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Spence, D. (2005). Hermeneutic notions augment cultural safety education. Journal of Nursing Education, 44(9), 409–414.
Abstract: In this article, the author integrates literature pertaining to the implementation of kawa whakaruruhau, or cultural safety, with the findings of a hermeneutic project that described the experience of nursing people from cultures other than one's own. It is argued that the Gadamerian notions of “horizon,” “prejudice,” and “play” can be used to facilitate understanding of the tensions and contradictions inherent in cross-cultural practice. Strategies are recommended that enable students to explore the prejudices, paradoxes, and possibilities experienced personally and professionally.
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Wepa, D. (2003). An exploration of the experiences of cultural safety educators in New Zealand: An action research approach. Journal of Transcultural Nursing, 14(4), 339–348.
Abstract: This research is a study of the experiences of four cultural safety educators in nursing education in Aotearoa, New Zealand. Action research methods assisted the participants to implement change in their practice and gain positive personal involvement in the study. Reflective diaries provided the major tool in this process as participants were able to achieve at least one action research cycle by identifying issues, planning action, observing the action, and reflecting. The findings of the research revealed that the participants not only coped with everyday stressors of teaching but were also required to formulate knowledge for cultural safety. For the Maori participants, their stress was confounded with recruiting and retaining Maori students and macro issues such as commitment to their iwi (tribe). Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that many issues were organisational in nature and out of their control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations include the following: support for cultural safety educators to have a dialogue on a regular basis, the introduction of nurse educator programmes, paid leave provisions for educators to conduct and publish research so that a body of knowledge can be developed, and that Maori cultural safety educators be recognised for their professional and cultural strengths so that they do not fall victim to burnout.
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Ferguson, K. M. (2021). The appropriation of cultural safety: A mixed methods analysis. Ph.D. thesis, University of Otago, Dunedin. Retrieved May 15, 2024, from http://hdl.handle.net/10523/12207
Abstract: Argues that the concept of cultural safety (CS) has been appropriated from an indigenous-led bicutural context to an inclusive cross-cultural framework for working with diverse patient populations. Investigates nurses' understanding of the 'Guidelines for Cultural Safety, the Treaty of Waitangi and Maori Health in Nursing Education and Practice' published in 2011 by the Nursing Council of NZ. Conducts a mixed-methods survey using both closed and open-ended questions to gauge nurses' confidence in applying the guidelines and their view of their relevance. Describes differences between NZ Registered Nurses (RN) and Internationally Qualified Nurses (IQN) in their understanding of CS. Argues that the CS model should be by Maori, for Maori.
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Te Whata, T. D. (2020). Determining the value of Maori nurses in Aotearoa. Master's thesis, Massey University, Palmerston North. Retrieved May 15, 2024, from http://hdl.handle.net/10179/17154
Abstract: Offers an understanding of how nursing discourse is embedded within legislation, regulatory bodies, and nursing practice and its direct impact on the health and well-being of Maori nurses. Argues that nursing discourse marginalises and undervalues tikanga. Explores the experiences of Maori registered nurses (RN) using a kaupapa Maori, mixed-method approach. Surveys over 300 Maori RNs about career and professional development, use of tikanga, cultural identity, and racism/discrimination at work.
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Kirkham, S., Smye, V., Tang, S., Anderson, J., Blue, C., Browne, A., et al. (2002). Rethinking cultural safety while waiting to do fieldwork: Methodological implications for nursing research. Research in Nursing & Health, 25(3), 222–232.
Abstract: The authors trace a series of theoretical explorations, centered on the concept of cultural safety, with corresponding methodological implications, engaged in during preparation for an intensive period of fieldwork to study the hospitalisation and help-seeking experiences of diverse ethnocultural populations.
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Roberts, J. (2020). An investigation into the preparedness for and experiences in working with Maori nursing students among New Zealand tertiary institutes, schools and nurse educators. Doctoral thesis, Massey University, Palmerston North. Retrieved May 15, 2024, from https://hdl.handle.net/10179/16056
Abstract: Performs an explanatory sequential mixed-methods study comprising a questionnaire followed by interviews, to understand the experiences and preparedness of nurse educators in working with Maori nursing students. Demonstrates that throughout NZ, nursing schools and the educational institutes in which they are situated are informed by a range of strategies aimed at supporting Maori learners. Finds from interviews that environments encompassing te ao Maori (the Maori world) and staff practises that aligned with this were enabling for Maori nursing students.
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Greenwood, S., Wright, T., & Nielsen, H. (2006). Conversations in context: Cultural safety and reflexivity in child and family health nursing. Journal of Family Nursing, 12(2), 201–224.
Abstract: This article outlines some key aspects of the practice of a number of nurse educators and researchers, and their commitment to the needs of their specific region. The group has been based at the Waikato Institute of Technology (WINTEC) over the last decade and have worked collaboratively across primary health, cultural safety, and child and family health domains of the nursing curriculum. They share a common philosophy underpinned by notions of diversity and health equity. The philosophy informs their theoretical inquiry, practice and research interests, and pedagogical concerns. In this article, the nurse researchers begin by situating themselves within the region, its people, and influences before moving into a consideration of the wider political and policy environment. They then consider the destabilising effects of cultural safety education and the tension between biculturalism and multiculturalism in their context. Finally, they reflect on how these ideas inform their work with postgraduate child and family nurses.
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Richardson, F. I., & Carryer, J. B. (2005). Teaching cultural safety in a New Zealand nursing education program. Journal of Nursing Education, 44(5), 201–208.
Abstract: This article describes the findings of a research study on the experience of teaching cultural safety. As a teacher of cultural safety, the first author was interested in exploring the experience of teaching the topic with other cultural safety teachers. A qualitative approach situated in a critical theory paradigm was used for the study. The study was informed by the ideas of Foucault and feminist theory. Fourteen women between ages 20 and 60 were interviewed about their experience of teaching cultural safety. Five women were Maori and 9 were Pakeha. Following data analysis, three major themes were identified: that the Treaty of Waitangi provides for an examination of power in cultural safety education; that the broad concept of difference influences the experience of teaching cultural safety; and that the experience of teaching cultural safety has personal, professional, and political dimensions. These dimensions were experienced differently by Maori and Pakeha teachers.
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Tipa, Z. (2021). Mahi Ngatahi: Culturally-responsive ways of working with whanau accessing Well Child/Tamariki Ora services. Ph.D. thesis, Auckland University of Technology, Auckland. Retrieved May 15, 2024, from http://hdl.handle.net/10292/14007
Abstract: Highlights the perspectives of Maori families using health services provided by Well Child/Tamariki Ora (WCTO), citing institutional racism and unconscious bias. Interviews 18 families with children under five years, about their experiences of WCTO services. Employs a Kaupapa Maori research methodology to develop Mahi Ngatahi, a theory for culturally-responsive WCTO services.
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Smye, V., Rameka, M., & Willis, E. (2006). Indigenous health care: Advances in nursing practice. Contemporary Nurse, 22(2), 142–154.
Abstract: In this introduction to a special issue on nursing with indigenous peoples, the authors affirm the need for continued application of tools and strategies for thinking critically about issues of culture, history and race. Without these things, evidence of discriminatory policies and practices in the health system remain hidden to many health professionals. Attention to socio-political structures is as essential to promoting health and preventing illness as are nurses' activities with the individual clients. To develop critical consciousness in nursing requires educational strategies and frameworks that focus on the responsibilities and implications of practicing nursing in a postcolonial context where race and power continue to create patterns of inclusion and exclusion in health care settings. The authors suggest that many contemporary nursing programmes fail to provide such strategies and frameworks, and argue that nursing must view critical analyses of these issues as central aspects of nursing education, research, theory and practice. They go on to engage with the notion of cultural safety as a means of fostering a critical political and social consciousness in nursing to create an opportunity for social transformation.
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DeSouza, R. (2008). Wellness for all: The possibilities of cultural safety and cultural competence in New Zealand. Journal of Research in Nursing, 13(2), 125–135.
Abstract: The author contends that responses to cultural diversity in nursing need to consider the theory and practice developments of the profession, whilst also responding to broader social and historical process that prevent marginalised groups from utilising universal health services. A combination of approaches is suggested in this paper to meet these two imperatives. Cultural safety is one indigenous New Zealand nursing approach derived in response to inequalities for Maori, whereas cultural competence is an imported paradigm derived from a multicultural context. Furthermore, research and dialogue are required to examine points of complementarity and tension. This paper offers a beginning for this process.
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Spence, D. (2001). Prejudice, paradox, and possibility: Nursing people from cultures other than one's own. Journal of Transcultural Nursing, 12(2), 100–106.
Abstract: This article provides a brief overview of the findings of a hermeneutic study that explored the experience of nursing people from cultures other than one's own. The notions prejudice, paradox, and possibility are argued to describe this phenomenon. Nurses in New Zealand are being challenged to recognise and address racism in their practice. Yet, the implementation of cultural safety in nursing education has created tension within the profession and between nursing and the wider community. As nurses negotiate the conflicts essential for ongoing development of their practice, the play of prejudice, paradox, and possibility is evident at intrapersonal and interpersonal levels as well as in relation to professional and other discourses. Nurses are challenged to continue their efforts to understand and move beyond the prejudices that otherwise preclude the exploration of new possibilities.
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Corner, K. (2020). Perceptions of Indian IQNs transitioning into a bachelor of nursing programme in New Zealand. Kai Tiaki Nursing Research, 11(1), 61–62.
Abstract: Aims to understand the experiences of Indian internationally-qualified nurses (IQN) making the transition into a NZ bachelor of nursing (BN) programme. Conducts a focus group with four Indian IQN students enrolled in an 18-month bridging course. Identifies four themes: adaptation to a new way of learning; cultural differences in living and working in NZ; adaptation to a different clinical environment; and cultural safety.
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Spence, D. (2001). The evolving meaning of 'culture' in New Zealand nursing. Nursing Praxis in New Zealand, 17(3), 51–61.
Abstract: The author traces the nursing definition of biculturalism as it has evolved from the colonial period to the present. An examination of nursing literature demonstrates that local understandings of culture have matured beyond anthropological interpretations to a sociopolitical definition of Maori culture. The author suggests that, in nursing, culture has come to mean cultural safety.
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Byrson, K. (2012). Perception of Cultural Safety and Attitudes: A Nursing Student's Reflection and Artwork. Available through NZNO library, (19), 51–58.
Abstract: A nurse's journey in cultural safety and how this is reflected in her nursing practice and described through her artwork.
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