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What does it mean to be culturally safe?

The following excerpt is from Cox, Taua, Drummond and Kidd (2020), Enabling Cultural safety, in Crisp, J. et al. (2020) Potter & Perry’s fundamentals of nursing. 6e ; Australia and New Zealand edition. Chatswood, NSW: Elsevier

While the above chapter is focussed on nurses the principles apply to all healthcare workers, registered professionals, and in support and other auxiliary roles. Wherever we encounter people we encounter diversity and therefore each one of us is charged with ensuring we are meeting the needs of each individual we support. A famous nurse in NZ, the late Irihapeti Ramsden is honored with gifting us the theories around cultural safety (initially focussed on caring for Māori ) and it is important we continue to evolve this theory into our everyday mahi (work) with each individual.

From Cox et al (2020) I now offer the following “There is no doubt that there has been a growth in awareness of so-called ‘diversity issues’ in the nursing and midwifery professions. However, a challenge in teaching cultural safety is an entrenched assumption that it is only applicable when working with Indigenous peoples. Ramsden established the wide applicability of cultural safety at the outset: ‘While protecting the unique issues of Māori through the Treaty of Waitangi relationship with the Crown, Cultural Safety has been expanded to include all people encountered by nurses who differ in any way from the nurse . . . Cultural Safety is therefore about the nurse rather than the patient’ (2002:5–6, emphasis added). Although cultural safety was conceptualised by Māori nurses and colleagues, and originated in a post-colonial context, it is applicable to any encounter whatsoever , because the interaction between a nurse and a patient is always a bicultural relationship, whether differences between individuals are expressed by gender, sexuality, social class, occupational group, generation, ethnicity or other variables. The underpinning tenet of cultural safety is that each person should receive care that takes account of their unique identities and experiences; therefore, cultural safety also addresses racism, homophobia, ageism, sexism and hetero-dominance“.

Therefore to put it simply in order to provide care that is culturally safe the healthcare worker must undertake a process of cultural self reflection to gain awareness – essentially know self first as a cultural being, be conscious to ones own values, beliefs and assumptions, recognise ones own individual ways of being, of knowing – your own worldview. In doing this then we become conscious that therefore every other person also has their own worldview underpinned by their own beliefs, values and assumptions. The health worker becoming conscious of this then offers support according to the care recipients needs. It is only then that the individual can determine that the healthcare worker is culturally safe. So it isn’t the worker that determines the safety it is the recipient of care who decides if they feel respected and have had their needs acknowledged and attended to appropriately.

Of course it doesn’t end there as the system and structures in which care is provided must also have a diversity lens and be cognisant of dominance and power. But that’s a discussion for another day.

In the meantime I encourage you to ponder on how you respond to the individual needs for each person you provide care or support for. If you asked your clients if they felt you were providing culturally safe care what do you think they might say?

Photo by Amy Elting on Unsplash

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