Understanding what it means to be culturally safe.

A PERSONAL reminder of what cultural safety is all about hit me recently during a family member's recent admission for day surgery. Following the intent of cultural safety innovator Irihapeti Ramsden's teachings, cultural safety is not only about nurses understanding the cultural nuances and norms of their patients, it is about encouraging your patient and, in this case, significant other, to express what they believe will keep them safe. They also need to express any fears that may hinder their recovery, especially fears around high-risk procedures. When a child is involved, this must also include the parents' or caregivers' views.

According to my beliefs and cultural norms (from hospital-based nurse training days), patients should never be wheeled to theatre in a "feet-first" position. This practice was reserved for the more unfortunate souls who had departed this world. Because of this belief and practice, I now request not to be transferred to theatre feet-first. When I have been the patient, as in the past, I have found myself quite "churned up" and uncomfortable on the occasions I have forgotten to request my bed to travel "head-first" to theatre.

When my son was recently transferred in this feet-first manner, the uncomfortable feelings and fears returned, including a superstition that travelling in this manner would bring bad luck in surgery. I wondered why I hadn't mentioned it to the nurse before my son left for surgery.

I believe nurses must be mindful of any pre-operative nerves experienced by patient and family, and encourage both to express any fears and superstitions they might have. When completing the initial pre-surgical assessment, nurses should try using a prompt sheet of questions to explore issues around patient/family beliefs and practices, to establish what will keep them feeling safe in our care. Be proactive and most importantly, understand what it means to be "culturally safe".

Liz Conroy, RGON

Wanaka

Co-editors note: In last month's issue we published a letter by Ketana Saxon entitled "Contact with Irihapeti Ramsden treasured" (p3). We have since received this response from Saxon: "While I respect the co-editors' right to edit letters, I wish to point out that, in my original letter, I referred to Irihapeti by her first name throughout and not as the edited form of "Ramsden". It may seem a minor point to most readers and common journalistic practice. However, I believe names to be very important and thus would never refer to a person for whom I had such deep personal respect by her surname, a practice I find impersonal and thus inappropriate to my letter."