Reconsidering the “NO SHOW” Stamp: Increasing Cultural Safety by Making Peace with a Colonial Legacy

Abstract

Practicing in a cross-cultural environment requires nurses to be critically aware of their personal and professional cultural attitudes and behaviours. In this article, the practice of using a “NO SHOW” stamp in primary health care settings in Canada’s North is analyzed. The aim is to examine the effects of this practice, which is embedded in nursing cultures in the North, with particular attention to the post-colonial context. A review of health disparities encountered by Aboriginal populations provides a social, cultural, and historical context. The literature review focuses also on the discourse of non-attendance of medical appointments. Observations from the author’s practice are used to describe the phenomenon of concern. A case-study approach using McLuhan’s Laws of Media is employed to examine this taken-for-granted tool, its use, and its implications. The analysis illustrates how the use of the stamp extends paternalism, obsolesces the individual story, signifies authority, and reverses caring. The analysis points to racist connotations attached to the tool and its use. The article concludes with a recommendation to discontinue the practice of using the “NO SHOW” stamp because of its discriminatory potential. Such policy change will strengthen cultural safety in nursing practice, contribute to reducing health disparities, and help create a more peaceful practice environment.