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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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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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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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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Westenra, B. (2019). A framework for cultural safety in paramedic practice. Whitireia Journal of Nursing, Health and Social Services, (26), 11–17.
Abstract: Critically considers the application of cultural safety to working with diversity in paramedic practice in NZ. Presents a sociological framework, based on Mills's concept of 'sociological imagination' to analyse the connections between social and cultural factors in NZ and the author's professional experience.
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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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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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Rameka, M. (2001). Perioperative nursing practice & cultural safety. Dissector, 29(3), 21–23.
Abstract: This article is from a conference paper presented to the 12th World Conference on Surgical Patient Care. It presents cultural safety, as differentiated from transcultural nursing, and investigates how it relates to perioperative nursing. Examples are presented of how nurses can adhere to medical requirements, and address the cultural needs of Maori patients.
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Richardson, S. (2009). Senior nurses' perceptions of cultural safety in an acute clinical practice area. Nursing Praxis in New Zealand, 25(3), 27–36.
Abstract: Presents the results of a small study aimed at eliciting the beliefs and attitudes of a group of senior nurses with respect to the concept of cultural safety, and their perception of its role in clinical practice.
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Mortensen, A. (2010). Cultural safety : does the theory work in practice for culturally and linguistically diverse groups? Nursing Praxis in New Zealand, 26(3), 6–16.
Abstract: Critically examines the theoretical base of the cultural safety guidelines for nursing practice with respect to culturally and linguistically diverse (CALD) groups. Poses two questions: have the guidelines led to culturally-safe nursing practice in health care for CALD groups; have the guidelines contributed to provision of culturally-acceptable health care for CALD groups?
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Foxall, D. (2013). Barriers in education of indigenous nursing students : a literature review. Nursing Praxis in New Zealand, 29(3), 18–30.
Abstract: Reports the findings of a review of the literature that sought to identify key barriers for indigenous tertiary nursing students in NZ. Reveals the barriers to recruitment and retention of nursing students, and strategies to overcome them. Stresses the need for partnerships between academic institutes and indigenous communities to ensure the provision of a culturally-safe environment for Maori nursing students.
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Cook, C., Clark, T., & Brunton, M. (2014). Optimising cultural safety and comfort during gynaecological examinations : accounts of indigenous Maori women. Nursing Praxis in New Zealand, 30(3), 19–34.
Abstract: Undertakes a thematic analysis to highlight Maori women's perspectives on health and wellbeing. Identifies 6 key themes in the data: mihi (initial engagement), whakawhanaungatanga (belonging through relationships of shared experience), kaupapa (consultations' main purpose), tapu (sacred and set apart), embodied memories, manawahine (women's knowledge and authority). Asks women about those approaches used by non-indigenous clinicians, receptionists and service providers that enhanced their experiences of cultural safety during sexual health consultations and gynaecological examinations.
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Hunter, K., & Cook, C. (2020). Cultural and clinical practice realities of Maori nurses in Aotearoa New Zealand: The emotional labour of Indigenous nurses. Nursing Praxis in New Zealand, 36(3). Retrieved May 20, 2024, from http://dx.doi.org/https://www.nursingpraxis.org/2020-363-cultural-and-clinical-practice-realities-of-maori-nurses-in-a
Abstract: Examines the tensions for Maori nurses that are involved in the integration of cultural priorities into clinical practice. Conducts semi-structured interviews with 12 Maori RNs and nurse practitioners to determine their professional practice experiences of delivering culturally-responsive care to iwi, hapu and whanau across health-care settings.
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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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Hughes, F., & Farrow, T. (2007). Caring for obese patients in a culturally safe way. Kai Tiaki: Nursing New Zealand, 13(4), 14–16.
Abstract: The authors review the contemporary notion of obesity and suggest that the nursing approach, with an emphasis on treatment, are shaped by a culture located within “western” views of ideal body shape. The biomedical framework regards obesity as disease and obese people as the cause of their own health problems. The authors note varying cultural interpretations of obesity, and suggest that by viewing obesity as a disease, the cultural, social or economic determinants of obesity are not acknowledged. Nursing needs to broaden the concept of the categories of difference to respond in a culturally safe way to obesity. Cultural safety asks that nurses care for people “regardful” of difference. This means nurses must reflect on the care given, so that the biomedical model is not just replicated. Nurse-led clinics offer an opportunity for practices based on nursing values of care and cultural safety. Such clinics are based on nursing's social model of health, rather than a biomedical, disease-focused model.
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