Garrod, A. (2002). Cultural safety: Living with a disability. Whitireia Nursing Journal, 9, 14-19. Every unique person living with a disability is part of a wider disability culture. This culture shares their experiences, values, beliefs and their general ways of life. Within a population, the disability culture has minimal power due to being the minority. Annette Garrod reminds us about the significance of reflecting on your beliefs and attitudes when caring for patients with disabilities.
This would allow the patient to partake in decision making about their care and as a result the patients physical, mental and emotional wellbeing would be upheld. She admits upon reflection, she noticed her lack of confidence and inability to connect with her patients effectively, and was unable to give the patient the right information for them to receive holistic care and support. Empowerment needs to be considered when nursing a patient with a disability.
The nurse needs to be able to give the patient support and correspond on their behalf, to help them if they are unable to understand or articulate their requirements and to see the patient as an individual rather than just seeing their disability. When caring for patients with disabilities in a culturally safe manner, positive language, good communication skills, kind advice, support and an encouraging outlook are very important. (205) Hughes, M. , & Farrow, T. (2007). Caring for obese patients in a culturally safe way. Kai Tiaki Nursing New Zealand, 13(4), 14-15.
Nursing’s ideas on obesity are constructed by cultures influenced by, the “western” model of a perfect body, the bio-medical model that sees obesity as a disease and thoughts around obese individuals being the sole cause of their condition. Cultural safety needs to be practiced, regardful of difference, when caring for obese clients. Nurses must reflect on their caring to make sure they are not merely replicating the bio-medical model. Different cultures have diverse beliefs towards obesity. These differences could affect the patient/nurse relationship, and the nurse should be aware of their patient’s beliefs about obesity.
Nurses also need to be mindful of their own beliefs about obesity to stay away from bringing shame upon their client. Often, obese patients will be judged by health care providers believing their condition was all their own doing, therefore believing they don’t deserve the same health care as a person who ‘looks after themselves’, which in turn can lead to worse health outcomes. Nurse-led clinics may be the answer for people struggling with their weight, as it would be a friendly, non-judgemental and safe environment. Support and growing self-regard is vital for success in their road to recovery. 194) Kruske, S. , Kildea, S. , & Barclay, L. (2006). Cultural safety and maternity care for Aboriginal and Torres Strait Islander Australians. Women and Birth, 19(3), 73-77. The concept of cultural safety, developed by Maori nurses in New Zealand, provides a great opportunity to improve the delivery of maternity services to the Aboriginal and Torres Strait Islander women of Australia. Rather than teach midwives and nurses about components of different cultures, cultural safety asks the health practitioner to discover their own cultures.
With cultural safety in mind, their aims are to be unbiased and non-judgemental. Nurses and midwives belong to a culture of their own. This culture can become very intimidating to the client and leave them feeling powerless and possibly alienate them from the service. They should also be mindful of the amount of confusing medical language they use and even offensive clothing as this could be domineering and isolating. An important thing to remember, the care provider can never assume they have supplied the care in a culturally safe manner, for the patient decides this outcome.
Aboriginal and Torres Strait Islander cultures don’t allow men to be present during childbirth, therefore it is necessary for male practitioners to recognise this difference in culture, and step back in these health situations. Maternity services should be ensuring all clients of all cultures feel safe culturally, physically, spiritually, socially and emotionally. (203) Meyst, S. (2005). Learning how to be culturally safe. Kai Tiaki Nursing New Zealand, 11(5), 20-22. Becoming a nurse who practices cultural safety involves learning the key principles of cultural safety and moulding them into daily routines concerning all clients.
Sandra Meyst shares her experiences of an education that lacked teachings around cultural safety, to becoming a nurse who has a great understanding of the concept and how she got there. Irihapeti Ramsden, described by Meyst (2005) as “The pioneer of cultural safety…” defines culturally safe practice in her thesis as the professional nurse being power conscious and involving their client in that power. For example, building a confident relationship with the client and their close ones, and helping them make decisions about the care they are receiving.
The New Zealand Nursing Council argues, for cultural safety to be less confusing it needs to be unconnected from the Treaty of Waitangi. Whereas, Ramsden argues, the Treaty is the key to practicing cultural safety. However, both parties agree on the patient being the assessor of weather or not their care was practiced in a culturally safe manner. It is important for a nurse to identify their own culture, beliefs and attitudes and how these influence their work. They also need to acknowledge and respect their client’s differences and be careful not to treat them all the same. 209) Accuracy: The information in this article was very informative and free from errors. A large amount of references shows that the article information has been well researched. There were no apparent editing errors that would question the articles reliability. Authority: The authors of this article have not stated their qualifications, but it states the paper is copyrighted to the Australian College of Midwives. This confirms the authors have a high knowledge around the subject of midwifery and academic writing.
Elsevier Australia is a very reputable publisher of health and science publishing for Australia and New Zealand. Their logo is found on plenty of helpful literature on campus. Objectivity: The goal of the article is to discuss cultural safety and to critically assess the provision of culturally safe midwifery services to the Aboriginal and Torres Strait Islander women. As stated above, there was a wide range of varied materials sourced for the article and includes different perspectives on the topic. Currency: The article was clearly accepted for publication on the 10th of July 2006 and published in that year also. 1 out of 57 references were within ten years of the publication date. Therefore, most of the content was current.
Coverage: The keywords are: Cultural safety, Aboriginal and Torres Strait Islander Australians, maternity care and midwives. The intended audience would be healthcare professionals who are seeking knowledge on these topics. Conclusion: I would use this article for an assignment because it offers well-researched, knowledgeable and current information. Through reading this article, the importance of cultural safety in remote Australian midwifery has become apparent. 262) Accuracy: Compared to other articles viewed on the topic of cultural safety, this article has more of a focus on how people live with disabilities, and compared, a minimal amount of information on cultural safety principles. There were no noticeable errors in the work. Authority: The author Annette Garrod has not made her qualifications obvious. But just going by her writing style and her wide range of knowledge on the topic, she seems to have great understanding. The Whitireia Nursing Journal is found in NMIT’s library, and is a reliable source of information for writing assignments.
Objectivity: The article aims to create awareness around some of the health experiences and apprehensions of people with disabilities under the framework of cultural safety. The literature used is quite narrow with a few references coming from the same journal. The article does incorporate different approaches around the ideas though. Such as Bio-medical versus holistic approach. Currency: The publication date is not clearly labelled on the article, however when sourcing the article it was on the journal cover.
All but one of the references were published within ten years of the articles publication date, but the article itself was written in 2002, so it is considered old information. Coverage: Keywords are disability, cultural safety, New Zealanders, empowerment, income and inequalities. The intended audience are registered nurses who are passionate towards caring for people with disabilities. Conclusion: Although this article was very insightful, I would not use it in future assignments, as it is not current information.
The article provided great insight into the experiences of people living with disabilities. (265) While the themes in each article concentrate on very different topics, they all have a common focus on culture and cultural safety principals. All of the articles at some point, explain culture as being part of a group of individuals who share common beliefs, values, attitudes, experiences and lifestyles. Annette Garrod (2002) and Kruske, Kildea and Barclay (2006), both continue on to express how the cultural groups in their articles, are considered to be the minority within their populations.
Sandra Meyst (2005) continues to state that culture is also defined by age, sexual orientation and gender and not merely ethnicity. There are some major similarities throughout the articles based around the principles of cultural safety. Every article holds the principle that it is essential for the health practitioner to identify or reflect, on their own cultural beliefs and values, before they can provide culturally safe care. Acknowledging and respecting a patient’s culture, along side being regardful of difference, un-biased and non-judgemental, were common statements used within all articles. Meyst (2005) and Kruske et el. 2006), both explain how it is the patient that decides wether the care they have received is culturally safe or not. Empowering your patient in the context of cultural safety, is defined as helping them make decisions about their care. In the disability culture just treating them like an able-bodied person can help with empowerment (Garrod, 2002). The only major difference in the four summarised articles was the different types of cultures . You might slightly alter you approach after recognising their cultural differences, but the basic principles of cultural safety remain the same for each culture. (271)
REFERENCES
Funnell, R., Koutoukidis, G. & Lawrence, K. (2005). Tabbner’s nursing care: theory and practice (4th ed.). Marrickville, New South Wales: Elsevier.
Garrod, A. (2002). Cultural safety: Living with a disability. Whitireia Nursing Journal, 9, 14-19.
Hughes, M., & Farrow, T. (2007). Caring for obese patients in a culturally safe way. Kai Tiaki Nursing New Zealand, 13(4), 14-15. Retrieved from: Cinahl with full text database
Kruske, S., Kildea, S., & Barclay, L. (2006). Cultural safety and
maternity care for Aboriginal and Torres Strait Islander Australians. Women and Birth, 19(3), 73-77. Retrieved from: www.elsevier.com
Meyst, S. (2005). Learning how to be culturally safe. Kai Tiaki Nursing New Zealand, 11(5), 20-22. Retieved from: Cinahl with full text database
Mackay, B., Harding, T., Jurlina, L., Scobie, N. & Khan, R. (2011) Utilising the hand model to promote a culturally safe environment for international nursing students. Nursing Praxis in New Zealand, 27(1), 13-24.
New Zealand Psychologists Board. (2009). Guidelines for cultural safety: the treaty of Waitangi and Mãori health and wellbeing in education and psychological practice. Retrieved from Http://www.psychologistsboard.org.nz/cms_show_download.php?id=83
Woods, M. (2010). Cultural safety and the socioethical nurse. Nursing Ethics, 17(6), 715-725. Retrieved from www.cinahl.com/cgi-bin/refsvc?jid=863&accno=2010870371
