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New Zealand is a bicultural country. The British crown and Maori people signed a document, since defined as the Treaty of Waitangi. It has influenced the health sector in providing better health care facilities. This essay will discuss three principles of the Treaty of Waitangi that are implicated in nursing. It will also consider the importance and affect of culture safety on the work of a nurse in practice. Moreover it will discuss the concept of self awareness and acknowledge how values affect the work of a nurse.
A treaty is defined as a formally signed binding agreement between two nations. The treaty of Waitangi is a written agreement between Maori and the British crown which took place in 1840 (Orange, 2001). There are English and Maori versions of this document Both Maori and the British crown guarantee protection of rights and control over resources. It is designed to establish new rights and obligation. In this document Maori have certain rights. The treaty Waitangi has three articles which outline the duty and obligation of the crown and the other treaty partner, which are Maori people. It agrees to partnership with Maori, to protect their own interests. It includes being responsive to the needs of Maori and this document ensures that Maori have equal opportunities in the health sector and other area (Durie, 2001).
The Treaty of Waitangi is a policy to protect Maori from the unfavourable effect of colonization. It also ensures them access to the benefit of the new society, because the Maori community are major user of health services and health must be recognised as a priority area (Nursing council, 2000). This document has three principles Partnership, Protection and Participation. In the context of nursing, Maori have the right to develop their health by using their authority and autonomy in managing their interest over health. The crown should recognise and accept the right of Maori to have control over their own knowledge and customs. They have the right to show their knowledge and choose strategies that will promote their well being. They can be independent in thinking and take action for safe management. According to this second principle of participation, nurses and patients can work together to improve health outcome by acting fairly and working together with common purpose for better health (Mckinney & Smith, 2004).
The Treaty of Waitangi gives an assurance for both nurse and patient that they will work together to preserve and improve better health outcomes. Protection is the most important principle for nurses in practice because it involves trying to protect Maori health status. It also ensures the servicers and delivery of health is done in an appropriate way. Nurses and midwifes must respect and protect Maori beliefs (Nursing Council, 2009).
According to New Zealand health strategy inequalities are reducing in health status is reduced by ensuring health services for all groups of Maori and Pacific people those are really accessible. People are encouraged to adopt a healthy and safe lifestyle by reducing bad habits and improving nutrition and increasing physical activities. Better physical, mental and social health has been improved through the reduction of the incidence disease, injuries and mental illness due to nursing management in New Zealand (King, 2000).
In New Zealand the Maori community has experienced harmful diseases due to colonization and economic inequalities. The Treaty of Waitangi lays a foundation that can guide nurses in the safe and equal care. This has resulted in the improvement of health outcomes for the Maori community. The Crown is working with Maori in partnership to improve health. One example is rheumatic fever. This was found rarely in New Zealand however, it affected the Maori population more because of unhealthy living conditions. The treaty of Waitangi empowers the Maori population to take command of their health outcomes and to co-operate with the health sector in determining what safe and healthy practices are. The result has been Maori initiatives working in this area to try to achieve better outcome to fight against the disease better living conditions and rapid treatment have been helping (Levien, 2008).
"Cultural safety is the effective nursing or midwifery practice of a person or family from another culture and it is determined by that person or family" (Scryymeour, 2009, p 94). New Zealand is a bicultural country and it is important for a nurse to understand cultural differences. One essential aspect of cultural safety is personal identification of attitudes that an individual may have towards a person or a group of people who may be different from the nurse. The nurses are expected to practice in a manner that the client determines as being culturally safe. Nurses should be aware about patient's culture in order to improve the health status of patients. This would ensure that nurses working for a health care facility would have respect and honour for cultural differences (Hally, 2009).
Nurses and doctors can be in positions of power and authority in a health care situation. They are expected to have knowledge about human diseases and the correct treatment for them. However addressing health issues should be a partnership between patient and carers. Therefore it is important for the carers not to assume they know the best in any situation. The patient's thoughts, attitudes and beliefs must be taken into account. Nurses need to be aware that differing cultural beliefs and values may affect the way a patient would wish to be treated. Nurses have an obligation to provide care realising that it is the patient, not the nurse, who decides whether the situation is culturally safe or not. In other words, it is the nurse's responsibility to maintain cultural safety for the patients because it is important for nurses to protect themselves from differences and not raise barriers to culturally safe care (Cortis, 2000).
Nurses should engage in culturally safe practices by knowing primarily his/her own culture (Nursing Council of New Zealand, 2005). A nurse, who is aware of their own culture and beliefs, can appreciate the need to be culturally safe in caring for others. This concept is fundamental to showing respect towards other's custom or values because unsafe practices can affect the patient's emotional health and can demoralize or disempowering the patient. In the nursing context a nurse who is working in a culturally safe manner can be a good promoter or role model for patients and co -worker (Richardson et al., 2009).
In order to achieve cultural safety there should be awareness of people's cultural values within emotional, social, economical and political context. There should be cultural sensitivity by being alert to differences and identifying with them because a nurse's own experiences can have both negative and positive impact in nursing. A nurse should realise that it is important to acknowledge his or her own culture, because he or she, like every other individual, is unique (Papps, 2005).
In New Zealand nursing, it is good for a nurse to accept cultural differences, attitudes, beliefs and diversity, but also to realise that these may be a barrier to other people. Maori society has their own beliefs and custom which they feel will help to keep them free psychologically and physically from harm. Generally the Maori population has poorer health status so they need more attention than other members of society. Sometimes nurses encounter some difficult situation in caring due to their cultural values where stereotyping may cause difficulty for the nurse because many Maori look European, but they may not be so knowing about the patient is very important. A nurse cannot assume a patient will conform to a certain set of cultural beliefs just because a patient looks as though they belong to a particular culture. In Maori culture according to their beliefs, like burning or throwing away hair returning body parts to the client are important practical issue may which influence the nursing care in the form of cultural safety (Scryymeour, 2009).
Self awareness and knowledge of values affecting the practice of nurse in the health sector, is important. Culture has both positive and negative effects. It includes values, beliefs, skills and attitude during nursing practise. These may affect a person in both negative and positive ways. Self-awareness makes a nurse confident and helps her to relate to other people with differences. It helps his or her to take action in any situation because nurse can respect others beliefs and values by understanding their own values and attitudes because it is impossible to replace values (Jack & Smith, 2007).
Sometimes nurses start to judging patients and caring for them according their own values which may harm their spiritual and emotional status. In nursing practise a patient believes the nurse, so nurse should behave to the patient with proper knowledge about her own skills and other beliefs and values rather than be prejudiced and stereotype because it is not necessary that patient would have the same spiritual or cultural values and same community feeling which the nurse has (Tate, 2003).
In nursing homes and hospitals, different people come from different communities, religions or race with different beliefs so nurses should avoid racism or superiority to their own culture or race because it can harm patients feeling and can leave negative impact on their well being. It is good for a nurse to work acknowledging their own knowledge and their own values but sometimes he or she have to care for people with different values. So he or she should be a good cultural bearer to save themselves from conflict because patient care and safety is the priority in nursing practise (Jack & Smith, 2007).
Nurses own values shape his or her professional values. These professional values are necessary for nurse to be competent in practice and patient caring. Some values are very important in nursing care such as having a compassionate humanistic manner. These values increase the power of the practitioner to understand meaning of life. Nurses' own values make them strong to face problems in practice. If a nurse has knowledge about their skills and experiences, then he or she can create awareness in people, to promote health and work fairly in their own field. These types of knowledge help a nurse in decision making. As nursing profession is a sensitive profession and nurses are closely engaged with patients during care so clients expect to be good nurse for care in a respectful manner. Nurses own values can make them more reflective, realistic, and honest in their profession (Shih et al., 2009).
Finally, in the nursing profession the Treaty of Waitangi, cultural safety and issues relating to Maori health have being implicated for nursing practice. The Treaty of Waitangi and its principles support Maori health as this is a priority area where nurses can improve wellbeing and the life style of Maori by engaging them in decision making about their own health. Besides this, cultural safety plays a vital role in client caring because it influences the work of a nurse in coping with diversity. Moreover, in nursing practise a nurse can improve the physical and mental health of the client by understanding own beliefs, values, skills and attitude towards patients which empowers herself and her patients. It also promotes the people for beliefs on nurse in health sector that is very relate to them during care. Bi-culturalism acknowledge the part played by both nurse and client, in striving to achieve better health outcomes for all.