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Cultural safety: Are we on the same page?https://www.infirmiere-canadienne.com/blogs/ic-contenu/2020/02/18/securisation-culturelle-parlons-nous-tous-de-la-me Feb 18, 2020, By: Tara HorrillTakeaway messages
Over the past decade, cultural safety has emerged as an important component of nursing practice, particularly when caring for Indigenous peoples within Canada. Originally conceptualized by Irihapeti Ramsden, a Maori nurse, cultural safety is a relational approach to nursing care. Its concepts are increasingly being incorporated into nursing curricula and continuing competency training within Canada. However, there still seems to be confusion about what constitutes cultural safety. I recently attended an Indigenous health conference and was struck by how often the term was used in ways that are inconsistent with its meaning. Cultural safety: What it is, and what it is not Cultural safety grew out of the recognition that nurses are often the first health care professionals that patients encounter, and the ways in which they interact with patients play a significant role in the willingness to seek health care. Cultural safety draws attention to unequal power relationships within health care and requires nurses to think about and recognize that power operates in every context. Cultural safety grew out of the recognition that nurses are often the first health care professionals that patients encounter … Establishing nurse–patient relationships that are built on trust and collaboration is also an essential component of culturally safe care. Within the context of Indigenous peoples in Canada, which includes a history of colonization and oppression, a culturally safe and relationship-based approach to care can improve access to health care services and patient experiences within the health care system. However, culture can also be understood more broadly—as any person or group that differs from us as nurses in any way, including socio-economic status, gender, age, ethnic origin, sexual orientation, (dis)ability, or religion. When culture is understood in this way, cultural safety becomes relevant to every nursing interaction. Practically speaking, cultural safety is about reflexivity. It is about us as nurses examining the beliefs, values, and assumptions held about the “other,” and how these might be influencing our nursing practice. It also includes reflecting on how power has worked to create unequal and unfair life opportunities for some groups of people, including Indigenous peoples in Canada. Establishing nurse–patient relationships that are built on trust and collaboration is also an essential component of culturally safe care. Cultural safety is not about becoming competent in specific cultural beliefs, practices, or ways of communicating across cultures, nor is it about sensitivity to different beliefs. While these are all important, and perhaps beneficial, they do not address the role of power within health care relationships and tend to ignore the context of patients’ lives, such as the social and structural determinants that shape life opportunities, health, and health care access. It starts with me Why are these differences important? Because as a nurse, I can’t possibly learn all there is to know about another culture. I can’t understand what it is like to experience intergenerational trauma as a result of residential school attendance. I don’t know what it is like to have my health concerns dismissed by a health care provider. But I can work to understand my own beliefs and assumptions. I can work toward establishing trusting and collaborative relationships with the patients I care for. When I do these things, I help to improve access to health care for Indigenous peoples and other underserved populations, improve the quality of care delivered, and ensure positive health care experiences. It starts with me. Additional resources Fact Sheet: Cultural Safety (National Aboriginal Health Organization) Cultural Safety training Book: Tara C. Horrill, BN, PhD(c), RN is a research assistant and doctoral student at the University of Manitoba, Rady Faculty of Health Sciences, College of Nursing in Winnipeg, MB. #opinions 2022-06-22T08:59:56+10:00 2022-06-22T08:59:56+10:00 Share This StoryPrint This StoryNursing Philosophy Statement: Nurses are responsible and accountable to provide person-centred and culturally safe care. As frontline healthcare providers, advocators and educators, nurses support patients, families and communities, promoting physical, emotional, social and cultural wellbeing.Australian First Nations People account for 3.4% of the total Australian population, residing across all Australian states and territories.1 As a significant part of this land, Australian First Nations People have diverse cultures and a rich long history dating back to 50,000 years ago. However, colonisation and colonial policies have devastatingly changed their lifestyles, resulting in a distinctive gap in health outcomes between First Nations People and other Australians. For instance, First Nations People experience 2.3 times the burden of disease than other Australians, higher rates of psychological distress and poorer access to health services.2 It is essential and also challenging for international nursing students to prepare themselves to provide culturally safe care for First Nations People. There are a few reasons for this.
Secondly, the ongoing racism and discrimination are barriers for international students to actively learn Aboriginal culture. Finally, mainstream education doesn’t provides minimal education on culturally safe care to First Nations People, resulting in low access to the resources. Through the study of “Indigenous Health and Cultural Safety”, international nursing students have access to the journey of cultural safety. Australia applies the concept of cultural safety as “the effective care of a person or family by health professionals who have undertaken a process of reflection on their own cultural identity and recognise the impact of their own culture on their practice”.
Cultural awareness is the first step on the journey of cultural safety. It requires international nursing students to acknowledge the cultural differences and reflect on their own culture, and its impacts on nursing practice. First Nations People are separated into different groups and communities, and each group has its own culture, language and traditions. Compared with the mainstream paradigm, First Nations People’s holistic concept of health encompasses physical, psychological, emotional, cultural, and spiritual health, along with close connections to families, communities and lands. International students come from different cultural backgrounds, their own beliefs, values and attitudes may influence nursing practice and have a great impact on care recipients. For instance, when practising health assessment, it’s significant to have an overall understanding of health and wellbeing of First Nations People and to involve their families in decision making.
Violent conflicts and colonial policies such as forcibly removing children from their parents led to intergenerational trauma which passed down to future generations. The combination of these factors resulted in First Nations People’s socioeconomic disadvantages, consequently causing disparities in health outcomes. International nursing students play a critical role in decolonisation and breaking the vicious trauma cycle. By reflecting on their own history and experiences, international nursing students can be better aware of the ongoing racism, discrimination and marginalisation as a result of colonisation, minimising the power inequality through empowering First Nations People. Cultural safety is the final phase and also an ongoing process of reflection. Within the principles of Registered Nurse Standards for Practice,5 international nursing students can prepare themselves as culturally safe nurses in the following ways. Firstly, provide person-centred and evidence-based care. International nursing students should be respectful of and responsive to the preferences, needs and values of individual Aboriginal patients, work collaboratively with patients, families and communities, sharing decisions and care plans. Secondly, communicate effectively and engage in professional relationships with Aboriginal patients and families. While international nursing students can experience language barriers and their negative impacts on daily life, it’s important to use proper language when communicating with Aboriginal patients and families. Finally, maintain partnerships with Indigenous Health Workers (IHWs).
Cultural safety is a key principle to improving the health outcomes of First Nations People. The journey to culturally safe care requires international nursing students to enhance their knowledge of First Nations People’s culture, the colonial history and its profound impacts on Aboriginal people’s health, reflect on their own culture, values and experiences, and create a culturally safe environment. References
Author: Xiaoping Yan is a first-year international nursing student at Flinders University, South Australia. Related PostsThis site uses Akismet to reduce spam. Learn how your comment data is processed. How can you promote culturally safe care?Strategies that enhance the ability to be culturally safe include:. reflecting on one's own culture, attitudes and beliefs about 'others'. clear, value free, open and respectful communication.. developing trust.. recognising and avoiding stereotypical barriers.. What are 3 examples of strategies to help improve culturally competent care?WHAT IS CULTURAL COMPETENCE IN HEALTH CARE?. Provide interpreter services.. Recruit and retain minority staff.. Provide training to increase cultural awareness, knowledge, and skills.. Coordinate with traditional healers.. Use community health workers.. Incorporate culture-specific attitudes and values into health promotion tools.. What are some culturally safe work practices?A culturally safe workplace provides all workers with a workplace that has:. Respectful communication.. Two-way dialogue.. An environment that values all contributions.. Recognition and avoidance of stereotypical barriers.. Shared knowledge.. What is culturally safe care?What is culturally safe care? PHSA defines culturally safe care as an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the healthcare system. It results in an environment free of racism and discrimination, where people feel safe.
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