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‘Strong like two people’: by speaking language of her patients, Indigenous nurse has crucial care role

Profile on Tłı̨chǫ-speaking nurse Lianne Mantla-Look is first in multi-part series

By Laura Eggertson
November 14, 2022
Photo by Tessa Macintosh
Without access to nurses, doctors, and other health-care providers who speak their language, family members often interpret for Indigenous patients whose first language is not English, Lianne Mantla-Look says. Sometimes, family members deliberately withhold information. When she’s not working as a nurse in her community, Mantla-Look enjoys spending time with her one-year-old daughter, Finnigan, and her husband, Kyle.
Editor’s note: In a four-part Q&A article starting next week, Lianne Mantla-Look will provide candid and first-hand insight into her experience as an Indigenous nurse working in the North.

Being able to speak Tłı̨chǫ (pronounced tli-cho or tlee-cho) sets Lianne Mantla-Look apart from other Indigenous nurses. Because she is able to speak the traditional language of her people while offering modern health-care services, she says she embodies the Tłı̨chǫ philosophy of being “strong like two people.”

The day a seriously ill Dene elder’s family member told him his medical team would put him on a machine to make him better if his heart stopped, Mantla-Look realized the critical role she plays as a nurse who speaks her patients’ language.

The elder, who spoke only Tłı̨chǫ, was relying on the family member to interpret the non-Indigenous doctor’s explanations about advance care planning and end-of-life directives.

But instead of explaining the risks and consequences of ventilation and CPR, the family member was trying to convince the elder to consent to full measures of care, even if there was scant chance of survival.

Mantla-Look, who is also Tłı̨chǫ, knew the elder couldn’t give informed consent. He was missing critical information.

“Nowhere in the conversation did the doctor say, ‘If we do all these things, we are going to save your life and you are going to be able to go home’,” Mantla-Look remembers.

Mantla-Look pulled the doctor aside. She explained the situation and advised him to get a medical interpreter.

Informed consent

With an interpreter in the room, the doctor repeated his explanation. Only then did the elder get an accurate picture of his condition, giving him enough information to sign a consent form.

Without access to nurses, doctors, and other health-care providers who speak their language, family members often interpret for Indigenous patients whose first language is not English, Mantla-Look says.

Sometimes, family members deliberately withhold information. They feel rushed, or they’re unwilling to share bad news. They don’t want to upset their parent or elder or cause them to lose hope.

“It’s so unethical,” Mantla-Look says. “I know they’re not acting out of malice; … they just don’t realize the seriousness of what they’re doing.”

Her experience with the elder and his family is only one of the reasons Mantla-Look is driven to educate the medical community about the importance of language and culture in health care.

“I always fear that a lot gets lost in translation,” she says.

Growing up in Behchokǫ̀, the largest First Nations community in the Northwest Territories, Mantla-Look learned English as her second language. Most families spoke Tłı̨chǫ; many, like her own, relied on traditional hunting and fishing to survive.

Next week — Q&A (part 1): as an Indigenous nurse, have you experienced racism?

First in region

She had no Indigenous role models; there were no First Nations nurses working in the community, which is an hour’s drive northwest of Yellowknife. During summer jobs at the community health centre, though, Mantla-Look could see how important nurses were. That knowledge motivated her to become the first Tłı̨chǫ person in her region to become a nurse.

Now 41, Mantla-Look has spent nearly 20 years working in pediatrics, general medicine, and pulmonary care in hospitals in Yellowknife and Edmonton, and as a community health nurse back in Behchokǫ̀.

Often, she’s the only Indigenous nurse on a shift, or one of few, as she was during her nursing diploma classes at Aurora College in Yellowknife and in her class while earning her bachelor of science in nursing degree from the University of Alberta.

“Even now, there’s talk of reconciliation, but there aren’t that many of us [Indigenous nurses],” Mantla-Look says.

She loves being a community health nurse, where she can use her advanced practice skills and get to know patients more personally than in a hospital setting. Her favourite patients are the elders, many of whom she grew up knowing.

Working with elders in their own language builds trust and helps Mantla-Look take more thorough patient histories in a shorter time than she could through an interpreter, she says.

Breaks barriers

The fact that Mantla-Look speaks Tłı̨chǫ also emboldens patients to confide in her about their health concerns in a way they are slow to do with non-Indigenous doctors and nurses, she adds. Those health-care providers are often transient, and patients are reluctant to invest in the relationships. It can take months for them to reveal the full extent of their health challenges.

Sharing the language breaks down those barriers, as with one of the first patients Mantla-Look saw when she returned to Behchokǫ̀ in 2012.

The nervous-looking elder was in the waiting room when Mantla-Look arrived and called her into the examining room.

Before Mantla-Look could introduce herself, the elder asked, in her limited English, about an interpreter.

“I said in Tłı̨chǫ, ‘Why do you need an interpreter? I can understand you just fine’,” Mantla-Look remembers.

The elder’s shock turned to laughter. By the time Mantla-Look had recounted her parents’ and her grandparents’ names, the customary form of introduction in Tłı̨chǫ, the elder had relaxed. She was able to explain why she’d asked to see a nurse that day.

At the end of the examination, the elder shook Mantla-Look’s hand.

“She said, ‘I’m so happy that there’s a Tłı̨chǫ nurse working here’,” Mantla-Look recalls. “That was pretty much the best day of working there for me.”

Provider to patient

Mantla-Look also knows about the importance of trust in health-care relationships from her own experience as a patient. When she was just 34, she was diagnosed with stomach cancer.

She credits her trust in her surgeon, who insisted on repeating biopsies to be sure of Mantla-Look’s diagnosis, for catching her cancer early and saving her life.

“Thankfully, my surgeon was amazing, and so was his team. They always kept me in the loop — they gave me actual numbers from my lab results. They spoke to me like I was a colleague, and I really valued that,” she says.

Now cancer-free, Mantla-Look is currently on parental leave. She enjoys spending time with her one-year-old daughter Finnigan, her husband Kyle, and their cats Mouse and Cheese.

The baby was a joyful surprise, since Mantla-Look and her husband Kyle had feared her cancer diagnosis and subsequent surgeries had made pregnancy impossible.

Today, “We’re coming up to seven years cancer-free,” says Mantla-Look. “My surgeon just encourages me to live my life and enjoy my baby.”

Although Mantla-Look “hated” being a patient, her own health crisis strengthened her empathy for her patients, she says. She’s channelled both her professional and personal experiences while sitting on patient engagement committees for the territory into becoming an even more determined advocate for her patients.

“I find that such a privilege,” she says. “If I can help navigate the health-care system for people in my region, then I feel I’ve provided the best care possible. If I can streamline the process for them, then I feel I’ve done my job.”

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