term care, or in home care nursing positions, compared to RNs in southern Canada. Findings from both the qualitative and quantitative studies contribute to an understanding of the RNs awareness of dementia. Recommendations for increasing the awareness of dementia in northern nursing practice include enhancing the resources and services available to older adults with dementia in small northern communities. It is hoped that further exploration of dementia within northern communities will result in improved care for individuals with dementia and their families.

Little is known about Registered Nurses (RNs) and their work in northern Canada and the care of older adults with dementia in this setting. As the prevalence of dementia is predicted to increase over the next 30 years, the purpose of this project was to discover key concepts that depicted salient issues in dementia care in northern Saskatchewan from the perspective of RNs working in northern health care facilities. A sequential exploratory mixed method design was chosen for this study with a qualitative lead complemented by a secondary analysis of quantitative data. <p>Interviews were conducted with 14 RNs, employed in small northern Saskatchewan communities, about their experiences with dementia caregiving and their perceptions of dementia care resources. The grounded theory method used in analysis of the interview data resulted in the construction of the theory, Insulating and Expanding the Awareness of Dementia in Northern Nursing. The study identified three categories of conditions that influenced awareness of dementia: Dementia Care and Community Caregiving, Characteristics of the Northern RN, and Northern Nursing Worklife. The quantitative secondary analysis, using a north-south comparison of data from the national survey (Stewart et al., 2005) in the multi-method study The Nature of Nursing Practice in Rural and Remote Canada (MacLeod et al., 2004), was used to explore contextual elements identified in the grounded theory analysis. The comparison of nursing practice in northern (n = 597) and southern (n = 2154) rural and small town communities found that fewer RNs in northern Canada reported dementia as a client characteristic, worked in long-term care, or in home care nursing positions, compared to RNs in southern Canada. Findings from both the qualitative and quantitative studies contribute to an understanding of the RNs awareness of dementia. Recommendations for increasing the awareness of dementia in northern nursing practice include enhancing the resources and services available to older adults with dementia in small northern communities. It is hoped that further exploration of dementia within northern communities will result in improved care for individuals with dementia and their families.

In 1944, the Government of Saskatchewan created the Northern Administrative District (NAD), which established Northern Saskatchewan as a spatial entity within the provincial milieu. Attention was focused on modernizing the region, and public health nursing became one of the first state-sponsored institutions to be introduced by the provincial government. By examining the day-to-day activities of nurses who worked at remote nursing outposts in Northern Saskatchewan between 1944 and 1957 and beyond, this research examines the complex internal factors involved in region-making. Nurses lived and worked amongst their patients in small remote communities, thus making them effective vehicles for promoting modernization principles through preventative and educations programs. Despite the governments intention to modernize Northern Saskatchewan, a colonial relationship emerged between the region and the rest of the province. This situation left nurses in a confusing and often difficult position, because the institution behind initiatives to modernize the region was also their employer to whom they had certain obligations. Furthermore, the colonial attitude towards the region also extended to the nursing stations and the nurses, which often frustrated their attempts to provide medical care. As such, the small cadre of nurses played an ambiguous role, both as agents of modernization, but also opponents of its egregious effects.<p> The research examines the role of nursing in region-making through two types of geography: A geography of region-making where the literature focuses on the formal process of institutionalization, and a geography of social life, where the emerging literature on the geography of nursing provides an entry point. This two-part approach provides an opportunity to use different lenses to view the processes involved in shaping Northern Saskatchewan as it emerged as a distinct northern place within Canada.

In 1944, the Government of Saskatchewan created the Northern Administrative District (NAD), which established Northern Saskatchewan as a spatial entity within the provincial milieu. Attention was focused on modernizing the region, and public health nursing became one of the first state-sponsored institutions to be introduced by the provincial government. By examining the day-to-day activities of nurses who worked at remote nursing outposts in Northern Saskatchewan between 1944 and 1957 and beyond, this research examines the complex internal factors involved in region-making. Nurses lived and worked amongst their patients in small remote communities, thus making them effective vehicles for promoting modernization principles through preventative and educations programs. Despite the governments intention to modernize Northern Saskatchewan, a colonial relationship emerged between the region and the rest of the province. This situation left nurses in a confusing and often difficult position, because the institution behind initiatives to modernize the region was also their employer to whom they had certain obligations. Furthermore, the colonial attitude towards the region also extended to the nursing stations and the nurses, which often frustrated their attempts to provide medical care. As such, the small cadre of nurses played an ambiguous role, both as agents of modernization, but also opponents of its egregious effects.<p> The research examines the role of nursing in region-making through two types of geography: A geography of region-making where the literature focuses on the formal process of institutionalization, and a geography of social life, where the emerging literature on the geography of nursing provides an entry point. This two-part approach provides an opportunity to use different lenses to view the processes involved in shaping Northern Saskatchewan as it emerged as a distinct northern place within Canada.

State dependency and the lingering impacts of colonialism dancing with Aboriginal peoples are known realities across the Canadian health care landscape. However, delving into the discourses of how to reduce health disparities of a colonized population is a sophisticated issue with many factors to consider. Specifically, nurses can play a central role in the delivery of essential health services to the ‘Other’ within isolated Northern Aboriginal communities. As an extension of the state health care system, nurses have a duty to provide responsive and relevant health care services to Aboriginal peoples. The conducted qualitative research, influenced by a postcolonial epistemology, sought to explore the roles and challenges of nurses working within rural, remote, and Northern Canadian Aboriginal communities, as well as individual, organizational, and system level factors that supported or impeded nurses’ work in helping to meet Aboriginal peoples’ health needs with meaningful care. Theorists include the works of Fanon on colonization and racial construction; Kristeva on semiotics and abjection; and Foucault on power/knowledge, governmentality, and bio-power were used in providing a theoretical framework to help enlighten the research study presented within this dissertation. Critical Discourse Analysis of twenty-five semi-structured interviews with nurses, physicians, and regional health care administrators was deployed to gain a better understanding of the responsibilities and challenges of nurses working in Northern Canada. Specifically, the research study was conducted in one of the three health regions within Northern Saskatchewan. Major findings of this study include: (1) the Aboriginal person did not exist without being in a relation with their colonial agent, the nurse, (2) being ‘Aboriginal’ was constructed as a source of treating illnesses and managing diseases, and (3) as a collective force, nursing was utilized as means of governmentality and as provisions of care situated within colonial laws. Historically, nurses functioned as a weapon to ‘save’ and ‘civilize’ Aboriginal peoples for purposes of the state. Primarily, present day nursing roles focused on health care duties to promote a decency of the state, followed by missionary tasks. In turn, the findings of this research study indicate that nurses must have a better understanding of the impact of colonialism on Aboriginal peoples’ health before they engage with local communities. Knowledge development through postcolonial scholarship in nursing can help nurses and health service providers to strengthen their self-reflective practice, in working towards de-signifying poor discourses around Aboriginal peoples’ health and to help create new discourses.