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Cultural Safety and Nursing Education in Aotearoa and Te Waipounamu Irihapeti Merenia Ramsden A thesis submitted to the Victoria University of Wellington in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing Victoria University of Wellington 2002 Table of Contents Abstract Acknowledgements Figures Tables Chapter One: Introduction Maori Nurse Recruitment and Retention Cultural Safety and Perspectives Ko Wai Matou? The Private Narrative He Huarahi Hou: A New Pathway He Whakawhanuitanga: The Public Narrative SECTION I: KO WAI MATOU? THE PRIVATE NARRATIVE Chapter Two: Early Years, the People and the Places Henrietta Merenia Manawatu Te Ra: 1918 - 1953 George Eric Oakes Ramsden: 1898 - 1962 Wellington: 1946 – 2001 Irihapeti Merenia Ramsden: 1946- Schools Chapter Three: Nursing New Graduate Team Building? Quality Assurance Expanding Horizons/Epiphanies Etcetera the bone people/The Spiral Collective Chapter Four: Community Health and Nursing Mokai Practice Issues and Ethical Dilemmas Borders and Frontiers Practice Examples Practice Example One: Informed consent on the border Practice Example Two: Doing things differently Practice Example Three: Establishing and maintaining trust Practice Example Four: The power of attitude Practice Example Five: Practice and research Moving On SECTION II : HE HUARAHI HOU : A NEW PATHWAY Chapter Five: Towards Cultural Safety Kawa Whakaruruhau: Maori Issues The Treaty of Waitangi Chapter Six: Learning and Teaching: Students as Teachers Practice Examples Practice Example One: Attitudes matter Practice Example Two: Recognising powerlessness and power Practice Example Three: Open-minded, self-aware Appointment to the Department of Education The Hui Waimanawa Origin of the Term Cultural Safety Chapter Seven: The Evolution of Cultural Safety Early Thinking/Conceptualisation 1988-1991 Refinement/Embeddedness 1992-1994 Political Turbulence/Public Commentary 1995-1998 Contemporary Cultural Safety/Re-Definement 1999-2001 Chapter Eight: Cultural Safety and Transcultural Nursing Comparisons and Contrasts The Redefinition of Cultural Safety SECTION III: HE WHAKAWHANUITANGA: THE PUBLIC NARRATIVE Chapter Nine: The Response to Cultural Safety Cultural Safety in the Wider Context The Appropriateness of Cultural Safety for Nursing and Midwifery The Response from Within Nursing and Midwifery Education Institutions The Nursing Council of New Zealand, the Media Response and the Select Committee Hearings 1990–1997 The Nursing Council of New Zealand 1990-1995 The Media Debates 1993-1994 The Select Committee Hearings 1995-1996 The Nursing Council of New Zealand Response 1995-1997 Practice Implications and the Continuing Evolution of Cultural Safety Chapter Ten: The Future of Cultural Safety Redefinition The term Cultural Safety Changing the name means changing the concepts Who Should Teach Cultural Safety Education of Cultural Safety Teachers and the General Public Multiculturalism Chapter Eleven: Conclusion Appendix 1: Biosketches Appendix 2a: Ethics Approval Letter Appendix 2b: Information Sheet Appendix 2c: Participant Consent Form Appendix 3a: Te Tiriti O Waitangi Appendix 3b: The English Translation of the Maori Treaty Text Appendix 3c: The Treaty of Waitangi – English text Appendix 4: Interview Schedule Appendix 5: Resolution to International Council of Nurses Appendix 6: Report on Education/Science Committee References