Northern Territory Aboriginal Health and Community Services Workforce Planning and Development
Strategy 2012
CULTURAL SAFETY
Cultural safety is a vital aspect of any organisation. The Services for Australian Rural and Remote
Allied Health (SARRAH) gives the following introduction to cultural safety in its online training
module.
The term cultural safety has been around for a long time but came to prominence in
academic circles in the 1980’s particularly through the work of a Maori nurse Irihapeti
Ramsden. Smith (2007) tells us that Cultural Safety is a philosophy of health care
that aims to improve the health of all indigenous peoples in first world colonised
countries, by providing culturally appropriate health care services.
Williams (2003, p3) describes cultural safety as having an environment: ’which is 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 with dignity, and truly listening’.
The Committee of Deans of Australian Medical Schools (CDAMS, 2004) has agreed
on the following description of cultural safety which separates the individuals (health
care professionals) and the systems delivering health care. ‘Ensuring that those
individuals and systems delivering health care are aware of the impact of their own
culture and cultural values on the delivery of services, and that they have some
knowledge of, respect for and sensitivity towards the cultural needs of others’.
The important point of these definitions is to understand that cultural safety is a
process and achieving it requires an acceptance and respect of cultural and
individual difference. Health professionals need to undertake a process of personal
reflection of their own cultural identity to enable them to recognise the impact that
their own culture has upon their health care practice (Nursing Council of New
Zealand 2002).1
Establishing cultural safety requires approaches which address both the institutional and the
individual aspects of health and community services care. Often the focus of cultural safety is on
health service delivery and the recipients of these services. Cultural safety is also crucial for
employees—particularly for Aboriginal people delivering services to other Aboriginal people in
conjunction with non-Aboriginal health care practitioners. Cultural safety is particularly relevant in
developing culturally appropriate processes and behaviour towards improved attraction,
recruitment and retention strategies.
1 Services
for Australian Rural and Remote Allied Health 2012,
<http://sarrahtraining.powersites.com.au/training/cultural_safety/index.html>. Other titles referred to in the
quote include: Ramsden, IH 1992,Cultural safety in nursing education in Aotearoa, at the year of Indigenous
peoples conference, Brisbane; Smith, JD 2007, Australia’s rural and remote health: a social justice
perspective 2nd edition, Tertiary Press, Melbourne; Williams, R 2003, Cultural safety—what does it mean for
our work practice? Northern Territory University, Darwin.
Cultural Safety
Page 1 of 3
Northern Territory Aboriginal Health and Community Services Workforce Planning and Development
Strategy 2012
Strategies and tools aimed at improving cultural safety toward more appropriate attraction,
recruitment and retention processes need to be multipronged. They need to address issues at an
organisational level and an employee level, from senior management to junior positions. They
also need to explore ways to better support existing and potential Aboriginal staff to enter and
thrive within their organisations.
Attraction and recruiting issues
It is very clear from both social marketing research undertaken at the national level 2 and through
stakeholder engagement in this project that Aboriginal people are far less likely to respond to
traditional attraction and recruitment mechanisms. Tailored approaches are needed, such as the
following.
Proactive and appropriate targeting of the potential workforce pool through existing
organisations. Clontarf and Stronger Smarter Sisters, for example, are already
‘connected’ to this potential workforce pool and can provide valuable guidance on
culturally appropriate processes.
Engagement with the school sector. The establishment of middle and senior school
scholarships and strategic participation in VET in Schools (VETiS) programs ensures a
‘value add’ component for all stakeholders. These programs give employers opportunities
to establish relationships with potential future workers. The programs help students
develop greater understanding of health care organisations, thereby preparing them to
enter this workforce.
The development of job application processes that are appropriate for potential
Aboriginal employees. Excessive ‘bureacracy speak’ may exclude some employees
from the application process. LLN requirements for the application and selection process
should not exceed what is required to demonstrate competence in the job role.
The exploration of recruitment strategies that match the target audience. Aboriginal
people are far less likely to respond to job advertisements than non-Aboriginal people. In
many cases, recruitment to a position results from ‘word of mouth’ and personal referral,
rather than printed advertisements.
Retention
Having non-Aboriginal staff who are culturally aware is crucial for cultural safety outcomes. This
means orientation and induction processes must include cultural safety training. Organisations
2
Department of Health and Ageing 2010, A report on developmental research to inform communications activities designed
to attract more Aboriginal and Torres Strait Islander secondary school students to work in health, prepared by ORIMA
Social Marketing.
Cultural Safety
Page 2 of 3
Northern Territory Aboriginal Health and Community Services Workforce Planning and Development
Strategy 2012
need to have a number of avenues and options whereby new and existing staff can develop and
maintain their cultural awareness and culturally safe practices.
Making sure all new employees receive cultural safety training is a challenge, especially in remote
areas where there is a high turnover of non-Aboriginal staff. Gaps may develop in an
organisation’s cultural safety program and practice. Some organisations have developed excellent
handbooks3, online modules4 and training programs5 and other resources6 to assist staff and
address these gaps. The practice of having cultural mentors for non-Aboriginal staff is also a
positive one.
Work is currently underway to establish a national framework to measure cultural competence in
health and wellbeing service delivery to Aboriginal and Torres Strait Islander people. This
framework will address cultural competence at all levels of organisations, and will include
measures to evaluate and improve cultural competence.
Organisations need a suite of cultural safety measures to ensure there are appropriate resources
and options to assist all relevant parties to develop their cultural safety skills. These parties
include: decision-makers who design policy and processes; staff in the field who work alongside
and manage Aboriginal staff; and Aboriginal staff themselves.
3
Remote Area Health Corps cultural orientation handbook, available for download at
<http://www.rahc.com.au/professionals/living-in-remote-aboriginal-communities/>.
4Service for Australian Rural and Remote Allied Health (SARRAH) cultural safety module
<http://sarrahtraining.powersites.com.au/training/cultural_safety/index.html>.
5 For example organisations like Indigenous Psychological Services who have developed a range of training
programs to support recruitment and retention of Aboriginal people. The program aims to better prepare and
support Aboriginal people in the workplace, and inform non-Aboriginal people who recruit, mentor or
supervise Aboriginal staff.
6 For example Smith, JD 2007, ‘Cultural perspectives’, in Australia’s rural and remote health: a social justice
perspective, 2nd edition, Tertiary Press, Melbourne. ‘The eleven principles for working effectively with
Australian Indigenous peoples’ were developed by Jacinta Elston, Tahnia Edwards, Regan Jane Smith and
Janie Dade Smith.
Cultural Safety
Page 3 of 3