Health professionals might wish for a list of cultural “dos and don’ts” they can tick off when dealing with Indigenous clients, but there isn’t one.
Remembering that each individual is different is a central aspect of the cultural safety approach advocated by Ms Kerry Taylor of the Centre for Remote Health and Dr Pauline Guerin of the School of Nursing & Midwifery in Health Care and Indigenous Australians: Cultural safety in practice.
The new book is intended for health students and professionals who want to improve their practice in relation to Indigenous Australian clients. The non-Indigenous authors aim to “shift the focus from the usual expectations that the clients are the ones who need to change in order to achieve improved health outcomes to focus on changing healthcare professionals” according to Ms Taylor.
“A critical part of cultural safety is reflecting on your own practices, being mindful of the situation and being able to think carefully about your behaviour, and being sensitive to the possibilities,” Dr Guerin said.
While it is worthwhile to acquire an awareness of what might be different, such as the appropriateness of touching or the etiquette around entering a client’s house, it should not be treated as a checklist.
“Health practitioners have to think about how what they are doing is being received,” Dr Guerin said.
“The one thing that distinguishes cultural safety from other models, such as cultural competence, is that it is the recipient of the care who determines whether or not they feel safe in an interaction.
“It is not something that a supervisor can observe or approve.”
Dr Guerin said health professionals can unwittingly perpetuate the attitudes of colonisation.
“Health professionals automatically come with the power, authority and privilege inherent in that role, and health professionals need to be sensitive that this power is not used to diminish how someone lives their life,” she said.
The book provides numerous case studies and scenarios to illustrate cultural safety in action.
Taking case notes that conspicuously ignore a patient’s cultural explanations of a symptom or ailment, for example, indicates indifference, but is a practice that is easy to reverse.
“By writing down what the clients says, it signals that what he or she says is considered to be important and valuable,” Ms Taylor said.
And, says Dr Guerin, building a client’s trust and confidence is essential to successful treatment.