Outline and mihi l Mihi/Acknowledgement: Irihapeti Ramsden, Nursing Council of NZ, EIT Hawkes Bay,...

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Transcript of Outline and mihi l Mihi/Acknowledgement: Irihapeti Ramsden, Nursing Council of NZ, EIT Hawkes Bay,...

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Slide 2 Outline and mihi l Mihi/Acknowledgement: Irihapeti Ramsden, Nursing Council of NZ, EIT Hawkes Bay, Pearson Education. l New Zealand context l Brief history of cultural safety in New Zealand l Cultural awareness, cultural sensitivity and cultural safety Slide 3 Outline (contd) l Journey of an indigenous woman to produce Cultural safety in Aotearoa New Zealand. l Lessons I have learnt in terms of cultural knowledge and the broad based concept adopted by the NCNZ. l Cultural competence, cultural security l Behaviourist debate l Ways of addressing relevant issues Slide 4 New Zealand context l With over a thousand years of human settlement its history is dominated by the relationship between Maori (indigenous people) and Pakeha (European descendants) Slide 5 The Treaty of Waitangi l The Treaty of Waitangi was signed in 1840 between the Maori chiefs and representatives of the British Crown. l Contains 3 articles guaranteed Maori certain rights and privileges including the protection of their customs, land, forests, fisheries and health. Slide 6 Treaty of Waitangi (contd) l The Treaty has always been the reference point from which Maori people have negotiated with the Crown for self determination over their resources. l The Treaty provides the reference point therefore for cultural safety in New Zealand. Slide 7 Cultural Safety l 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 safetywhat about cultural safety? Slide 8 Definition l Simply put cultural safety is defined by those who receive the service (1996) l The term Kawa Whakaruruhau is also used which was developed by Irihapeti Ramsden. Slide 9 Cultural safety l Cultural safety is well beyond cultural awareness and cultural sensitivity. l It gives people the power to comment on care and to be involved in changes in where their experience has been negative. Slide 10 The process towards achieving cultural safety l 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. Slide 11 Cultural sensitivity l 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. Slide 12 Cultural safety is an outcome of nursing and midwifery education that enables safe service to be defined by those who receive the service. Slide 13 Founding concepts l The inter-dependence of culture and ethnicity l The Treaty of Waitangi and Te Tiriti o Waitangi l Sociological concepts such as power Slide 14 Evolving nature of cultural safety l Collaboration of stories from health professionals, educators and commentators l Always mindful that the pain of the Maori experience of poor health provided the catalyst for cultural safety Treaty based Broad based Slide 15 Related 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 Slide 16 The behaviour debate l Is it to be assumed that one can perform a value? (Cairns, 1992) l Human action is nothing but behaviour Or l Human action is something that excludes behaviour l So how do you measure attribute acquisition by individuals? Slide 17 l Attributes such as empathy, patience, creativity, honesty, respect and compassion do not lend themselves to simple measurement l Solution: Devise competency standards that are restricted to describing knowledge & skills l Empathising with the patient can be assessed holistically in the workplace & above, beside and below l Adaptive learning vs generative learning Slide 18 l Specialised knowledge comes at a price l Self regulation vs externally imposed system l Legislation & governing/professional bodies regulates cultural safety practice in the same manner as ethical, legal and physical safety Slide 19 Cultural safety & Cultural competence or cultural security l Achieve certain competencies to become safe Or l Achieve certain safety milestones to become competent Slide 20 Where to from here? l Beginning step towards stimulating critical thinking about the taken-for-grantedness in the health professions l Lessons learnt from the nurse-patient relationship in Aotearoa New Zealand can help inform new learning in countries outside New Zealand Slide 21 Whakatauki / 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 Slide 22