Cultural safety is not about saying "sorry" for being a white nurse

OPINION: The idea that Australian nurses and midwives are now required to verbally acknowledge their white privilege is straight up not true, writes Summer May Finlay.

Commentators are hitting back over nurses and midwives' "white privilege" in Code of Conduct.

Commentators are hitting back over nurses and midwives' "white privilege" in Code of Conduct. Source: NMBA

If you have seen the news or had your eye on social media recently, you wouldn’t of been able to avoid the overreaction by right-wing commentators about the Cultural Safety guidelines in the new   for Australian nurses and midwives.

Following a sensationalised report from Channel 7's  introduced as, "The contentious new code telling nurses to say 'sorry' for being white when treating their Indigenous patients", Senator , Graeme Haycroft (Nurses Professional Association of Queensland), Peta Credlin (Sky News) and political commentator,  (none whom, I might add, are experts on Cultural Safety), have been promoting the idea that white nurses and midwives are now required to verbally acknowledge their white privilege.

As someone who is Aboriginal and works in public health, let me set you straight up - they don’t.

This is just a complete media beat up, at the expense of Indigenous peoples lives. Yet again.

So where did all this start? The new Codes of Conduct state that care for Aboriginal and Torres Strait Islander patients’ needs to be Culturally Safe, and outlines what that means in practice. What the Codes ask of nurses and midwives is not anything that even resembles proclaiming, “I acknowledge my white privilege”, before they treat their patients.
Nursing Midwifery Board's Codes of Conduct
Nursing Midwifery Board's Codes of Conduct (Nursing and Midwifery Board of Australia) Source: Nursing and Midwifery Board of Australia
The Codes do include, however, at the back, a definition of Cultural Safety in the glossary which is what has caused the furore. In defining ‘Cultural Safety’, the critical component of this concept is an individual’s ability for self-reflection. A self-reflection seeking to understand how their culture and beliefs influence their attitude towards clients of different cultural backgrounds, and how this can impact their practice. This includes acknowledging ‘White Privilege’.
Nursing Midwifery Board's Codes of Conduct
Nursing Midwifery Board's Codes of Conduct (Nursing and Midwifery Board of Australia) Source: Nursing and Midwifery Board of Australia
And just so we are clear on what the word “acknowledgment” means, given that it is this word which has caused such a debate, the Cambridge Dictionary as, the fact of accepting something that is true or right. It does not say that anything has to be verbalised for an acknowledgement to occur.

Now, the concept of white privilege is what has really caused all the fuss. So what is it?

White privilege is many things. Firstly, it's a term that gained wide popularity in the 1980s through the work of academic, Peggy McIntosh called ''. White privilege isn’t something that people consciously use, it's silently pervasive and it permeates through institutions. It’s about the distribution of power based on race. It's about the many privileges society gives white people because their race is considered 'the norm'.
White privilege isn’t something that people consciously use, it's silently pervasive and it permeates through institutions.
It's about believing what is good for white people, must be good for other people. White privilege is built on the foundation that western culture is “normal”, and is therefore better, and other cultures are exactly that - "other".
In our society, systems are set up by white people to align with their values and expectations. For example, when told about "civilisation", white folk are shown that people of their colour made it what it is; white students can be sure to be given curricular materials that testify to the existence of their race; white folk can turn on the televisions, buy a magazine, see a move or open a newspaper and see their race widely represented; if a white person's day or week is going badly, they do not need to question whether each negative episode or situation had racial overtones. 

One of McIntosh's (who is a white woman)  identifiers is: I can be sure that if I need legal or medical help, my race will not work against me.    

Aboriginal and Torres Strait Islander peoples have than other Australians. This is an undeniable truth. Racism and unconscious bias, as much as people want to deny, does impact peoples care. This is not new news.

Australia’s National Institute for Aboriginal and Torres Strait Islander Health Research the  has published research which links racism and health outcomes. Racism in health care was acknowledged as an issue in the  launched by the previous Labour Government. It is also addressed in the Liberal Government’s . We can’t hide from the truth of because it might make people uncomfortable. Aboriginal and Torres Strait Islander people’s lives are too important.

We can’t dig out heads in the sand and say that don’t have a role to play in combating racism and inequality. Nor can we say all people are and should be treated the same, because it's just not true. Many white mothers, for example, have the privilege of in the way that Aboriginal mothers are.
Many white mothers, for example, have the privilege of not being judged for their parenting capabilities in the way that Aboriginal mothers are.
When it comes to health care in Australia, acknowledging white privilege is also about understanding that Aboriginal and Torres Strait Islander people may have different cultural values to the mainstream West. And not assuming that as a non-Aboriginal and Torres Strait Islander person, the way you want to be treated is the way everyone else wants to be treated. It’s about making sure that you don’t place judgements on someone for wanting to be treated differently.

We live in a world where people are different, and therefore people’s needs a different. That's why in a hospital, it's common that some might require an interpreter because English is not their first language. Or that out of respect for an older person, we might call them "Mr" or "Mrs", instead of by their first name. We appreciate that many women want to see a female doctor, particularly for women’s health issues. And we recognise that often men feel more comfortable talking about prostate cancer and potential complications of surgery with another man. We appreciate and accept that these differences, which require health practitioners to behave differently with different people while they deliver a vital service in our community. 

Why then do the public, who benefits from these kinds of cultural protocols, get upset as soon as another kind culture is mentioned? Why is it that it's acceptable to treat people differently based on age or gender, but not cultural heritage?

The health care system is made up of people. People who bring their own beliefs and attitudes as, well as unconscious bias. It’s important for people to reflect on their practice and on how white privilege may impact that practice. This is 'Cultural Safety', and it's a philosophy backed by research.  

I suggest anyone wanting to have the facts simplified (before they address national media), to take a look at Dr  summary:
Five Facts about Cultural Safety
Five Facts about Cultural Safety (Twitter / @DeSouzaRN) Source: Twitter / @DeSouzaRN
Summer May Finlay is a Yorta Yorta woman, academic, writer and a public health consultant. Summer has worked in a number of different areas relating to Aboriginal health and social justice. Follow Summer  


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7 min read
Published 28 March 2018 4:04pm
Updated 28 March 2018 4:29pm


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