Cultural safety: A vital element for nursing ethics

Abstract
This paper argues that the globalisation of nursing and the internationalisation of nursing education have lead to Western values being embedded into nursing curricula in nations where the cultural values and beliefs may be based in quite different philosophies. It argues for critical examination of assumptions underpinning ethics education in nursing and proposes that the principles of cultural safety need to be incorporated into ethics education to create a culturally safe ethic for both nurses and patients in a multicultural healthcare environment.

Keywords
ethics, cultural safety, nursing education, internationalisation

The internationalisation of nursing education
A significant contemporary phenomenon is the globalisation of the nursing workforce and the internationalisation of higher education in nursing (Allen & Ogilvie 2004). Although the large number of students studying out of their home countries may be a relatively recent phenomenon, the internationalisation of nursing education is not. Nursing education has been an ‘export industry’ since the inception of the professional era in nursing following the Nightingale reforms in the Western world in the 1880s.

In New Zealand, as in most nations, the origins of contemporary nursing practice and education lie in the work of Nightingale’s lady-pupils: her disciples who propagated her methods throughout the world dominated by the nineteenth century British Empire. Consequently, Western paradigms have been highly influential worldwide in the development of nursing practice and education. In Australia, for example, Dickson, Lock and Carey (2007) note that nursing education and practice “is framed by the values, beliefs and expectations of a dominant western culture, inclusive of theoretical and practice underpinnings from other first world English speaking countries” (p. 2). Western cultural perspectives and values, embedded in nursing education, practice and research have been exported to countries with different cultural perspectives and practices. They have been transported by nurses from countries in the Anglo-US axis who have worked overseas, including teachers and researchers, and many nurse leaders from non-Western nations have undertaken some of their education in English-speaking countries.  Cont.