Cultural Safety: Beyond the rhetoric

Abstract

We acknowledge the sovereignty of Indigenous peoples across the Earth as the traditional custodians of Country, and their timeless and embodied relationships with cultures, communities, lands, waters, and sky. We pay our respects to Elders, past and present, particularly those who led the way, allowing us to realise our own calling to be healers. In this second iteration of a two-part special issue on Cultural Safety, we the Australian and Aotearoa New Zealand members of the guest editorial team would like to take this opportunity to draw attention to two contemporary examples of institutional racism in nursing and midwifery care in our respective countries. Despite decades of Indigenous activism, antiracism educational initiatives, and regulatory reforms, racism continues to be an endemic oppressive element in nursing and midwifery, and health systems. Despite Indigenous knowledges, anti-racism and Cultural Safety mandates being embedded in our professional standards and codes of conduct (Nursing and Midwifery Board of Australia, 2018; Nursing Council of New Zealand, 2011), we are forced to continue to interrogate the ongoing practice of culturally unsafe nursing and midwifery care. As a guest editorial team, we are also members of our Indigenous communities. We share the lived experience of family and community, of marginalisation, intergenerational trauma, and the profound bereavement of deaths from preventable health conditions. Statistics tell a narrative of deficit, of inequitable determinants of health and disproportion in our Indigenous health status compared to the mainstream population. As Indigenous nurses and midwives, we are also members of an international body of health care professionals where we have seen and experienced racism in our respective national health care systems. We bring witness to its complicit role in enacting direct and indirect trauma upon Indigenous peoples and their communities from culturally unsafe, and negligent nursing and midwifery practices. The examples of unsafe practices we share in this paper are to highlight our argument that systemic racism continues to go unchecked and reforms at leadership and policy levels are not addressing the issue with expedience.