outline and mihi l mihi/acknowledgement: irihapeti ramsden, nursing council of nz, eit hawkes bay,...
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Outline and mihiOutline and mihi
Mihi/Acknowledgement: Irihapeti Ramsden, Nursing Council of NZ, EIT Hawkes Bay, Pearson Education.
New Zealand context Brief history of cultural safety in New
Zealand Cultural awareness, cultural sensitivity and
cultural safety
Outline (cont’d)Outline (cont’d)
Journey of an indigenous woman to produce ‘Cultural safety in Aotearoa New Zealand’.
Lessons I have learnt in terms of cultural knowledge and the broad based concept adopted by the NCNZ.
Cultural competence, cultural security Behaviourist debate Ways of addressing relevant issues
New Zealand context New Zealand context
With over a thousand years of human settlement it’s history is dominated by the relationship between Maori (indigenous people) and Pakeha (European descendants)
The Treaty of WaitangiThe Treaty of Waitangi
The Treaty of Waitangi was signed in 1840 between the Maori chiefs and representatives of the British Crown.
Contains 3 articles– guaranteed Maori certain
rights and privileges
– including the protection of their customs, land, forests, fisheries and health.
Treaty of Waitangi (cont’d)Treaty of Waitangi (cont’d)
The Treaty has always been the reference point from which Maori people have negotiated with the Crown for self determination over their resources.
The Treaty provides the reference point therefore for cultural safety in New Zealand.
Cultural SafetyCultural Safety
The term “cultural safety” was coined by a Maori nursing student in the late 1980s. She made a plea at a meeting of health educators by saying “You talk of ethical safety, legal safety and physical safety…what about cultural safety?”
DefinitionDefinition
Simply put cultural safety is defined by those who receive the service (1996)
The term Kawa Whakaruruhau is also used which was developed by Irihapeti Ramsden.
Cultural safetyCultural safety
Cultural safety is well beyond cultural awareness and cultural sensitivity.
It gives people the power to comment on care and to be involved in changes in where their experience has been negative.
The process towards The process towards achieving cultural safetyachieving cultural safety
Cultural awareness is a beginning step
toward understanding that there is difference. Many people undergo courses designed to sensitise them to formal ritual and practice rather than to the emotional, social, economic and political context in which people exist.
Cultural sensitivityCultural sensitivity
Alerts students to the legitimacy of difference and begins a process of self-exploration as the powerful bearers of their own life experience and realities and the impact these may have on others.
Cultural safetyCultural safety
is an outcome of nursing and midwifery education that enables safe service to be defined by those who receive the service.
Founding conceptsFounding concepts
The inter-dependence of culture and ethnicity
The Treaty of Waitangi and Te Tiriti o Waitangi
Sociological concepts such as power
Evolving nature of cultural safetyEvolving nature of cultural safety
Collaboration of stories from health professionals, educators and commentators
Always mindful that the pain of the Maori experience of poor health provided the catalyst for cultural safety
Treaty based Broad based
Related conceptsRelated concepts
Cultural security defined as:“a commitment to the principle that the construct and
provision of services offered by the health system will not compromise the legitimate cultural rights, values and expectations of Aboriginal people” (Western Australian Department of Health)
“…shift in emphasis from attitude to behaviour”
Source: Cultural security and related concepts: a brief summary of the literature, Professor Neil Tomson, Health InfoNet, Perth, WA, 2005
The ‘behaviour’ debateThe ‘behaviour’ debate
Is it to be assumed that one can perform a value? (Cairns, 1992)
Human action is nothing but behaviourOr
Human action is something that excludes behaviour
So how do you measure attribute acquisition by individuals?
Attributes such as empathy, patience, creativity, honesty, respect and compassion do not lend themselves to simple measurement
Solution: Devise competency standards that are restricted to describing knowledge & skills
“Empathising with the patient’ – can be assessed holistically in the workplace & above, beside and below
Adaptive learning vs generative learning
Specialised knowledge comes at a price Self regulation vs externally imposed
system Legislation & governing/professional
bodies regulates cultural safety practice in the same manner as ethical, legal and physical safety
Cultural safety & Cultural Cultural safety & Cultural competence or cultural securitycompetence or cultural security
Achieve certain competencies to become safe
Or Achieve certain safety milestones to
become competent
Where to from here?Where to from here?
Beginning step towards stimulating critical thinking about the ‘taken-for-grantedness’ in the health professions
Lessons learnt from the nurse-patient relationship in Aotearoa New Zealand can help inform new learning in countries outside New Zealand
Whakatauki / proverbWhakatauki / proverb
Nahau te rourou
Naku te rourou
Ka ora ai te manuhiri
With your basket of knowledge
and my basket of knowledge
the people will prosper