Introduction
Cultural safety seeks to address power and privilege imbalances in institutions and throughout society.
It addresses systemic, scientific, and personal racism, which create and sustain health inequalities in neo-colonial societies such as Australia.
It is an explicitly political model, which considers how society, and its institutions respond to historically situated social determinants of health and educational access, such as power imbalance, privilege, racism, and stigma.
History
The cultural safety model was developed by Māori nursing scholar Dr Irihapeti Ramsden and her colleagues in response to a student’s concerns about the safety of Māori students undertaking nursing training in Eurocentric monocultural institutions in Aotearoa/New Zealand.
Aims
This book aims to equip educators, students and health professionals with the knowledge and skills, to provide respectful and culturally safe teaching, learning experiences and health care provision.
Which cultures?
A key element of cultural safety is the recognition that services (including tertiary institutions and health services) are designed by people from a mainstream cultural position and based on the assumptions of the dominant culture.
Cultural safety focuses on the cultures of health professionals, institutions, and services as the site of scrutiny and change.
Cultural safety’s definition of personal culture encompasses the interaction between,
- worldviews (values, beliefs, assumptions, and attitudes)
- aspects of the lifeworld (social experience, privilege, opportunity)
- personal cultural factors such as age, gender, class, ethnicity, and ability (intersectionality)
In this way cultural safety positions professionals, professions and systems as cultural entities and promotes a grasp of intersectionality and its impacts that can be applied to self and others.
Cultural safety in practice
The application of cultural safety navigates the relationships between history, culture, society, and inequity and acknowledges all forms of power imbalance and discrimination including but not limited to racism.
The focus is on the cultures of professionals, professions, and services. Culturally safe organisations accept and acknowledge the impact of their cultures on outcomes for their users.
Cultural safety in practice is an ongoing exercise of reflection by individuals (health professionals, educators, researchers) on their personal, professional, and institutional cultures and the dimensions of power that inform them.
Culturally safe professionals are aware of their own values, assumptions, biases, and related feelings that affect users’ experience when accessing services (be it a health service or a tertiary institution). This self-reflective work is essential to gain and maintain trust between services and users (patients or students), to ultimately improve equity within institutions.
What cultural safety is not
Cultural safety is not being an expert in someone else’s culture.
It does not concern the ethnicity, gender, sexuality, or other attributes of service users. This is distinct from other transcultural approaches such as cultural competence, capability, awareness.
Cultural safety is not something you “achieve” but is rather an ongoing process of reflection and awareness.
What cultural safety asks of us is an ongoing process of reflection, acknowledgement of the power dimension in our professional and personal relationships and the creation of a respectful space in which each individual feels safe to express themselves.
Cultural safety asks that each individual reflect on their personal and professional assumptions, biases, values, power and privilege and bring this awareness to their interactions with others in their professional and personal contexts.
