BNURS20 Nursing

Introduction

A commonly used term is cultural safety that is defined as an environment that is socially, emotionally, physically, and spiritually safe for all people (Rowan et al., 2013). Thus, a culturally safe environment is one where there is no denial, challenge, or assault of the identity of the person, and of the demands and preferences (Funston, 2013). This essay will be a reflective account of cultural safety from the perspective of a healthcare professional.

Reflection

In New Zealand, cultural competency refers to the operative nursing practice of an individual or clan from a different culture that is determined by that being or family (Giles, Hognestad & Brooks, 2015). I began working in the healthcare domain as a registered nurse, with a keen interest in cultural safety. According to Pauly, McCall, Browne, Parker and Mollison (2015) one important role of all healthcare professionals is to display an ability to demonstrate cultural competence towards all service users, regardless of their beliefs, values, feelings, and opinions. During my placement, I encountered an incident where I had to assist a senior in caring for a patient who belonged to the indigenous population. However, my senior held some stereotypic views for the indigenous people and considered it a waste of time to treat them. This stereotype is commonly faced by them and often fosters prejudice, thus acting as a barrier in the implementation of a culturally safe environment (Kirmayer, 2013).

I became aware of how narratives related to past colonisation lead to these stereotypes, followed by subsequent discrimination and prejudice. I tried to implement it in my future practice, with the aim of respecting, recognising and nurturing the exclusive cultural identity of my patients. Another incident related to cultural safety occurred the next year while working with patients who belonged to the Maori community, and were drug addicts. Castro, Van Regenmortel, Vanhaecht, Sermeus and Van Hecke (2016) opined that patient empowerment refers to the way by which healthcare professionals assist patients to gain control over their lives, thereby enhancing their capability to act on different issues. A certain degree of cultural fluency is expected from the healthcare workforce, while treating the Maori population (Betancourt, Corbett & Bondaryk, 2014). They are expected to manifest essential skills, attitudes, and knowledge that would create a shared understanding as fragment of professional supervision (Garneau & Pepin, 2015).

I empowered the patients by providing them with the much needed support, for becoming equivalent partners in care. I demonstrated a sound understanding of their values, beliefs and culture and also worked towards increasing their self-awareness, coping skills, and health literacy. In the words of Ruth Grant Kalischuk (2014) cultural safety also comprises of cultural humility that is a lifelong journey of learning and self-reflection. I gradually realised its importance while working with multidisciplinary team members and patients belonging to different ethnicities and race. Future practice would involve listening to others without decree and being open to knowledge from others.

One noteworthy incident occurred few months back when I realised the influence of my own culture on the perception I held about a patient suffering from a mental illness, thus acknowledging my bias. With cultural awareness and compassion comes an accountability to act deferentially (Montenery, Jones, Perry, Ross & Zoucha, 2013). This in turn reinforced the idea of working respectfully and effectively with diverse people, with the aim of increasing cultural safety, and developing the necessary skills, attitudes, and knowledge. Culturally safe healthcare facilities should be free of prejudice and discrimination. Persons are reinforced to draw powers from their individuality, philosophy and society.

Conclusion

To conclude, it can be stated that the primary goal of cultural safety is to make all people feel safe and respected, while interacting with the healthcare professionals. Although I have had encountered several instances where the cultural safety of patients were on the verge of being threatened, I intend to offer care services that are free from all kinds of discrimination and racism.

References

Betancourt, J. R., Corbett, J., & Bondaryk, M. R. (2014). Addressing disparities and achieving equity: cultural competence, ethics, and health-care transformation. Chest, 145(1), 143-148. https://doi.org/10.1378/chest.13-0634 

Castro, E. M., Van Regenmortel, T., Vanhaecht, K., Sermeus, W., & Van Hecke, A. (2016). Patient empowerment, patient participation and patient-centeredness in hospital care: a concept analysis based on a literature review. Patient education and counseling, 99(12), 1923-1939. https://doi.org/10.1016/j.pec.2016.07.026 

Funston, L. (2013). Aboriginal and Torres Strait Islander worldviews and cultural safety transforming sexual assault service provision for children and young people. International journal of environmental research and public health, 10(9), 3818-3833. https://doi.org/10.1111/phn.12210 

Garneau, A. B., & Pepin, J. (2015). Cultural competence: A constructivist definition. Journal of Transcultural Nursing, 26(1), 9-15. https://doi.org/10.1177%2F1043659614541294

Giles, A. R., Hognestad, S., & Brooks, L. A. (2015). The need for cultural safety in injury prevention. Public health nursing, 32(5), 543-549. doi:10.3390/ijerph10093818

Kirmayer, L. J. (2013). Embracing uncertainty as a path to competence: Cultural safety, empathy, and alterity in clinical training. Culture, Medicine, and Psychiatry, 37(2), 365-372. https://doi.org/10.1007/s11013-013-9314-2

Montenery, S. M., Jones, A. D., Perry, N., Ross, D., & Zoucha, R. (2013). Cultural competence in nursing faculty: A journey, not a destination. Journal of Professional Nursing, 29(6), e51-e57. https://doi.org/10.1016/j.profnurs.2013.09.003 

Pauly, B. B., McCall, J., Browne, A. J., Parker, J., & Mollison, A. (2015). Toward cultural safety. Advances in Nursing Science, 38(2), 121-135. https://doi.org/10.1097/ANS.0000000000000070 

Rowan, M. S., Rukholm, E., Bourque-Bearskin, L., Baker, C., Voyageur, E., & Robitaille, A. (2013). Cultural competence and cultural safety in Canadian schools of nursing: A mixed methods study. International journal of nursing education scholarship, 10(1), 1-10. https://doi.org/10.1515/ijnes-2012-0043 

Ruth Grant Kalischuk RN, P. H. D. (2014). Conceptualizations of culture and cultural care among undergraduate nursing students: An exploration and critique of cultural education. Journal of cultural diversity, 21(3), 99. Retrieved from https://search.proquest.com/openview/241d34ca93cba9467cafaa537fc57d9f/1?pq-origsite=gscholar&cbl=34124