Cultural safety: does the theory work in practice for culturally and linguistically diverse groups?

Culturally diverse refugee and migrant groups under-utilise health services in New Zealand and cultural barriers are cited as reasons for not using health services. According to the Nursing Council nurses are required to demonstrate competency in culturally safe practice, yet cultural safety is determined by the person receiving the care. This article critically examines the theoretical base of the cultural safety guidelines for nursing practice with respect to culturally and linguistically diverse (CALD) groups. Two key questions were posed: have the guidelines led to culturally safe nursing practice in health care for CALD groups, and have the guidelines contributed to provision of culturally acceptable health care for CALD groups? It is concluded that further theoretical consideration should be given to the conceptual basis for including CALD groups in the cultural safety model. The cultural competencies required for culturally safe nursing practice need to apply to the care of all culturally diverse groups present in New Zealand. Recommendations are made for strengthening the cultural safety model, and the registered nurse competencies for culturally safe practise.