Cultural immersion enhances nursing skills: a desire to strengthen her cultural safety skills led a Canadian nursing student to New Zealand to participate in an international practicum.

Ko te mea tuatahi, ko te mihi ki a Io taketake. (The first acknowledgement is to God, m whom all things derive.)

Ka whakahonoretia te Kingi Maori, a Tuheitia, me te Kahui Ariki nui tonu. (I pay homage to the Maori King and the Royal family.) Pai marire! (It is good! It is peaceful!)

Ki a tatou nei mate o nga kokonga katoa o te motu, haere, haere, hoki atu kautou ki te kainga tuturu mo tatou katoa! (To those who have passed away, throughout the whole of the nation, journey on, in spirit, towards the eternal home awaiting us all!)

Kaati! Te hunga mate ki a ratou! Te hunga ora Ida tatou! (If I may now turn my attention away from the deceased to those of us, the living!) E nga reo, e nga mana, e nga karangatanga maha. (Greetings to the distinguished people.)

Ko Danielle Newson taku ingoa. (My name is Danielle Newson.) Ko nga pae Maunga Pohatuhatu o Kanata te maunga. (The mountains west of my home are the Rocky Mountains.) Ko Awa Pewa te awa. (My river is the Bow River.) Ko Calgary, Alberta, taku taone noho. Heoi ano, i whanau ke ahau i British Columbia. No Kanata ahau. (I live in Calgary, Alberta, but was born in the west coast province of beautiful British Columbia, Canada.)

Ko Trevor raua ko Christine oku matua. (My father's name is Trevor and my mother's name is Christine.) Ko Devon taku tungane, engari kua mate ia. (My younger brother's name is Devon, who has passed away and lives with us in spirit.) He nehi tauira ahau e ako anai raro i Te Kuratini o Waikato me etehi atu. (I am a fourth-year nursing student who studied with the Waikato Institute of Technology and Hauraki Health Providers.)

Deciding to spend my final clinical practicum in Aotearoa New Zealand early last year was one of the best decisions I made as a nursing student. Not only did the experience enhance my cultural self awareness, it also allowed me to gain vast insights into how I functioned, both professionally and personally. Taking part in an international practicum is something I would highly recommend to other nursing students.

My placement was organised through the Waikato Institute of Technology and Athabasca University in Alberta, Canada, where I was completing my nursing degree. For ten weeks, I worked in community mental health nursing (CMHN), based at the Manaaki Centre in Thames. My main objective was to develop and enhance culturally safe nursing skills while focusing on Aotearoa New Zealand's indigenous Maori culture.

Immersing myself within a different culture enhanced my cultural self awareness. A 2005 study of international student nursing placements states, "there was no change in students' ethnocentrism if the experience did not include immersion into the cultural groups ..." (1) I believe this was true of my experience. In the future, I plan to travel further and work in other cultures different to my own. I will take with me the valuable culturally safe nursing practice skills I learnt in Aotearoa New Zealand, using and expanding on them. For my practice, this will be essential in terms of offering the best quality care to health care consumers.

Culturally safe practice in Aotearoa New Zealand is defined as, "effective nursing practice of consumers and/or their whanau (family) from another culture, which is determined by that consumer or whanau". (2) Such effective practice encompasses the principles of Te Tiriti O Waitangi and Maori health. Te Tiriti is the nation's founding document and its three articles outline the Crown's duties and obligations. Within the health sector, key treaty principles include partnership, participation, protection and self-determination, which need to form the basis of interaction between nurses and Maori consumers or clients. (2) I came to appreciate these principles as a valuable set of guidelines to assist in providing culturally safe care, together with Maori. This is because the principles enable health professionals to prioritise and strengthen culturally safe practice within nursing and overall health care. I experienced examples of the principles in practice while working with CMH nurses from the Manaaki Centre.

Accompanying my preceptor and one of our clients on a visit to a marae was particularly meaningful. This client had been concerned about hallucinations he'd had of his tupuna. The nurse helped him normalise these experiences and thus reach a state of healing and acceptance. Accompanying another client to a traditional Maori healer and then incorporating the healer's directions into the client's care plan helped me understand the principles in action. By acknowledging and honouring Maori beliefs and values, the nurse was able to uphold the principle of protection, showing how to work with clients effectively and collaboratively.

I chose CMHN as I was attracted to mental health and interested in community nursing practice. I believe this is where I can best support individuals, families and communities to attain or maintain their optimal health and well-being. Professionally, this practicum consolidated my aspirations to build a future career working within communities, most likely in the area of health promotion and illness prevention. It has also sparked an interest in applying what I have learned about culturally safe practice, specifically with Canada's indigenous population.

The international experience challenged me to discover further ways to take care of my own emotional, spiritual, physical, and mental health and well-being. The highlights of my trip were all the amazing activities, eg fishing, tramping, surfing and, dolphin and whale watching. Most of all, I will treasure my memories of the wonderful people I met along the way.

I would like to thank those who made this practicum possible, especially the staff at Manaaki Centre, Wintec, and Athabasca University. Special thanks go to Maureen Mitchell (Calgary), Angela Stewart (Wintec), and my brilliant CMH mentors Ora Guptill (Coromandel), Althea Hill (Waihi) and Jannine Hey (Whitianga). I also thank Hone Thompson at the Waikato District Health Board for help in writing my mihi.

References

(1) Caffrey, R.A., Neander, W., Markle, D. & Stewart, B. (2005) Improving the cultural competence of nursing students: Results of integrating cultural content in the curriculum and an international immersion experience. Journal of Nursing Education; 44: 5, 234-240. Retrieved 28/03/08 from CINAHL with full text database (www.cinahl.com).

(2) Nursing Council of New Zealand. (2002) Guidelines for cultural safety, the Treaty of Waitangi, and Maori health in nursing and midwifery education and practice. Retrieved 20/03/08, from CINAHL full text database (www.cinahl.com).