Cultural Safety
Cultural safety is a concept that emerged in the late 1980s as a framework for the delivery of more appropriate health services for the Maori people in New Zealand. More recently it has become recognised that the concept is useful in all health care settings - not just those involving Indigenous peoples, eg. Maori, Aboriginal and Torres Strait Islander peoples. A commonly used definition of cultural safety is that of Williams (1999) who defined cultural safety as:
- an environment that is spiritually, socially and emotionally safe, as well as physically safe for people; where there is no assault challenge or denial of their identity, of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience of learning together (p.213).
Culturally safe practices include actions which recognize and respect the cultural identities of others, and safely meet their needs, expectations and rights. Alternatively, culturally unsafe practices are those that “diminish, demean or disempower the cultural identity and well-being of an individual” (Nursing Council of New Zealand 2002, p. 9).
An important principle of cultural safety is that it doesn’t ask people to focus on the cultural dimensions of any culture other than their own. Instead, cultural safety is primarily about examining our own cultural identities and attitudes, and being open-minded and flexible in our attitudes towards people from cultures other than our own. Identifying what makes someone else different is simple - their English isn’t very good or they don’t do things in the same way as others (Morris 2010). Understanding our own culture, and its influence on how we think, feel and behave is much harder. However, in the increasingly multicultural environments in which we all live and work, the importance of being culturally safe in what we do cannot be underestimated.
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
- being prepared to engage with others in a two-way dialogue where knowledge is shared
- understanding the influence of culture shock
Read more about the process toward achieving cultural safety in practice.
The process toward achieving cultural safety in practice
The process toward becoming culturally safe includes three key elements: Cultural awareness, cultural sensitivity and cultural safety. Although these are related concepts, it is important to understand that they are not the same as each other. All need to be achieved to be in a position to negotiate culturally safe interactions with others. A practitioner who can understand his/her own culture and the concept of transfer of power between dominant and less dominant groups can be culturally safe in a number of contexts.
CULTURAL AWARENESS |
CULTURAL SENSITIVITY |
CULTURAL SAFETY |
Is a beginning step toward understanding that there is difference. Many people undergo courses designed to sensitise them to formal ritual and practice rather than the emotional, social, economic and political context in which people exist. |
Alerts practitioners to the legitimacy of difference and begins a process of self-exploration as the powerful |
Is an outcome that enables safe service to be defined by those who receive the service. |
Strategies that can enhance the ability to undertake culturally safe interactions with others include:
- Reflecting on self, one’s own culture and profession, power imbalances, attitudes and beliefs about ‘the other’
- Applying basic communication skills
- Developing trust
- Actively negotiating knowledge and outcomes through bi-cultural relationships with others
- Understanding the influence of culture shock
Eckermann, A-K, Dowd, T. & Jeffs, L. (2009). Culture and nursing practice. In J. Crisp & C. Taylor, (Eds.), Potter and Perry’s Fundamentals of Nursing, 3rd Ed., (pp. 118-124). Mosby: Sydney.
References
Williams, R. (1999). Cultural safety – what does it mean for our work practice? Australian and New Zealand Journal of Public Health, 23(2), 213-214.
Nursing Council of New Zealand. (2002). Guidelines for cultural safety, the treaty of Waitangi, and Maori health in nursing and midwifery education and practice. Wellington: Nursing Council of New Zealand.
