Cultural Safety Module 3: Peoples Experiences of  Colonization in Relation to Health Care


1. Using Power Constructively

You can use your personal and professional power to contribute to more positive health and heath care experiences for your patients.

Record your thoughts on the following issues:

  1. Think of someone you know who advocates for people and their families in your health care setting. How does this person use her/his personal and professional power to create helpful relationships and/or to challenge unhelpful structures and practices in the health care setting?
  2. How do you use your personal and professional power to create healing relationships with people?
  3. How can you use your power to change organizational structures, policies, or practices that create negative health care experiences for people?

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2. Private Reflection

Take five minutes to write about, or reflect on, things that you might be do in your nursing practice to improve how you relate to your patients. You can find more ideas later in this module, in the section entitled "Small is Beautiful: What You Can Do."

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3. Standing Your Ground

This activity is based on: Dealing with Stereotypes and Offensive Remarks, by Sandy Berman & Suzu G. Speier, Diversity Consultants, 1991.

Here are some ideas for standing your ground when you are uncomfortable with stereotypical or offensive remarks or racist jokes or comments made by others.

We often fail to act in situations like these because we don't want to draw attention to ourselves, embarrass anyone, make a fuss, or hurt anyone's feelings, even though we may sense that others feel the same way. However, although doing nothing or blaming the person making the comment may feel like the most comfortable thing to do, standing your ground can educate, provide feedback, and make your limits on respectable ways of interacting clear to the other person.

Specifically, in a calm and respectful way:

  • describe the behaviour that is offensive
  • express your feelings about its effects (own your emotions, for example, I felt this way, when you said ...)
  • surface and clarify assumptions (I need to clarify what you meant and let you know that ...)
  • discuss and acknowledge intents (I think it is important to talk about what you said because I am concerned these remarks feed racism and stereotyping, or ...)
  • set limits (It is not okay to make that type of remark because it is disrespectful, so please do not do so around me any more. I would also appreciate you taking some time to think about all of this.)

Find two colleagues who are willing to engage with you in the following exercise. Then

Person A: stereotypes, or makes an offensive remark, to Person B

Person B: gives feedback to Person A by doing what he/she thinks is appropriate, using the steps above as a guide

Person C: observes the other two and comments on the effectiveness of Person B's feedback

Person A: comments on Person B's effectiveness.

Take turns so that everyone has a chance to play all three roles.

Talk together about how you felt. Did giving feedback work? Did you feel comfortable giving feedback? Receiving feedback? Do you think you would try this is "real life"?

Many individuals have difficulty directly confronting others. In many cultures, direct confrontation or conflict is not the usual way of interacting. How can this be addressed using a cultural safety lens?

What are your limits?

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4. Cultural Safety: A Way Forward?

Note: The authors acknowledge that the following scenario is an example of the double-edged sword. One edge is the danger of perpetuating the labelling and stereotyping of people; the other edge is the danger of saying nothing and failing to understand how this relates to cultural safety. In the end, we decided that speaking openly about inequality in the health care system, as it relates to oppression, is more important, and we included this scenario for your reflection.

Scenario: Nursing Practice

Your patient/client on a rehabilitation unit is an older male of Euro-Canadian ancestry. Each time you engage with your client, he makes a disparaging remark about the male patient in the adjacent bed, whose ancestry is that of a racialized minority. Your client complains about the number of visitors his roommate has at all hours of the day and evening and the fact that he and his family speak another language when they visit together. Your client is quite outspoken about his concerns and speaks loudly, possibly within hearing of his roommate. Some of his comments are offensive to you, and you are worred they will be offensive to the other client and his family. Your colleagues have reported similar experiences. One colleague agrees with your client, that the number of visitors is excessive and that the patient and his family should speak English.

What cultural safety issues are at play in this scenario? Which issues affect which people? How did you feel after reading the scenario? Has anything like this happened in your practice? Has working though some or all of these modules changed your views on how people are treated in the health care system? How you approach your practice? Reflect on the possibilities.

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