Expressions of cultural safety in public health nursing practice

Abstract

Cultural safety is an essential concept within New Zealand nursing that is formally linked to registration and competency-based practice certification. Despite its centrality to New Zealand nursing philosophies and the stated expectation of cultural safety as a practice element, there is limited evidence of its application in the literature. This research presents insight into public health nurse's (PHN) experiences, demonstrating the integration of cultural safety principles into practice. These findings emerged following secondary analysis of data from a collaborative, educative research project where PHNs explored the use of family assessment tools. In particular, the 15-minute interview tool was introduced and used by the PHNs when working with families. Critical analysis of transcribed data from PHN interviews, utilising a cultural safety lens, illuminated practical ways in which cultural safety concepts infused PHN practice with families. The themes that emerged reflected the interweaving of the principles of cultural safety with the application of the five components of the 15-minute interview. This highlights elements of PHN work with individuals and families not previously acknowledged. Examples of culturally safe nursing practice resonated throughout the PHN conversations as they grappled with the increasing complexity of working with a diverse range of families.

Fostering positive spaces in public health using a cultural humility approach

“…Cultural safety is an outcome of care that results from providers who respectfully engage with clients and who recognize and address power imbalances (First Nations Health Authority, ; Richardson, Yarwood, & Richardson, ). Although cultural safety has its origins in indigenous nursing care, there is support and rationale for applying this concept beyond ethnicity, to a range of diverse social identities including sexual orientation and gender identity (Beagan, ; First Nations Health Authority, ; Richardson et al, ).…”

“…Cultural safety is an outcome of care that results from providers who respectfully engage with clients and who recognize and address power imbalances (First Nations Health Authority, ; Richardson, Yarwood, & Richardson, ). Although cultural safety has its origins in indigenous nursing care, there is support and rationale for applying this concept beyond ethnicity, to a range of diverse social identities including sexual orientation and gender identity (Beagan, ; First Nations Health Authority, ; Richardson et al, ). The term cultural safety draws comparisons with the notion of cultural humility; both terms are used to convey the importance of recognizing power imbalances, addressing societal inequities, and engaging in self‐reflection (Beagan, ; Foronda et al, ; Richardson et al, ).…”

“…Although cultural safety has its origins in indigenous nursing care, there is support and rationale for applying this concept beyond ethnicity, to a range of diverse social identities including sexual orientation and gender identity (Beagan, ; First Nations Health Authority, ; Richardson et al, ). The term cultural safety draws comparisons with the notion of cultural humility; both terms are used to convey the importance of recognizing power imbalances, addressing societal inequities, and engaging in self‐reflection (Beagan, ; Foronda et al, ; Richardson et al, ). The relationship between the two concepts may be best understood when we consider cultural humility as the process of care and cultural safety as the intended outcome (First Nations Health Authority, ; Hammell, ).…”

Tangled pasts, healthier futures: Nursing strategies to improve American Indian/Alaska Native health equity

“…Culturally safe nursing practice emerges from a solid theoretical foundation in cultural safety (Aboriginal Nurses Association of Canada, 2009). While the essential skills associated with cultural safety are initially encouraged and evaluated in the educational setting, the onus is upon both nursing leadership and clinicians to embed the approach into the everyday care of AI/AN patients, families, and communities across clinical settings (Richardson et al, 2016).…”

“…Nurses who actively seek out and honor AI/ AN preferences surrounding health and well-being facilitate a more equitable dynamic. The nurse moves from authority figure and representative of the dominant system to the role of partner in health and well-being (Racine & Petrucka, 2011;Richardson et al, 2016).…”