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Senior nurses’ perceptions of cultural safety in an acute clinical practice area.

Sandra Richardson, RN, BA, Dip Soc Sci, Dip Hlth Sci (PG), Nurse Researcher, Canterbury District Health Board and Senior Lecturer, University of Otago, Christchurch

Tracey Williams, RN, PG Cert, Associate Clinical Nurse Manager, Emergency Department, Christchurch Hospital, Christchurch

Annette Finlay, Quality and Risk Co-ordinator & Privacy Officer, Nurse Maude, Christchurch

Marrilyn Farrell, Cultural Safety Educator, Nurse Maude, Christchurch

Richardson, S., Williams, T., Finlay, A., & Farrell, M. (2009). Senior nurses’ perceptions of cultural safety in an acute clinical practice area. Nursing Praxis in New Zealand, 25(3), 27-36.


Cultural safety is a concept that emerged within the New Zealand nursing context. The purpose is to ensure that nursing practice is congruent with the aims and objectives of the Treaty of Waitangi (the founding document between Maori and the Crown) and so facilitates the nursing of patients regardful of all that makes them unique and individual. While cultural safety has continued to develop since its inception in the 1980s, there remains relatively little research looking at its application in practice. This is due in part to the core element that recognises that only the recipient of care can determine if cultural safety has occurred. There are inherent difficulties in questioning patients about the quality of their care from a cultural safety perspective. One of these is the uncertainty around the public perception and understanding of cultural safety together with the implications of asking a vulnerable group to comment on this aspect of care. An alternative to asking patients to comment on whether they received culturally safe care is to consider the perceptions of health care professionals regarding this concept. This paper presents the results of a small study aimed at eliciting the beliefs and attitudes of a group of senior nurses with respect to the concept of cultural safety, and their perception of its role in clinical practice. It was undertaken as a preliminary to a wider survey.

Key Words: Cultural safety, attitudes and beliefs, senior clinical nurses, nursing perceptions.


Much has been written outlining the evolution of cultural safety, and identifying its role in relation to New Zealand nursing (Benham, 2001; Meyst, 2005; Papps & Ramsden, 1996; Richardson, 2004; Richardson & Williams, 2007; Wepa, 2001). This article explores the views of a small group of senior nurses working in an acute clinical area, with regard to the perceived relevance of cultural safety in clinical practice. It is acknowledged that only the patient has the right to identify whether cultural safety is present in an interaction, yet there are ethical concerns with asking patients to comment on this. While approaching patients is a necessary step, other preliminary measures can be undertaken to examine the nursing context and environment. One such measure is to explore the beliefs and perceptions practicing nurses hold regarding cultural safety.          ....Cont.