Cultural Safety and Nursing Education in Aotearoa and Te Waipounamu

Abstract

The research on which this thesis is based involves both a private narrative and a public narrative. It traces a personal history in order that the story of Cultural Safety can be told and the history, theory and the future direction can be gathered into one qualitative work. The work is divided into three sections. The first is entitled, Ko Wai Matou? The Private Narrative. This section seeks to explore the historical, social, educational, physical, emotional, political and moral influences and ephiphanies which brought about the personality which introduced Cultural Safety ideas into nursing and midwifery. Early nursing practice is investigated and examples from practice are used to illustrate learning and consolidation of the ideas which led to Cultural Safety theory. The second section is entitled He Huarahi Hou: A New Pathway. This section explains the progress of the theory and its relationship to education pedagogy and to nursing practice. Comparison between the work of Madeline Leininger and the Transcultural Theory of Nursing and the New Zealand concept of Cultural Safety is undertaken. The role and application of the Treaty of Waitangi to the theory of Cultural Safety is explored in this section. The third section, entitled He Whakawhanuitanga: The Public Narrative, looks at the introduction of Cultural Safety into the nursing education system and its implementation. The public and media reaction to the inclusion of Cultural Safety in the national examination for nursing registration and the subsequent parliamentary response are noted. The interviews with nursing and midwifery leadership, Maori and pakeha key players in the process and consumer views of the ideas are documented and pertinent excerpts have been included. The work concludes with a discussion on the likely future of Cultural Safety as a theory and in practice and outlines several issues which represent a challenge to the viability of the concept in nursing and midwifery education. The story of Cultural Safety is a personal story, but also a very public one. It is set in neo-colonial New Zealand, but has implications for indigenous people throughout the world. It is about human samenesses and human differences, but is also a story about all interactions between nurses and patients because all are power laden. Finally, although it is about nursing, it is also relevant to all encounters, all exchanges between health care workers and patients.