Abstract: The author points to the oppression of colonisation living on in the daily lives of colonised people, and goes on to say that it is vital for nurses to understand the effects of that oppression, as well as the restrictive impacts, and dislocation from one's land and culture to-day. Nurses come from both the descendants of colonisers and the colonised. This thesis is a journey and a quest for insights into the impacts and significances of colonisation by looking at historical and socio-political contexts that have bearing on the health of colonised people who remain mostly powerless and marginalised. It is prompted in response to a cultural safety model which advocates that nurses should become familiar with their own background and history in order to be culturally safe in practice. This reflective autobiographical account is a personal effort and provides the foundation for an exploration of issues during nursing practice encounters, from a colonised ethnic minority perspective. The method was informed by Moustakas research approach and Johnstone's Reflective Topical Autobiographical process. The selection of specific events are deliberate, to make visible some of the many barriers that exist within our health structures as pertinent issues for non-dominant cultures that remain on the margin of our society. Maori issues provide a contrast and became a catalyst for the author while working for kaupapa Maori services. The intention of this thesis is to generate new knowledge about what it means to be a nurse from an ethnic minority working in a kaupapa Maori mental health service, and to encourage other nurses to explore these issues further. Some recommendations are made for nurses in the last chapter.

Abstract: The research on which this thesis is based involves both a private narrative and a public narrative, with the story of cultural safety, and the history, theory and the future direction gathered into one qualitative work. The work is divided into three sections. The first is entitled, Ko Wai Matou? The Private Narrative. This section seeks to explore the historical, social, educational, physical, emotional, political and moral influences and ephiphanies which brought about the personality which introduced cultural safety ideas into nursing and midwifery. Early nursing practice is investigated and examples from practice are used to illustrate learning and consolidation of the ideas which led to Cultural Safety Theory. The second section is entitled He Huarahi Hou: A New Pathway. This section explains the progress of the theory and its relationship to education pedagogy and to nursing practice. Comparison between the work of Madeline Leininger and the Transcultural Theory of Nursing and the New Zealand concept of cultural safety is undertaken. The role and application of the Treaty of Waitangi to the theory of cultural safety is explored in this section. The third section, entitled He Whakawhanuitanga: The Public Narrative, looks at the introduction of cultural safety into the nursing education system and its implementation. The public and media reaction to the inclusion of cultural safety in the national examination for nursing registration and the subsequent parliamentary response are noted. The interviews with nursing and midwifery leadership, Maori and pakeha key players in the process and consumer views of the ideas are documented and pertinent excerpts have been included. The work concludes with a discussion on the likely future of cultural safety as a theory and in practice and outlines several issues which represent a challenge to the viability of the concept in nursing and midwifery education. The author notes that the story of cultural safety is a personal story, but also a very public one. It is set in neo-colonial New Zealand, but has implications for indigenous people throughout the world. It is about human samenesses and human differences, but is also a story about all interactions between nurses and patients because all are power laden. Finally, she points out that, although it is about nursing, it is also relevant to all encounters, all exchanges between health care workers and patients.

Abstract: Cultural safety is taught in all undergraduate nursing programmes in Aotearoa/New Zealand. There is a predominance of Pakeha nurse educators in teaching this content. There is little explanation of what being Pakeha entails. This perpetuates a silence and continues the dominant hegemonic position of Pakeha in Aotearoa/New Zealand. This study suggests that as Pakeha cultural safety nurse educators we examine our dominance and critique the delivery of cultural safety education. This autobiographical study undertakes to explore the Pakeha identity of a cultural safety nurse educator. The author discusses identity in the context of a globalised world, and challenges the idea of a definitive Pakeha identity. There are multiple descriptions of Pakeha, all underdeveloped and inadequate for the purposes of cultural safety education. In this study, the author uses the heuristic process of Moustakas (1990) and Maalouf's (2000) ideas of vertical and horizontal heritage to locate and present the essence of the self. In keeping with the purpose of cultural safety education, the author considers her ethnic cultural self as described by Bloch (1983) and explores Helms' (1990) theory of White racial identity development. This thesis describes the position of one Pakeha in the context of teaching cultural safety in an undergraduate nursing degree programme in Aotearoa/New Zealand. For Pakeha cultural safety nurse educators the author argues that exploration of one's heritages and location of a personal Pakeha identity is pivotal to progressing the enactment of cultural safety in Aotearoa /New Zealand.

Abstract: This thesis is a study of the experiences of four cultural safety lecturers in nursing education in Aotearoa / New Zealand. A review of literature reveals the recent and turbulent evolution of cultural safety. The media which documented this journey in a negative light in the 1990s prompted ministerial inquiries and the publication of the Nursing Council of New Zealand's guidelines for cultural safety in nursing and midwifery education (1996). Action research methods enabled 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 every day stressors of teaching but they were also required to formulate knowledge of cultural safety. For the Maori participants their stress was confounded with recruiting and retaining Maori students and macro issues such as commitments to iwi. Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that it was organisational in nature and out of their immediate control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations have been made which focus on supporting cultural safety educators to dialogue on a regular basis through attendance at related hui; the introduction of nurse educator programmes; paid leave provisions for cultural safety 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 burn out.

Abstract: This paper is an analysis of the cultural and traditional factors that the author presents as essential considerations in the treatment of Samoan people who have been diagnosed with a mental illness. Just as important to any clinical diagnosis, is the spiritual nature of Samoan culture and traditions, which inform belief systems. A full understanding of these will explain how the traditional beliefs and cultural values of Samoan people have an impact on their perception of mental illness, its causes and cures. The thesis places emphasis on 'ma'i -aitu', the Samoan term for most ailments pertaining to the mind or psyche. The focus is on defining 'ma'i -aitu' as part of a Samoan world view and likewise a description of a similar type of manifestation in the Papalagi (western) context of a psychiatric disorder and how treatment and management is usually undertaken. The issues addressed in this paper aim to highlight the Samoan client's world view from a Samoan perspective of mental illness which then poses the question of how they can be managed holistically and appropriately under the Papalagi medical system. Furthermore, it questions if the traditional belief system of Samoans run deeper than originally thought and can the replacement thereof by a foreign culture be responsible for the increased mental problems in Samoans living in New Zealand? This paper emphasises the importance of integrating the western medical model and Samoan health models, for appropriate mental health service delivery to Samoan people.

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.