Nursing Practice: Cultural Safety and Professional Standards

This nursing assignment explores the critical concept of cultural safety within contemporary nursing practice, emphasizing its significance in providing a safe and inclusive environment for patients from diverse backgrounds. The essay begins by defining cultural safety and its application in healthcare settings, highlighting the importance of professional expectations in delivering culturally competent care, especially within the context of New Zealand's healthcare system. It then analyzes a scenario, identifying and critically evaluating three key issues that hinder the delivery of professional nursing care, such as horizontal violence, discrimination, and breaches of patient trust. The assignment further delves into the implementation of correct professional nursing responses, outlining a graduate nurse's perspective on addressing the identified issues and promoting culturally safe practices. The essay also discusses the application of the Bridges Transition Model to facilitate change and demonstrates culturally competent and person-centered practices. The discussion encompasses the importance of effective communication, adherence to professional standards, and the protection of patient rights to ensure high-quality, ethical patient care.

Running head: Nursing assignment
Nursing assignment
Name of the student:
Name of the university:
Author note:

1Nursing assignment
Introduction:
Cultural safety helps in providing physically, socially, emotionally and spiritually safe
environment for each and every individual. It is also used in the healthcare setting to provide
culturally safe environment to the patient as well as the healthcare staff (Richardson, Yarwood &
Richardson, 2017). Delivery of the cultural safe practice helps the patient to get involved in the
care practice and which leads to positive outcome of the health. This essay mainly focusses on
the overview of the cultural safety and its application in the contemporary nursing practice. The
professional expectation of the nurse or the healthcare staff in order to provide cultural safety are
also mentioned in the essay. It is frequently observed that in the contemporary nursing practice,
there are certain barrier which can hamper the patient care process. There are instances in the
case study which determines that the professional nursing standards are not achieved. Such
instances or the incidents are mentioned in the essay. The essay also includes correct
professional nursing standards response for the nursing standard barrier. Being a graduate nurse,
it is my responsibility to implement models that helps an achieving the change with the help of
Bridges Transition Model. The essay also involves the factor that will help in the demonstration
of the culturally competent practice and also person-centred.
Task A:
Cultural safety is extremely important in the field of nursing as it helps an individual to
get their identity and their needs and the interests (Richardson, Yarwood & Richardson, 2017).
In the healthcare setting, patient from different cultural and economic background are provided
with care and treatment, hence it is very important for the healthcare staff and the healthcare
authorities to implement cultural safety in order to deliver best patient care (Woods, 2017).
According to the New Zealand legislation, the nurse who are recruited to provide efficient care to

2Nursing assignment
the minority population or the vulnerable population should be aware of the culture safe practice
and the also have knowledge regarding the culture safe interaction among the nurse and the
patient. In New Zealand, the cultural safe practice focusses on the patient’s autonomy, providing
safe physical, cultural and spiritual environment to the minority population. Absence of cultural
safety leads to multiple disorder such as depression and other mental health issue due to
discrimination regarding health care facility and care (Sue et al., 2019). The vulnerable
population of New Zealand such as the individual from different cultural background or the
individual who belongs to the poor socio-economic class have the highest death rate (Regidor et
al., 2015). In order to reduce such death rate among the vulnerable population, it is important to
provide cultural safety to the individual (Henderson et al., 2016). In New Zealand, the culture
safe practice is provided by focussing on the principles of Treaty of Waitangi. The treaty of
Waitangi also formulated into action to enhance the health outcomes of the Maori which is a
minority population includes, protection, partnership and participation According to the
principles which are protection, partnership and participation of Treaty of Waitangi for the nurse,
encourages the nurses and the healthcare staff to form partnership with the Maori population in
order to meet their needs. The treaty also enhances the responsiveness to the needs and interests
of the minority population such as Maori. To provide cultural safety to an individual, it is
ensured that the each and every population gets equal opportunity which is considered by treaty
of Waitangi of New Zealand. The treaty of Waitangi also evaluates and measures the councils
and the education providers in response to the treaty (Nursing Council.Org.Nz, 2019). All these
can be achieved by effective communication which help in establishing the relationship and
helps in understanding the needs and interests of the individual.

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Contemporary nursing aids in providing better care to the patient by critically analysing
all the factors such as, social, political (Fisher, 2017). By the assistance of the cultural safety,
contemporary nursing practice can be used to provide patient care to the individual from
different cultural background (Repo et al., 2017). The contemporary nursing previously focuses
on the principle of “one design fits for all”. However recent advancement made it possible to
design treatment based on the need of the patient. Hence, the nurse should use that to provide
culturally safe environment to the minor population of the New Zealand
The common barrier which are observed in the contemporary nursing practice are as
follows:
Satisfying patient’s expectation:
Considering the expectation of the patient in order to provide better patient care is very
important in the contemporary nursing practice (Geiballa, Abubakr & Ibrahim, 2016).
Ineffective communication:
Ineffective communication among the nurse and the individual who belong to the minor
population is also considered as barrier in the contemporary practice with respect to culturally
safe practice in New Zealand.
Lack of knowledge in the healthcare staff
In order to provide enhanced and improved patient care and culturally safe care, it is
extremely important for the healthcare staff to have enough knowledge regarding the patient’s
culture (Koch & Breland, 2017).

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This barrier should be removed to enhance the contemporary nursing practice and to
provide cultural safe practice to the minor or vulnerable population of New Zealand.
Task B:
Professional nursing care means providing care and treatment to the patient based on the
professional nursing standard of New Zealand (Urden, Stacy & Lough, 2017). Professional
nursing practice is the model which describes the communication, collaboration, and the
development of the professional traits of a nurse which can be used to provide high quality care
to the patient (Slatyer et al, 2017). The Privacy Act of New Zealand was developed in order to
provide safety regarding the disclosure of the information and data related to an individual’s
health and treatment with others. The law guides the nursing staffs regarding the privacy policy
of an individuals and provides knowledge to respect one’s dignity and values.
Professional practice of a nurse can be applied in the healthcare organization with the
help of professional nursing standards. Professional standard of New Zealand is described as the
competent level of passion and care provided to the patient in each of the nursing phase
(Meretoja, Lindfors & Kotila 2019). In New Zealand, it is applied in the nursing practice in order
to achieve desired level of the performance of the nurse. The professional standard of the nurses
is evaluated by comparing with the professional nursing practice formulated by the higher
healthcare authorities (Regan, Laschinger & Wong, 2016). The New Zealand Nurses
Organization underlines the role of the nurse in the healthcare to maintain the privacy and
confidentiality of the patient.
In the provided scenario, all the registered nurse of a healthcare organization is arguing
loudly among themselves regarding the treatment of the patient who has been recently admitted
to the hospital. The patient has been admitted to hospital for the eight factor transfusion. The

5Nursing assignment
patient has been diagnosed with haemophilia. As the patient has been serving a home detention
for a period of time for the offence of sexual abuse.
As, I arrived at the work station, I heard that all the nurses are arguing loudly among
themselves and the patient is present directly across the area and has been hearing all the
incident. By observing the case study, it can be stated that, the professional standards of the
nurse that should be followed in not followed in this case. The scenario includes certain events
and action that are affecting the professional nursing care are as follows:
The 1st issue which is said to be effecting the professional care of the nursing is the
horizontal violence among the nurses. It is observed according to the scenario, that all the nurses
are argue loudly among themselves at the nursing station. In an organization, especially in the
healthcare setting it is extremely important to maintain a quiet and peaceful environment in order
to provide better patient care (Salzmann‐Erikson, Lagerqvist & Pousette, 2016). Quite
environment is extremely essential in the recovery and healing process of an individual (Hedges,
Hunt & Ball, 2019). The horizontal violence among the nurses might hamper the sleeping of a
patient which is one of the most important part of the recovery process of the patient (Harrington
& DeLeskey, 2015). In the presence of excess noise, the health of the patient might get further
deteriorated. It can have negative impact on the recovery process of the individual. Noise is
considered as one of the stressor which can be considered as barrier or hurdle in the healing
process of the individual (Pedersen, 2015). Hence, in order to avoid such condition, it is
important to maintain a quiet and peaceful environment.
2nd issue which is observed in the scenario is the refusal of the nurse to take care of the
patient causing to a situation of discrimination. In the case study it is observed that the not even a
single nurse agreed to take care of the patient. As the patient is on the home detention for the

6Nursing assignment
offence of sexual abuse. It can hamper the health condition of the patient. Though it is the right
of the nurse to refuse for the treatment of the patient if they are not feeling safe, but in such case
it can be harmful for the health condition of the patient (Griffith, 2015). In such condition of
discrimination, the treatment of the patient get delayed which can lead to further deterioration of
the health (Watson et al., 2017).
3rd issue which can be considered to be harm the professional nursing care is that all the
incident is Non-maleficence. The patient had heard everything that not a single nurse wants to
take care of him. It can lead to mistrust among the patient (Dale et al., 2016). Trust is one of the
most important tool that can be successfully used to build rapport between the patient and the
nurse (Graban, 2016). Lack of trust might hamper the treatment of the patient (Groenewegen,
Hansen & de Jong, 2019). In this case the patient knows that no a single nurse wants to take care
of him and he might build a perspective. This perspective will not allow him to trust any nurse
during his treatment (Drucker, 2017).
Hence, in order to avoid such circumstances, it is important for the supervisor to conduct
a meeting and the assign a nurse who can take of the patient (Perry, Henderson & Grealish,
2018). It can lead to less argument as well as patient will also get the treatment on the stipulated
time and also the feeling of mistrust will not have developed among the individual.
Task C:
From the given scenario, it can be identified that there are several nurses who do not
follow the professional conduct of nursing. It is important for the nurse to apply the knowledge
of legal, ethical, and professional knowledge in order to provide culturally safe care to the

7Nursing assignment
patient. Being a new graduate registered nurse, it is my responsibility to take certain steps that
should be taken to ensure culturally safe practice to the vulnerable patient.
According to the NCNZ (2019), nurse should be competent enough in order to provide
better care to the patient. All the nurse who are working in the healthcare organization have
negative attitude and their attitude can be considered as incompetence and professional
negligence. All the nurses should be skilled and qualified which is not observed in the case.
According to the Nursing Council of New Zealand (2012), it is a patient right to get proper
treatment. However, in this case all the nurses’ are refusing to provide treatment to the patient
which is considered as direct breach in the patient right. Hence, as a new graduate registered
nurse it is my responsibility to make them understand about the patient right. I will try to solve
the breach by myself by communicating with all the nurses who are there. However if the issue
will not be resolved, I will inform my senior regarding the scenario. I would also appeal that we
desist from creating loud remarks about the client to trail appropriate moral compliance, and also
to reserve the confidentiality and privacy of the patient. The nurses will also be educated
regarding the consequences of making loud comments regarding patient. According to Health
and Disability Services Consumers’ Rights and the Privacy Act (1993), such breach which
violates the privacy of the patient leads to punishment (New Zealand Legislation, 2017).
Apart from these, being a registered nurse my subsequent act will be to utilize my clinical
information and skill In order to ensure that I will be able to accomplish the needs and preference
of the patient. Anxiety and nervousness is often observed in the beginner nurse as they are not
sure their ability to achieve specific patient care activities, and in addition they also have of fear
of by patients. According to the Nursing Council of New Zealand’s competency 2.8, it can be
stated that nurses must recognize their possibility of clinical practice and also should imitate that

8Nursing assignment
based on their experience and knowledge. If the nurse are unsure about their action, it is
recommended that they should take help from the senior nurse or the supervisor.
I noticed that during the argument, the patient was across the nursing station and had
heard everything. It can lower the self-confidence and the self-esteem of the patient and it also
provide the patient a feeling of mistrust, which can have negative impact on the health of the
individual. In order to reduce the adverse effect on the health of the patient, the culturally safe
care is provided to the patient irrespective of the background of the patient.
As a registered nurse, it is my responsibility to provide culturally safe care to the patient.
By utilizing my knowledge of the code of conduct of nursing, I will try to educate the nurse and
the healthcare staff that each and every patient should be equally treated. The dignity of the
patient should be maintained and in order to maintain better health conditions, trust is also
important (Nursingcouncil.org.nz, 2019).
As the patient has heard everything, it is important for me as a registered nurse to calm
down the patient to regain the trust. Hence, in order to do that, I will communicate with the
patient in order to get information about the pain and worries of the patient. During the patient
care I will ensure that all the nursing guidelines is followed as well as the primary functions of
the nursing which are, justice, non-maleficence and beneficence which will help to maintain
cultural competency.
Another issue which is identified in the case study, which is observed in the scenario is
the refusal of the nurse to take care of the patient. In the case study it is observed that the not
even a single nurse agreed to take care of the patient. As the patient needs health care from the
health care providers, but due to the refusal the treatment of the patient might get delayed which

9Nursing assignment
lead to further deterioration of the health of the patient. Hence, in this case, I will report the
incident according to the 8th principle of the COCNNZ, which explains the risk of delayed
treatment as it can lead to further health deterioration or might turn into a serious health issue.
According to the Nursing Council of New Zealand (2012), the treatment of the patient should not
be delayed in order to reduce the risk and harm of the health. I also work toward to provide
patient centered care to improve the health outcome of the patient which is discussed in the
fourth domain of the Nursing Council of New Zealand.
Task D:
As observed in the case study that the patient is discriminated by the patient for
his background (Alpers, 2018). It can have negative impact on the patient and might also
hampers the recovery process of the patient (Drewniak et al., 2016). In order to implement
person centred care and culturally competent care according to the case study, it is important to
bring change in the healthcare organization (Dixon, Holoshitz & Nossel, 2016). The change
which should be implemented in the workplace involves:
Implementing change in the nursing care is essential as it helps to evaluate oppurtunitues
which helps to improve the quality of the patient which helps to overcome the crisis and also
helps to fill the gap which hinders the patient care and satisfaction.
In order to enhance the change in the healthcare setting, three recommendations
were made which is done with the help of Kurt-Lewin Model (1950). This model is divided into
three stages which includes, freezing, moving and refreezing (Bro, 2019).
Freezing: recognizing and collaborating the restraining and driving and forces which may
influence the group.

10Nursing assignment
Moving: awareness generation for the shared understanding.
Refreezing: sustaining and evaluating the alteration over time.
My 1st recommendation is that all the leadership nurses should effectively deal while
conflict. It is observed in the case study that all the nurses are arguing loudly at the nursing
station. Hence in the 1st step, the meeting between the healthcare staff and the nurse will be
conducted. An open communication among the healthcare authorities and the nurses will be
conducted. In the meeting the reason behind the breach is mentioned and a policy will be
suggested that helps to improve the condition and will also help to implement professional
standard of nursing. It will provide the nursing leader to draw the attention of the staff for the
basic responsibilities of the nursing.
The second recommendation is to apply a policy that can be used to minimize the
horizontal violence. In order to do that, anti-HV policy should be implemented which helps to
underline the impacts of horizontal violence amongst all the health care staff members. The 2nd
stage is the ‘unfreezing’ stage. In the unfreezing stage, all the senior.
Healthcare authorities should be called to a conference by Nurse Manager in order to
acknowledge the issue. In the meeting, suggestions that can help to improve the condition of the
patient and help in the development of the policy. Apart from that, a zero-tolerance method
should also be taken into consideration which helps to deal with horizontal violence. All the
healthcare staff should be acknowledged about the consequences which includes, poor patient
consequences, increased staff turnover, deprived mental health. In the ‘moving’ stage,
understanding of new anti- horizontal violence policy amongst the staff and the consequences of

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horizontal violence should be evaluated. The 3rd stage is the refreezing stage, where the changes
that has been implemented is continuously monitored to evaluate the effectiveness of the change.
The 3rd recommendation is to train the healthcare staff in order to make them capable of
adapting the new changes that has been implemented. The staff should be trained and educated
so that they can adapt the changes effectively (Burke, 2017). As the breach that has observed in
the case study is due to the poor healthcare management and due to lack of professional standard.
Hence, by training the nurse, such breach will be avoided in future.
Task E:
Cultural competence is described as the awareness of the cultural diversity (Chiu & Shi,
2019). It requires to function effectively as well as respectfully with the patient as well as the
healthcare staff in order to provide better care to the patient irrespective of their cultural
background (Degrie et al., 2017). Culture competence in the healthcare staff is defined as the
skills, ability and knowledge to provide better patient care (Ang & Van Dyne, 2015). Factors
which help in demonstrating that whether the practice in the healthcare is culturally competent
and person centred are discussed below:
The 1st strategy that will be used to provide cultural competent to the patient is to
maintain the privacy and confidentiality of the patient. Before implementing any procedure or
planning any care plan taking informed consent from the patient is very necessary (Benito &
García, 2016) Sometimes, the patient’s cognitive amenableness and capability to understand the
likely significances which is associated with a process is a barrier to the cultural safety. In order
to address the cultural safety, I will reflect the education, cultural unfamiliarity and intelligence
of the patient. I will explain full treatment to the patient and after that if the patient will feel he