Clarifying Cultural Safety: its focus and intent in an Australian context

Abstract

The nursing/midwifery professions are facing a sea change with the inclusion of cultural safety in the Code of Conduct for Registered Nurses [Nursing and Midwifery Board of Australia. (2018a). Midwife standards of practice. Retrieved January 30, 2021, from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx], the Code of Conduct for Midwives [Nursing and Midwifery Board of Australia. (2018b). Code of conduct for nurses. Retrieved January 30, 2021, from https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards.aspx], the Registered Nurse Accreditation Standards (Australian Nursing and Midwifery Accreditation Council. (2019). Registered Nurse Accreditation Standards. Retrieved from https://www.anmac.org.au/), and the Midwife Accreditation Standards [Australian Nursing and Midwifery Accreditation Council. (2021). Midwife Accreditation Standards. Retrieved from https://www.anmac.org.au/standards-and-review/midwife]. In this paper, we focus on the theme of enabling cultural safety seeking to overcome the barrier of confusion surrounding it. The inclusion of cultural safety in codes and accreditation standards highlights the pressing need for these professions to attain deep understanding of cultural safety so that clinicians and educators can confidently practice and teach in this area. This need is underscored by the context of heightened awareness, that developed amongst mainstream Australians with Black Lives Matter in 2020, of inequity including health inequity. Our concern as academics responsible for staff development, curriculum development and implementation in university Schools of Nursing/Midwifery is to enable and support the teaching and practice of cultural safety. Its focus on working in partnership, addressing power imbalances, racisms and related systems of discrimination constitutes it as a vastly different model to cultural other-awareness and notions of cultural competency which have held sway on matters of culture in health service provision up to now. Our approach was to undertake a reflection on our combined decades of studying, leadership, teaching, and practice of cultural safety, which consistently showed the confusion in Australia about the model overall and about the definition of culture underpinning it. This paper supports the profession by addressing the need to educate academics and clinicians on cultural safety itself and on the role of all nurses/midwives, Indigenous and non-Indigenous, in these endeavours. This paper encourages a coherent development and confident implementation of cultural safety curriculum and practice to meet current requirements.