Cultural Safety in Healthcare: Ensuring Respect and Equity in Patient Care

This article discusses the concept of cultural safety and how nurses can ensure cultural safety while providing care to indigenous people. It also highlights the importance of cultural considerations and guidelines to ensure culturally competent safe care to patients.

Running head: CULTURAL SAFETY
CULTURAL SAFETY:
Name of the student:
Name of the university:
Author note:

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Introduction:
Cultural Safety is the concept of care that was first advocated by the Maori nurses in the
nation of New Zealand in the late 1980s. It mainly helps in creating an atmosphere for the
service users where they feel that their cultural traditions, perceptions and inhibitions are
respected and interventions are designed according to their cultural requirements (Durey et al.,
2017). The goal of the cultural safety by the nurses is to ensure that all service users feel
respected as well as safe when they successfully interact with the health care system. Culturally
safe health care services would be free from any form of racism as well as discrimination by the
healthcare services (Cross et al., 2017). The culturally competent nursing professionals should
always support the service users by drawing strengths from their identity as well as culture and
community. This assignment would focus how nurses while providing care to indigenous people
can ensure cultural safety.
Cultural safety:
Cultural safety always requires a proper level of cognitive, attitudes as well as personal
skills, which will help in enhancing effective communication as well as interaction with the
others. Every nursing professionals need to develop cultural competence by involving into
personal reflective practice as an effective means of recognizing specific beliefs and values that
are inherent in the culture of nursing. They would also need to reflect on the aspects of one’s
own culture that may conflict with the culture of patients or other workers (Cameron et al.,
2014). Accordingly, they would develop specific skills that would help in being more affluent in
ensuring cultural safety towards patients. Development of culturally safe practices always require
the capacity for making adjustments to different services that successfully accommodate

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culturally different needs of the patients. In order to develop cultural safety, nurses need to go
through three important steps to develop cultural safety.
The first important step is to develop cultural awareness or cultural consciousness. This
trait can be discussed as the development of awareness of the different construct of one’s own
culture as well as recognition of the unique and similar qualities of other cultural groups
(Karatay et al., 2016). Another important component is the cultural appraisal as well as the
assessment for the identification of the cultural domains of differences that nurses need to
considered by the nurses while developing care interventions for the patients. Another important
trait is the cultural safety skill development that would comprise of different appropriate
behaviors, communications, attitudes and other strategies that help in reduction of the gap of
inequities in the patient health outcomes. When nursing professionals can successfully develop
all the above-mentioned traits, they can successfully become culturally competent and thereby
ensure following cultural safety in their healthcare practices.
Cultural considerations:
Health is traditionally a holistic concept for the Aboriginal as well as Torres islander
people. The cultural beliefs of such groups regarding their health issues mainly encompass the
different physical, emotional as well a social, spiritual and cultural well-being not only of a
particular individual but also of the whole community. Studies have stated that the indigenous
people possess a whole-of-life view and mainly include the concept of life-death-life (Hart et al.,
2015). Therefore, different cultural aspects of the indigenous people should be considered while
caring for the patients for ensuring that their holistic health as well as their individual needs is
met successfully. Researchers are of the opinion that kinship, family obligations and even the

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other responsibilities tend to be of greater importance to the indigenous people than their
personal health needs. Therefore, nursing professionals while developing care for them should
respect all these factors.
One of the most important aspects that need to be kept in mind by the nurses while
providing service to the indigenous people is the development of rapport. The indigenous people
are not comfortable in sharing any personal information with strangers and therefore, they might
feel uncomfortable in revealing their health information to the nurses at one-go. Therefore,
nurses need to first make the patients comfortable and develop a rapport with them through
informal interaction and communication sharing stories, discussing on topics of common
interests and others (Mc.Ghough et al., 2018). This would help the indigenous people to
overcome the uneasiness feeling and henceforth they can engage in therapeutic relationship with
the nursing professionals and actively take part in their own healthcare plans. There is another
important cultural aspect that the nursing professionals also need to consider while interacting
with the patient and fixing appointments. This is their ideas about time management. The
Western culture of healthcare education puts importance and emphasis on time and they strictly
try to meet their deadlines and schedules. While on the other hand, time is perceived entirely
differently by the indigenous people (Brown et al., 2016). They do not consider significant in
following of time patterns and appointments as they place more importance to the values placed
on community relationships and family responsibilities. Therefore, the nursing professionals
should consider allocation of flexible consultation times. They should be also taking enough time
for explaining to the indigenous people about aspects of their healthcare and should never rush
the patients.

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Another very important cultural aspect that nurses need to consider while interacting with
the patient is their eye contact. In the western culture, when professionals fail to maintain proper
eye contact, the patients are mainly seen to believe that their care-providers are “hiding
something” or they cannot trust the professionals. However, in case of the indigenous people, not
ensuring eye contact is a method of showing respect to each other. Studies have stated that
among the indigenous people, eye contact is taken as an offence during communication where
people feel uncomfortable and consider this act as the sign of rudeness, disrespect as well as
aggression (Kellet & Fitton, 2017). Therefore, the appropriate strategy that the nursing
professionals need to follow to convey polite respect is to avert of lower one’s eye in
conversation. Another important aspect on which nurses need to develop cultural awareness to
ensure culturally competent care for maintaining cultural safety is the concept of silence. In the
western culture, silence during the time of communication is negatively perceived as a gap that
immediately needs to be filled. However, the indigenous people do not perceive it in negative
sense. Rather in the Aboriginal society, lengthy periods of silence is considered a norm and are
expected to be maintained during the times of conversation mainly during the times of sharing as
well as information sharing (Lyford et al, 2018). The indigenous people utilize silence for
listening, allowing for consensus or for indicating non-commitment. The nursing professionals
should never mis-interpret the positive use of silence as the lack of understanding or agreement.
Guidelines:
One of the most important practice standards that need to be followed by nursing
professionals according to NMBA guidelines is standard 1 “thinking critically and analyzing
nursing practice” (Registered nurse standards for practice, NMBA, 2016). One of the sub point
of this standard focuses on the importance of respecting all the cultures and experiences that

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include responding of the nursing professionals to the role of family as well as community that
underpins the health of the indigenous people as well as people of other cultures. This can be
well explained with the help of evidences. Researchers have shown due to family or kinship
relationships as well as cultural beliefs of the indigenous people, a patient might be visited by
large groups of immediate as well as extended family (Martin, et al., 2019). Although, it might
be accepted in culture of indigenous people, it is against the norms and laws of disciplines of a
western healthcare centers. In such arenas, nurses need to think critically about the solution of
this situation where she can handle it without affecting the cultural emotions of the indigenous
people. The nurse should first seek for the correct person among the large group for sharing the
information. She should then negotiate options for effectively accommodating the presence of
the visitors in a nearby lunge area as the waiting place for meeting the patient. She should also
discuss the impact calmly and politely that this gathering might have on health of patients. All
these might prove to be fruitful in managing the huge number of indigenous people in
understanding the impact of their present on health of patient without feeling culturally
disrespected. Another practice standard called the standard 2 advises nurses to engage in
therapeutic and professional relationship with patients. One of the nursing sub point states that
nurses need to actively foster a culture of safety as well as learning that would include interacting
with other members of the team to provide person centered care (Wilson et al., 2015). This
would help in ensuring person-centered care to the indigenous people that would be based on
following their cultural preferences to ensure respecting their dignity and autonomy and hence
develop therapeutic relationship with them to ensure patient satisfaction. Another sub-point also
instructs nurses to communicate effectively and they should be respectful of the dignity, culture,
values, rights and beliefs of the people. The codes of conduct by NMBA have shown about the

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importance to make ethical decision making to ensure culturally competent safe care to patients.
The principle 3 states of the importance of cultural practice and respectful relationships (Codes
of conduct, NMBA, 2016). Providing holistic care, free from biasness, racism, and beliefs based
upon assumptions used to form the main foundation of ethical decision-making. The codes of
ethics by NMBA advises that nurses need to make informed decision making where they need to
involve patients in making care plans allowing them the scope to make their own health
decisions. At the same time, they also advise nurses to value diversity of people as well as to
value a culture of safety in nursing and healthcare (Codes of ethics, NMBA, 2016). The
bioethical principle of justice dictates that nurses need to provide equal and high quality care
irrespective of the caste, creed, religion, ethnicity a well as background. Hence, nurses, while
making ethical decisions, should follow the guidelines and bioethical principles in mind in order
to develop a plan that aligns with cultural traditions of patients.
Conclusion:
From the above discussion, it becomes clear that cultural safety is important to ensure
dignity and autonomy in the patients and to ensure patient satisfaction. The indigenous people
have their own cultural perspectives as well as inhibitions. Nurses need to develop cultural
awareness not about their own culture but also be aware about the differences that exist between
their own culture and the culture of the indigenous people. This would help in providing high
quality care that aligns with their cultural traditions. This would help in developing better quality
health and ensure cultural safety.

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