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.

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.

Abstract: Student nurses rely on their teachers, both academic and clinical, to assist them to develop their capacity to practice safely. Yet, in relation to cultural safety, relatively little has been written to assist the integration of theoretical knowledge to the world of practice. This article presents the findings of a small project undertaken by lecturers whose experiences supporting students' learning during clinical placements in Auckland stimulated interest in the students' attempts to use their classroom learning to begin their journey towards culturally safe nursing practice. A qualitative descriptive approach was used to explore the experience of nursing clients from cultures other than one's own and to describe culturally safe practice from the perspective of third year students.

Abstract: Homosexuality has been practiced since ancient times, but through the centuries this expression of sexual identity has moved from being acceptable to unacceptable and finally regarded in a contemporary era as a mental health problem that needed to be, and it was thought could be, cured. This paper focuses on the barriers that lesbian women perceive when wanting to access health care. Most of the research about lesbian women has been conducted in the United States with some in the United Kingdom, Canada and New Zealand. Through reviewing the available literature and grouping common themes, the author identifies three main barriers to health care that exist for lesbian women. Firstly, ignorance or insensitivity of the health care professional about the specific health care needs of this client group; secondly, homophobia or heterosexism that may be present in the health care environment; and thirdly the risk of disclosing one's sexual orientation. These barriers are discussed using the concepts of cultural safety and nursing partnership. The author concludes that the negative health care experiences that lesbian women encounter leave them feeling vulnerable and fearful. This fear and stigmatisation has resulted in lesbian women becoming an 'invisible' community. It is the assumption of heterosexuality that immediately places the lesbian woman at a disadvantage and this potentially may produce missed opportunities to provide individualised care to the lesbian client. The purpose of this work is to encourage discussion within nursing to challenge attitudes and the approach to women who identify as lesbian. The author hopes that this paper will contribute to the increasing body of knowledge in regard to this client group.

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 purpose of the research was an evaluation of practice exemplars as a reflective process in teaching and learning about cultural safety. Six Maori, two Pacific and five Pakeha students, ranging in age from 30 to 40, took part in the research. The research findings revealed five sub themes: personal safety, power/ powerlessness, reflection, teaching and learning and cultural safety. The presentation, while acknowledging that cultural safety shared some commonalities with culture care theory, highlighted differences between the two. These included that cultural safety was explicit in identifying the inherent power of the nurse in health care relationships; related to the experience of the recipient of nursing care, and extended beyond cultural awareness and sensitivity; provided consumers of nursing services with the power to comment on practices; and contributed to the achievement of positive outcomes and experiences for them. It outlined the characteristics of a culturally safe nurse as a nurse who had undertaken a process of reflection on her/his own cultural identity and who recognised the impact their personal culture had on client care.