Cultural Safety in New Zealand Healthcare: A Patient Perspective

This report examines the concept of cultural safety within the New Zealand healthcare system, emphasizing its importance in a bicultural context. It focuses on a case study involving a patient, Samuel, diagnosed with COPD, and analyzes the care he received from nurses and GPs. The report highlights the significance of culturally competent practices, therapeutic communication, and adherence to the principles of the Treaty of Waitangi. It underscores the need for healthcare professionals to respect patients' beliefs, values, and cultural backgrounds, ensuring that care is delivered in a way that preserves the patient's cultural integrity. The report also discusses the impact of power imbalances and the importance of continuous learning to enhance knowledge of diverse cultural preferences. Overall, the report concludes that Samuel received culturally competent care, emphasizing the role of empathetic understanding and respectful collaborations in achieving positive patient outcomes.

Running head: CULTURAL SAFETY IN NEW ZEALAND
CULTURAL SAFETY IN NEW ZEALAND
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1CULTURAL SAFETY IN NEW ZEALAND
New Zealand widely practices biculturalism, and hence, practicing cultural
competence by the clinical workforce is of importance (Wepa, 2015). Cultural safety implies
efficient and safe healthcare practice, regardless of the patient’s socioeconomic condition,
ethnic group, racial status and gender (Nursing Council of New Zealand [NCNZ], 2011). The
aim is to administer perceptions that the healthcare organization preserved and respected the
cultural integrity of the healthcare consumer (Muir-Cpchrane, Barkway, & Nizette, 2011).
Hence, healthcare personnel must respect the beliefs and values held by healthcare
consumers. The importance of culturally competent practices has also been promoted by the
Treat of Waitungi’s core principles (participation, protection and partnership) (NCNZ, 2011).
Despite high rates of stress and depression in Samuel (pseudonym) after enlightened
chronic obstructive and pulmonary disease [COPD] diagnosis, the clinical workforce (nurses,
GP) strived to support and empathise with his fears without judgement. A health consumer’s
perception of their health status, beliefs and values, are influenced by their social and cultural
environment. Hence, this necessitates compliance to cultural safety and deliverance of
culturally competent interventions to encourage patients in coping with disease related stress
(Phiri, Dietsch, & Bonner, 2010, Taylor & Guerin, 2010). Samuel also admitted that the
nurses were eager to ensure his emotional wellbeing as evidenced by their administration of
therapeutic communication skills. The practice of therapeutic communication (listening
actively), strengthens patient autonomy and enables a clinical environment free from
judgment, mitigates the unintentional effects of nursing autonomy and improves informed
decision-making skills in the patient (Elder, Evans, & Nizette, 2011). Unawareness of nurses
concerning personal cultural values and their association with nursing practice, may result in
imposing their beliefs and autonomy upon patients resulting in practices of culturally
incompetent care (Crisp & Taylor, 2012).

2CULTURAL SAFETY IN NEW ZEALAND
Samuel recalled his reluctance and lack of motivation to adhere to his medication plan
(e.g., bronchodilators) and need to avoid smoking. However, upon communicating with the
nurse, she demonstrated patient listening followed by gentle persuasion on the associated
harms, such as, loss in the functioning of his airways. Such skills demonstrated lack of
judgment and maintenance of patient autonomy. The nurse also enlightened Samuel and
improved his ability of informed decision-making and choices. Such nursing skills are
indicative of well-practiced, culturally competent care (Gregory, Stephens, Raymnd-Seniuk,
& Patrick, 2019). Samuel also recalled a lack of any stringent ‘instructive’ nature among the
nurses. For example, the nurse would always ensure Samuel’s comfort prior to administration
of a procedure. A key pre-requisite of ensuring culturally safe practice is obtaining informed
consent (Stein-Parbury, 2017). Additionally, the avoidance of stringently imposing nursing
practice by taking care to ensure that Samuel was truly comfortable with an intervention
(prioritising the needs of the patient) demonstrates nursing adherence to culturally competent
healthcare deliverance (Best & Fredericks, 2017).
For the optimum deliverance of culturally safe practice, the clinical workforce must
adhere to the Nursing Council of New Zealand’s standards [NCNZ], established in alignment
with the Treaty of Waitangi’s principles. Additional resources as guidance for nurses in
practicing culturally safe care include nursing documents such as the Code of Ethics and the
Code of Conduct (Daly, Speedy & Jackson, 2017). Such documents highlight guidelines on
the importance of healthcare based self-reflection and the advantages of acquiring assistance
from clinical leaders and interpreters in obtaining informed consent from patients (Weir,
2016). According to Wepa (2015), New Zealand’s cultural diversity and biculturalism
continues to expand, hence necessitating nurses to continuously enhance their knowledge on
the cultural preferences and practices of minor ethnic groups.

3CULTURAL SAFETY IN NEW ZEALAND
Additional essentials for maintaining culturally safe includes acceptance and respect
for the sexuality, gender and intrinsic cultural beliefs of patients, along with an empathetic
understanding of their personal attitudes (Crisp & Taylor, 2012). Culturally safe practices
also necessitates an understanding of the impact of power imbalances on patient care.
Absence of such an understanding results in usage of inappropriate behaviours and words,
which maybe distressful for the patient and hinder their quality of life (Best & Fredericks,
2017). Efficient therapeutic communication at the inter-personnel level builds trust,
understanding, cooperative and respectful collaborations and hence, is essentially for
culturally safe practices. (Wepa, 2105). In conclusion, considering Samuel’s views and
opinions, he was delivered care that was culturally competent.