Indigenous Practice Protocol

The Indigenous Practice Protocol is designed to help staff accommodate Indigenous patients when they request a traditional ceremony.

Please review the new Indigenous Practice Protocol and see the FAQ below for a summary of how to accommodate patient requests.

What do I do if a patient requests a smudging or other Indigenous ceremony?

When a request is received from the patient or family for an Indigenous ceremony, the healthcare provider will contact his or her operational manager or, if after hours, the After Hours Manager.


Manager contact information:
  • Spiritual Care - Contact through Switchboard (519) 254-5577
  • Indigenous Navigator - Audrey Logan (519) 995-9523
  • Facilities - Contact through Switchboard (519) 254-5577
  • Security - Ouellette Campus 33192 or Met Campus 52215


The Family:
  • May contact an Elder to perform the ceremony- if they do not provide an Elder, access can be coordinated through the Indigenous Navigator.
  • May choose to provide the ceremonial items.
  • Will be asked respectfully to follow WRH protocols if performing their own ceremony.


Spiritual Care & the Indigenous Navigator: 
  • Facilitate access to Indigenous ceremonial items, if not provided by the family.
  • Maintain the Indigenous Ceremony items (See Policy Appendix B);
    • Items listed will be kept securely and respectfully in an appropriate box within a labelled cupboard (Ouellette: Spiritual Care office on the 1st floor, Met: Spiritual Care office on the 4th floor) and may be reordered by contacting the Indigenous Navigator or received as a donation. 
    • Record all necessary fields in the Indigenous Ceremony Inventory List & Log sheet
  • Assist with coordination of ceremony; guide, but not necessarily participate.
  • In preparation for an Indigenous ceremony, spiritual care should ask the patient or substitute decision maker which family/friends/staff will participate. Based on the number of participants and patient needs, a space where participants can assemble in a circle, should be created.
  • Will ensure that other persons in the area are made aware that this ceremony is taking place, by placing the “Indigenous Ceremony taking place” sign outside the door.
  • Provide ceremony items if Elder not available to perform the ceremony.


  • Assists with preparing an appropriate space to safely conduct the ceremony.
  • Temporarily places fire alarm system in appropriate bypass, if necessary (as per Hot Work policy).


  • Assists in obtaining Indigenous Ceremony items (respecting moontime protocols).
  • Assists with the preparation of designated space if needed.
  • If after hours, records the date, time, and patient name of the ceremony on the Indigenous Ceremony Inventory List & Log sheet

What do I do if a patient requests a ceremony after hours?

We are committed to accommodating any request to practice an Indigenous ceremony at any time of day. WRH will provide materials and items necessary for a ceremony and a dedicated location, however, the patient and/or their family members will need to facilitate their own ceremony.


If a request is made after hours:
  • Alert the after-hours manager who will alert security and facilities.


  • Assists with preparing an appropriate space to safely conduct the ceremony.
  • Temporarily places fire alarm system in appropriate bypass, if necessary (as per Hot Work policy).


  • Request the following:
    • Patient’s name
    • Patient’s room #
    • Name of the individual staff member requesting the ceremony
  • Attends the Spiritual Care office and obtain the box marked for Indigenous Practices.
  • Delivers the box to Unit for the ceremony.


Upon completion of the after-hours ceremony, Security will:
  • Be called to retrieve and the box and ensure all of the items have been returned to their location.
  • Verify that the Eagle Feather is inside the holding case and that it is “face down” (sleeping).
  • Ensure that the Log Sheet is completed and verify items have been returned to box.
  • Return Indigenous Practice box to the Spiritual Care Office with Log Sheet.
  • Email Manager and Site Supervisor to inform of the ceremony to ensure Leadership is aware.

Where are the ceremonies held?

Special rooms have been designated to accommodate the ceremonies at each Campus.
  • Met Campus - Fourth floor, Atrium
  • Ouellette Campus - Multi-Faith Room, first floor
These locations were chosen based on previous experiences, appropriateness of space, patient and staff safety, and consideration of patient/family privacy. Should either of these designated spaces not be suitable in a particular instance, an alternative plan will need to be worked out in conjunction with Security/Facilities.

Where are the items used for the ceremony stored and who can access them?

  • Items are stored in a locked box in spiritual care at Ouellette and spiritual care on the fourth floor at Met.
  • During regular hours, the Spiritual Care team and the Indigenous Navigator can access the ceremonial items
  • During after hours, weekends, and holidays, Security can access these items on behalf of patients and families
  • Each box contains an inventory list and log.

What are the roles and responsibilities after the ceremony?

Upon completion of the ceremony, remaining smoke should be ventilated if possible.

Any ashes from the ceremony are transferred to a jar and returned outside by the facilitator at a later time, as required by tradition.

If using WRH items, the facilitator returns the ceremonial items to the space in which they are kept in Spiritual Care. If after hours, the patient/family will inform Security when the ceremony is complete. Security will return the items to the Spiritual Care office. It is important that all items are returned.

The Indigenous Navigator maintains an inventory sheet and the well-being of ceremonial items. The sign in/out tracking sheet is attached. If any item is not present or in need of repair/replenishment, the facilitator will notify the Indigenous Navigator and Spiritual Care as soon as possible.

Who ensures inventory is replenished after the ceremony?

The Indigenous Navigator is responsible for stocking and maintaining the ceremony items. If the items are low, please contact Audrey Logan

Who determines if there are any health concerns for the patient participating?

The clinician determines if the participation of the patient is a potential health risk.

If a patient is on oxygen and cannot safely take part in a smudging ceremony due to the oxygen requirements, they are encouraged to participate in an alternative ceremony. This could include spray, lotion, or cream as long as it does not raise concerns for a reaction.