Cultural Safety and Indigenous authority in nursing and midwifery education and practice.

Abstract

We begin by acknowledging the sovereignty of Indigenous Peoples across the Earth as the traditional custodians of Country, and their timeless and embodied relationships with cultures, communities, lands, waters, and sky. We honour children born and yet to be. We pay our respects to Elders, past and present, particularly those who led the way, allowing us to realise our own calling to be healers. We the guest editorial team, are an international collaboration of Indigenous nurse scholars from Australia, Aotearoa (New Zealand), Canada, the United States of America, and Central America. Although we come from different countries, we share observations and experiences of disadvantage in the social and cultural determinants of health faced by our communities, clans, and Nations. Likewise, we share observations and experiences of transformations and overcoming disadvantage through the application of our Indigenous knowledges, skills, strengths, and resilience. These transformations fuel our resolve and commitment to continue the work of dismantling oppressive practices in the nursing profession. Never has the ongoing impact of neo-colonialism been more apparent than in the higher rates of mortality and morbidity for Indigenous Peoples than during this global pandemic (Power, Wilson, et al., 2020). Zoonotic diseases such as COVID-19 (Austin, 2021), recent loss of biodiversity and wildfires stem from the capitalist-driven destruction of the natural world introduced by ‘imperial and colonial structures’ (Lambert & Mark-Shadbolt, 2021, p. 368; Long et al., 2021). Change is occurring as a result. There is growing recognition by governments and the general public that Indigenous knowledges, and ways of being and doing, such as cultural burning practices by First Nation Australians and Native American Tribes to manage environments, provide ‘solutions to prevent or mitigate future disasters’ (Lambert & Mark-Shadbolt, 2021, p. 368; Long et al., 2021). Likewise, Indigenous authorities guiding the development of Cultural Safety in curricula and healthcare is necessary to end societal, institutional, and interpersonal racism in health systems; improve Indigenous Peoples access to culturally safe healthcare; and, achieve equitable outcomes for education, health, and wellbeing (Best, 2021; Geia et al., 2020; Power, Geia, et al., 2020; Sherwood et al., 2021). Dr Irihapeti Ramsden (2002, p. 1), the architect of Cultural Safety, maintained that understanding ‘historical, social, educational, physical, emotional and political influences’ are critical to developing and embedding Cultural Safety constructs into nursing and midwifery. ‘Cultural Safety originated from the Māori response to difficulties experienced in interaction with the western based nursing service’ (Ramsden, 2002, p. 110). Our collaboration builds on Ramsdens’ work and like Ramsden, we aim to address the deep inequities and difficulties in western-based nursing and midwifery services and workforce in our respective countries and across the globe. In response to the gross disparities in health outcomes between Indigenous and non-Indigenous people, and a lack of parity in nursing and midwifery workforces, Cultural Safety is increasingly being mandated through legislated standards, codes and guidelines for the nursing and