Trading on ambiguity.

I refer to the article published in your February issue entitled "Preparing for cultural safety assessment" by nursing lecturers Margaret Hughes and Tony Farrow (p12-14).

It is a pity an artificial distinction that reties on ambiguity is accepted when writing on cultural safety. The regardful/regardless dichotomy referred to in the article (from remarks made by cultural safety pioneer Irihapeti Ramsden) trades on the ambiguity inherent in the word "regardless", interpreting it in the worst sense possibite. This is insulting to the women who developed the oath historically said by nurses when they received their nursing medals that they would nurse people "regardless of their differences" This oath was a statement against prejudice, racism and bigotry. Used in this sense, "regardless" stems from compassion and means "we will not withhold care based on any prejudices." They were prepared to minister to friend or foe alike, on the battlefield or off. It would be honest to reframe the oath positively in keeping with the intention of those nursing pioneers who deserve our respect, not our misinterpretation and criticism. Setting up a straw position so it can be knocked down is becoming to no one.

Andrew Bennet, RN, Christchurch

Margaret Hughes and Tony Farrow reply: Andrew Bennet makes o good point in suggesting we should not ignore the past when we consider current nursing practice. Indeed the historical context in which the nursing oath was developed meant that it was important for nurses to be overt in their intention to minister nursing care in this way.

However, understandings of culture and power have developed since that time. Cultural safety recognises that nursing practice is laden with issues of power, and that recipients of care may have different experiences of that care, despite nurses" best intentions.

The move from "regardless" to "regardful" nursing does not set up a straw position as Bennet suggests, but rather develops the oath to recognise that people from different cultures may not wish to be treated the same as all others.