The concept of cultural safety was developed in a First Nations’ context and is the preferred term for midwifery and nursing. Cultural safety is endorsed by the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), who emphasise that cultural safety is as important to quality care as clinical safety. However, the “presence or absence of cultural safety is determined by the recipient of care, it is not defined by the caregiver” (CATSINaM, 2014, p. 9).
Cultural safety is a philosophy of practice that is about how a health professional does something, not [just] what they do…. It is about how people are treated in society, not about their diversity as such, so its focus is on systemic and structural issues and on the social determinants of health….Cultural safety represents a key philosophical shift from providing care regardless of difference, to care that takes account of peoples’ unique needs. It requires nurses and midwives to undertake an ongoing process of self-reflection and cultural self-awareness, and an acknowledgement of how a nurse’s/midwife’s personal culture impacts on care.
In relation to Aboriginal and Torres Strait Islander health, cultural safety provides a decolonising model of practice based on dialogue, communication, power sharing and negotiation, and the acknowledgment of white privilege. These actions are a means to challenge racism at personal and institutional levels, and to establish trust in health care encounters. (CATSINaM, 2017b, p. 11)
In focusing on clinical interactions, particularly power inequity between patient and health professional, cultural safety calls for a genuine partnership where power is shared between the individuals and cultural groups involved in health care. Cultural safety is also relevant to Aboriginal and Torres Strait Islander health professionals. Non-Indigenous nurses and midwives must address how they create a culturally safe work environment that is free of racism for their Aboriginal and Torres Strait Islander colleagues (CATSINaM, 2017a).
CATSINaM, 2014, Towards a shared understanding of terms and concepts: strengthening nursing and midwifery care of Aboriginal and Torres Strait Islander peoples, CATSINaM, Canberra.
CATSINaM, 2017a, Position statement: Embedding cultural safety across Australian nursing and midwifery, CATSINaM, Canberra.
CATSINaM, 2017b, The Nursing and Midwifery Aboriginal and Torres Strait Islander Health Curriculum Framework (Version 1.0), CATSINaM, Canberra.