Cultural Safety and Respectful Relationships
Cultural safety is a response to systemic and structural barriers and health inequities that have affected access to and quality of health care provided to First Nations, Inuit, and Métis peoples. First introduced into nursing education and practice in New Zealand, cultural safety seeks to address health inequities experienced by Indigenous peoples within all health care interactions and embodies principles of cultural humility, competency, and awareness.
Touted as a best practice, this model of care values and empowers minority and marginalized clients, including First Nation, Inuit, and Métis clients, and works to disrupt power imbalances and deeply held biases, attitudes, and practices expressed by health care providers to ensure a safe environment. It responds to the unique needs of clients by incorporating respect for their cultural traditions and identities, and accounting for the systemic and structural barriers that affect their access to and quality of care received. A culturally safe environment leads to respectful communication and patient-provider interactions, and ultimately better health outcomes for First Nations, Inuit, and Métis peoples. An environment is perceived as culturally safe environment by patients and clients, not practitioners and managers.
While originally conceptualized as a decolonizing model of practice and policy for Indigenous populations in a health care setting, the concept has since expanded to encompass other marginalized populations who may experience barriers to care, including those based on ethnicity, age, sexual orientation, religious beliefs, gender, and (dis)abilities. It has also expanded to other settings beyond the health sector where marginalized individuals may encounter racism or discrimination, including education, social work, employment, justice, corrections, and others.
To varying degrees, initiatives are being implemented across Canada and diverse sectors to ensure First Nations, Inuit, and Métis individuals experience cultural safety when interacting with mainstream systems. The NCCIH has prioritized cultural safety and respectful relationships as one of its key pillars, with a wide range of resources intended to enhance the capacity of practitioners, policy makers, and decision-makers to provide anti-racist, respectful, and culturally safe services.