What is cultural safety What is its relationship with cultural awareness and cultural competence?

Cultural safety is a concept that emerged in the late 1980s as a framework for the delivery of more appropriate health services for the Maori people in New Zealand. More recently it has become recognised that the concept is useful in all health care settings - not just those involving Indigenous peoples, eg. Maori, Aboriginal and Torres Strait Islander peoples. A commonly used definition of cultural safety is that of Williams (1999) who defined cultural safety as:

• an environment that is spiritually, socially and emotionally safe, as well as physically safe for people; where there is no assault challenge or denial of their identity, of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience of learning together (p.213).

Culturally safe practices include actions which recognize and respect the cultural identities of others, and safely meet their needs, expectations and rights. Alternatively, culturally unsafe practices are those that “diminish, demean or disempower the cultural identity and well-being of an individual” (Nursing Council of New Zealand 2002, p. 9).

An important principle of cultural safety is that it doesn’t ask people to focus on the cultural dimensions of any culture other than their own. Instead, cultural safety is primarily about examining our own cultural identities and attitudes, and being open-minded and flexible in our attitudes towards people from cultures other than our own. Identifying what makes someone else different is simple - their English isn’t very good or they don’t do things in the same way as others (Morris 2010). Understanding our own culture, and its influence on how we think, feel and behave is much harder. However, in the increasingly multicultural environments in which we all live and work, the importance of being culturally safe in what we do cannot be underestimated.

Strategies that enhance the ability to be culturally safe include:

• reflecting on one’s own culture, attitudes and beliefs about ‘others’
• clear, value free, open and respectful communication
• developing trust
• recognising and avoiding stereotypical barriers
• being prepared to engage with others in a two-way dialogue where knowledge is shared
• understanding the influence of culture shock

The process toward achieving cultural safety in practice

The process toward becoming culturally safe includes three key elements: Cultural awareness, cultural sensitivity and cultural safety. Although these are related concepts, it is important to understand that they are not the same as each other. All need to be achieved to be in a position to negotiate culturally safe interactions with others. A practitioner who can understand his/her own culture and the concept of transfer of power between dominant and less dominant groups can be culturally safe in a number of contexts.

Strategies that can enhance the ability to undertake culturally safe interactions with others include:

• Reflecting on self, one’s own culture and profession, power imbalances, attitudes and beliefs about ‘the other’
• Applying basic communication skills
• Developing trust
• Actively negotiating knowledge and outcomes through bi-cultural relationships with others
• Understanding the influence of culture shock

Eckermann, A-K, Dowd, T. & Jeffs, L. (2009). Culture and nursing practice. In J. Crisp & C. Taylor, (Eds.), Potter and Perry’s Fundamentals of Nursing, 3rd Ed., (pp. 118-124). Mosby: Sydney.

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References

Williams, R. (1999). Cultural safety – what does it mean for our work practice? Australian and New Zealand Journal of Public Health, 23(2), 213-214.

Nursing Council of New Zealand. (2002). Guidelines for cultural safety, the treaty of Waitangi, and Maori health in nursing and midwifery education and practice. Wellington: Nursing Council of New Zealand.

Cultural safety is about creating an environment that is safe for Aboriginal and Torres Strait Islander people. This means there is no assault, challenge or denial of their identity and experience.

Cultural safety is about:

• Shared respect, shared meaning and shared knowledge
• The experience of learning together with dignity and truly listening
• Strategic and institutional reform to remove barriers to the optimal health, wellbeing and safety of Aboriginal people. This includes addressing unconscious bias, racism and discrimination, and supporting Aboriginal self-determination
• Individuals, organisations and systems ensuring their cultural values do not negatively impact on Aboriginal peoples, including addressing the potential for unconscious bias, racism and discrimination
• Individuals, organisations and systems ensuring self-determination for Aboriginal people. This includes sharing power (decision-making and governance) and resources with Aboriginal communities. It's especially relevant for the design, delivery and evaluation of services for Aboriginal people.

Key elements of culturally safe workplaces and services 

Knowledge and respect for self: Awareness of how one's own cultural values, knowledge, skills and attitudes are formed and affect others, including a responsibility to address their unconscious bias, racism and discrimination.

Knowledge and respect for Aboriginal people: Knowledge of the diversity of Aboriginal peoples, communities and cultures, and the skills and attitudes to work effectively with them.

A commitment to redesigning organisations and systems to reduce racism and discrimination: Strategic and institutional reform to remove barriers to optimal health, wellbeing and safety outcomes for Aboriginal people.

Cultural safety is an ongoing learning journey: An ongoing and response learning framework that includes the need to unlearn unconscious bias and racism and relearn Aboriginal cultural values.

Why is cultural safety important?

Cultural safety is a fundamental human right. It's also a legislative requirement of public agencies to provide safety in the workplace.

The workplace environment, services and settings for health, wellbeing and safety must be culturally safe for all people.

For a fair and equitable society free from racism and discrimination, we must address the underlying causes of culturally unsafe practice.

Everyone's responsibility?

Everyone has a responsibility for the cultural safety of Aboriginal people in their organisation. Everyone is responsible for how they work with Aboriginal staff, health consumers and clients of community services.

Aboriginal and Torres Strait Islander cultural safety framework 

The Aboriginal and Torres Strait Islander cultural safety framework has been developed to help mainstream Victorian health, human and community services and the department to create culturally safe environments, services and workplaces.

The framework provides a continuous quality improvement model to strengthen the cultural safety of individuals and organisations. 

It aims to help the department and mainstream health, human and community services to strengthen their cultural safety by participating in an ongoing learning journey. 

We would like to acknowledge the following people and groups for their contribution to the early conceptualisation of the framework:

• Professor Gregory Phillips, CEO, ABSTARR Consulting
• DHHS Aboriginal employment subcommittee
• DHHS Aboriginal Staff Network
• DHHS Pilot Groups. 

For a copy of the Aboriginal and Torres Strait Islander cultural safety framework, please email .

Cultural competence refers to understanding and interacting respectfully with people of other cultures, along with developing relationships and collaborations that exceed the sum of their parts.

As demand for online cultural competency training grows exponentially, it presents an opportunity to explain why cultural awareness promotes cultural safety – and the difference between the two terms.

What is Cultural Safety?

The core difference between cultural competence and cultural safety is that the latter goes beyond cognition and acknowledgement.

In a workplace, cultural safety means that Aboriginal and Torres Strait Islander people are in an inherently safe and protected environment.

Individuals benefit from shared appreciation, knowledge, and experience, with active listening to overcome barriers to inclusion and empower teams to grow and develop together.

Principles of Cultural Safety

To implement a culturally safe climate, managers need to generate pathways to positively recognise and celebrate the diversity of cultures within their organisations.

There are variances between:

• Cultural sensitivity: a grasp and knowledge of cultural differences.
• Cultural awareness: a greater depth of understanding about divergent cultural identities.

Before a team can become culturally safe, it must first be culturally competent, as the initial building block in a foundation where every person can contribute.

The Importance of Cultural Competence

Many Australian companies, groups, clubs, and businesses will have a diverse range of individuals with varying racial and ethnic backgrounds.

However, we must appreciate that cultural competence does not solely apply to corporate environments and is necessary for all aspects of our lives, both personal and professional.

The value of cultural competence is that it gives us the tools to create dialogues and truly engage with one another, rather than co-existing with others we haven’t taken the time to understand.

A lack of basic cultural competence risks miscommunication, bias (systemic and endemic) and disengagement.

Putting some effort into learning cultural competence aptitudes is a powerful way to avoid these problems and ensure everybody has the opportunity to succeed, engage and perform their roles effectively.

Advantages of Cultural Competence in the Workplace

There are many situations where cultural competence can profoundly impact the end outcomes, whether removing language barriers, appreciating traditions, or respecting different approaches.

Some of the primary benefits include:

Broadened Skills and Lived Experiences

The wider the range of knowledge, talents and perspectives within the workplace, the more innovative the results, with better problem-solving capacity.

Where teams have diverse make-ups, there is increased potential to resolve issues with unexpected and dynamic ideas to push progress forward.

Market Expansion Prospects

Businesses equipped to communicate and engage with diverse location cultures have improved prospects for global market expansion.

A culturally competent company can use that knowledge to inform their approaches, promotions, language, and development to appeal to customers in a respectful, positive, and successful way.

Enhanced Collaborations

Managers and leaders who advocate for the advantages of cultural competence are positioned to reap the rewards of strong connections, coordinating work between clients and co-workers.

Inclusive teams with diverse representation and culturally competent communications achieve higher productivity and make decisions significantly faster.

Higher Workforce Motivation

Staff turnover and retention rates can be an extremely difficult challenge for businesses. 

Where colleagues are seen, respected, heard, and given a voice to participate fully, they are far more likely to be satisfied with their role and wish to continue contributing.

Making cultural competence a priority is also beneficial to employees looking to augment their self-awareness as a life skill they will retain for the long term.

Employees can harness cultural competence training to feel more confident in their dialogues, producing strong relationships and greater creativity.

How to Become Culturally Competent

Cultural competence is a resource we apply when meeting new people or in different environments, with the openness to respect worldviews.

Leaders in the workplace can take proactive steps to embrace the value of cultural competence by working through the following stages.

Evaluating Cultural Competence 

The first place to begin is to collate feedback and conduct surveys to assess employee experiences and views on the cultural competence displayed by managers and colleagues.

It is also important to understand the make-up of the workplace and develop policies that emphasise the importance of diversity and cultural competence.

Providing Training Programmes and Workshops

Training programmes and online learning effectively address gaps in cultural awareness, sensitivity and competence.

Developing Collaborative Opportunities

Communication breakdowns can thwart team-building opportunities. Developing collaborative working structures and projects helps form bonds and ensure employees of different cultures are included.

Incorporating Diversity Into Workforce Schedules

Every culture may have holidays or proportions of the day that have significance, so looking at time zones and holidays when organising meetings, events and projects will ensure inclusivity of globally and culturally diverse participants.

Forming a Foundation of Transparency

As a basis for cultural safety, the key to cultural competence is to ensure every individual feels comfortable and safe in sharing authentic experiences and thoughts about the workplace.

Regular meetings or feedback are valuable ways to identify any potential issues, including intolerance, prejudice or discrimination, that managers can address appropriately, backed by thorough cultural competence training.