Report: Analyzing the CDNM ANZ Position Statement on Cultural Safety

This report provides a comprehensive analysis of the Council of Deans of Nursing and Midwifery of Australia and New Zealand (CDNM ANZ) position statement on cultural safety. It examines the organization's support for cultural safety in education, practice, and research, emphasizing its importance in improving health outcomes for Aboriginal and Torres Strait Islander peoples. The report outlines the rationale behind the position statement, including the need for culturally safe healthcare environments, effective communication, and health literacy. It also discusses external factors influencing cultural safety, such as racism and limited career pathways. Furthermore, the report addresses barriers to implementing the position statement, including workforce shortages, ethical and legal challenges, and cultural diversity. It concludes by highlighting the significance of addressing these issues to achieve the goals of the CDNM ANZ and improve healthcare practices.

Running head: CULTURAL SAFETY AND POSITION STATEMENT 1
CULTURAL SAFETY AND POSITION STATEMENT
Name
Institution

CULTURAL SAFETY AND POSITION STATEMENT 2
Council of Deans of Nursing and midwifery
The Council of Deans of Nursing and Midwifery of Australia and New
Zealand (CDNM ANZ) supports expansion and introduction of cultural safety
in plans that involve activities of educating, practicing and researching for
nurses and midwives (Brooks, Manias & Bloomer, 2018). The organization
states that cultural safety offers a vital outline for looking into the integral
definition of power between the health professional and the patients
receiving care. This is by associating the recipients with better health
outcomes and cultural empowerment.
Position
Cultural safety was introduced in the undergraduate curricula in 1992
as a competency. A Maori nurse educator named Irihapeti Ramsden
proposed curriculum development and content. The CDNM ANZ position,
statement and strategy has been laid down in four documents. The
documents have the whole positioning and summary for cultural safety in
teaching, training and research in Australia. The positions identified after
reviewing these papers include: Support for cultural safety in three levels of health; individual,
systematic and institutional.
 Ensuring maximum participation in the labor force involving
health activities for the people of Aboriginal and Torres Islander. These
strategies are by respecting and recruiting people safely.
 Safe cultural education and environments for working.
 Provision of education on cultural safety and native health at
both undergraduate and postgraduate levels.
 Understanding the results that led to the current belief in cultural
safety. This is by looking at economic, social, political, historical, and cultural
factors that impacted people’s health in the previous past.

CULTURAL SAFETY AND POSITION STATEMENT 3
 To ensure that cultural safety is shared amongst all healthcare
professionals.
 Introducing a model that will ensure there is understanding of
aboriginal and non-indigenous participant commitment in urban, rural, as
well as remote frameworks.
These positions and challenges needed to be responded to effectively
by the nurses and midwives. They needed proper education in
undergraduate and postgraduate and additional teaching to ensure provision
of harmless and operative cultural care in all the three frameworks; urban,
rural and remote. Health workforces needed to be prepared before
registration and even after it had been registered (Humphris, 2015). A
research by sponsored by Health Workforce of Australia studied preparations
of non-indigenous professionals in health who had been registered and how
the ways they prepared themselves to work with Aboriginal and Torres Strait
Islander coworkers and clients. It was found that there was need to develop a
curriculum for education of undergraduate health professionals’ (Taylor &
Guerin, 2019). CDNM had partnered with CATSINaM in the introduction and
ensuring the framework for nursing and midwifery was implemented by
institutions and healthcare providers. They came up with the following
position in relation to cultural safety in education, practice and research:
 Cultural safety is a critical part of ANMAC, NCNZ and MCNZ
capabilities for nurses and midwives who are registered.
 The organization (CDNM) agreed to work with other health
organizations like CATSINaM and the Department of Health in coming up with
a curriculum that integrated educational frameworks that ensured cultural
safety and respect in learning environments.

CULTURAL SAFETY AND POSITION STATEMENT 4
Rationale
The position statement of CDNM ensures that nurses and midwives
knows the importance of providing a culturally safe health system. Nurses
and midwives should be able to engage with all people as individuals in a
culturally safe and respectful manner. This ensures the discrimination that
affected the Aboriginal and Torres Strait Islander Australians should be cut
off in many ways possible. The nurses and midwives should foster open,
authentic and empathetic relationships in a professional manner, and adhere
to the requirements about concealment and privacy of clients (Khalil, Poon,
Byrne & Ristevski, 2019). The CDNM positional statement ensures that their
nurses and midwives provide healthcare that produces best health results to
their patient/woman they are caring for. This is by working in partnership and
proper understanding amongst themselves (Fleming, Creedy & West, 2018).
CDNM understands how vital it is to provide and improve health familiarities
and results amongst the Aboriginal and Torres Strait Islander people.
Families of patients are also aware of the standards that their relatives will
receive after the position statement on cultural safety codes of behavior of
nurses and midwives.
Effective communication is another powerful tool that determines if
there is culturally safe environment in healthcare. Australia has become so
culturally diverse and so do the patients served by the healthcare facilities.
Effective communication is vital in several areas including, treatment,
therapy, and health promotion by nurses and midwives (Pritchard, 2013).
This factor should be recognized as a priority in Australia since the
population is diverse and therefore ensuring culturally safe health
environment is provided (Arnold & Boggs, 2019). Patient satisfaction is one
of the key goals of effective communication since the goal of cultural safe
environment is to avoid discrimination and ensure all patients feel equal in
all healthcare facilities. A study has revealed that the nurses who have
passed through undergraduate courses that offer cultural sensitive

CULTURAL SAFETY AND POSITION STATEMENT 5
communication skills have been associated with increased patient
satisfaction (Bloomer et al., 2019, p.166). Therefore, effective
communication is very important in providing a culturally safe environment.
It ensure adherence to treatment regimens, improved patient engagement
and therefore improved health outcomes.
Health literacy is the individual’s capability to endure and act on
information about health. Patients with limited health literacy are more likely
to misunderstand health information and also face problems in interpreting
medical instructions. Healthcare professionals should provide health
information in ways that patients clearly use and understand. These patients
include those who have limited health literacy. A study found that the
patients who had limited health literacy had the highest likelihood to report
that they had received patient-centered communication in their respective
health care facilities (Nouri & Rudd, 2015, p.569). Promotion of effective
communication in healthcare facilities was found to have a positive impact in
improving the experiences of healthcare and outcomes that given by
patients with limited health literacy. Therefore, methods such as training of
staff in clear communication techniques, and offering educational materials
would help patients and caregivers who face communication challenges
(Waterson, 2018). Understanding and improving ways of communication will
lead to acquiring national health policy goal of addressing discrepancies.
There are several external factors that contribute to cultural safety in
healthcare environment. They include racism, proximity to community, and
limited career pathways. Racism affected indigenous health professionals
and it was linked significantly to poor mental health, co-workers who were
racist, and no respect by the community in terms of cultural practices (Fan et
al., 2016, p.122). The other factor, proximity to community, is described to
be caused by setting of cultural boundaries. This causes the health care
professionals to experience imbalances in their personal and work life.
Meeting community expectations may be hard and such cultural obligations

CULTURAL SAFETY AND POSITION STATEMENT 6
may induce mental stress and exhaustion to healthcare professionals. The
result is distracting the professionals from providing culturally safe health
practices (Khater, Akhu‐Zaheya, & Al‐Mahasneh, 2015, p.85). Finally, limited
career pathways makes health workers look for other options outside the
other sector where there is the perception of greater chances for career
progression.
Implementing the positional statement of CDNM is faced by several
barriers. There is serious shortage of nurses and midwives in Australia
therefore implementing the position statement will face this problem. This is
found mostly in rural and remote frameworks which are also key parts in the
CDNM and their position statement. This could be caused by factors such as
job dissatisfaction, retiring early, agency working and part time working. The
government therefore should work on the issue and ensure there are deep
analyses of nurses in the future (Coyne, Rands, Gurung & Kellett, 2016,
p.467). Policies and strategies that are incentive-oriented should be brought
in place so that nurses can be brought back in the workforce. Another way is
offering of scholarships to students interested in nursing profession.
Another barrier that stands on the way of implementing the positional
statement in CDNM is ethical and legal chafallenges that faces the nurses
and midwives whenever they present themselves as clients’ advocates. Care
that the nurses provide to the clients is guided by certain code of ethics.
Therefore, that care is often faced with legal challenges (Philip, Manias &
Woodward‐Kron, 2015, p.2635). Nurses often find themselves in conflict
whenever they act as the advocate for the clients in terms of their rights.
Nurses found guilty of not following the code of ethic face rustication by the
board of authorities. Nurses can be discouraged from following the whole of
the position statement due to the distinctions made between the legal law
and ethics.

CULTURAL SAFETY AND POSITION STATEMENT 7
Finally, cultural diversity is the main problem that can prevent
implementation of CDNM’s positional statement. Analyzing the ways that
which communities in a country like Australia communicate with each other
maybe very difficult. Use of non-verbal communication is an option that
nurses should use and using them may violate cultural code of certain
communities which may land nurses in serious trouble (Stanley et al., 2016,
p.1157). This can be avoided when nurses learn codes of ethics, and beliefs
of certain communities and their values based on the cultural group of the
patient they are serving.

CULTURAL SAFETY AND POSITION STATEMENT 8
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