Indigenous peoples' experiences of waiting for care : an equity-oriented study to investigate structural barriers in Nanaimo, British Columbia

This thesis explores Indigenous Peoples’ experiences of waiting for cardiac care in Nanaimo, British Columbia (BC), where patients requiring coronary angiography must wait to be transferred to Victoria because Nanaimo lacks a cardiac catheterization lab. Guided by Jo-Ann Archibald’s Indigenous Storywork methodology, this study used conversational storytelling with Indigenous individuals with a cardiac care history, their family members, and an Elder who shared experiences of waiting, transfer, and care. The stories showed that waiting for cardiac care can shape an entire healthcare experience. Waiting created fear, uncertainty, and stress for patients and their families. Patients and their family members described waiting days for medical transport between hospitals and cities. Those waiting for care described not knowing when care would happen or when and how they would return to their communities. Their stories described the stress of finding last-minute accommodation, worrying about the Malahat Highway in BC, and trying to support a spouse or family member while being kept just out of reach. Across the stories, participants’ healthcare experiences echoed earlier colonial harms. Participants situated these experiences within personal and family histories of residential schools, Indian hospitals, and other harmful healthcare experiences. Through Indigenous Storywork, these connections show that the stories cannot be reduced to isolated accounts of hospital transfer. The person waiting for care is not separate from family, community, land, the systems shaping the journey, or even the past. These stories carry teachings about respect, holism, responsibility, reverence, interrelatedness, synergy, and reciprocity. This thesis contributes to Indigenous health equity and nursing knowledge by demonstrating that waiting for cardiac care in Nanaimo, BC, is fundamentally a colonial and systemic equity issue, shaped by geography, communication barriers, transportation limitations, family displacement, racism, and a critical lack of local cardiac services. The findings call for cardiac care planning that accounts for waiting, transfer, and return home as part of the care experience, while addressing the distinct inequities implicated in Indigenous patients’ travel from Nanaimo to Victoria for time-sensitive cardiac services.