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BN501 Session 4 Culture and Nursing C ulture. Session outcomes. At the end of this session students will be able to: Define ‘culture’ Examine personal culture and relate to definition of culture Explore the culture of nursing. News desk. Cultural Identity (How hard can it be?).

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Session 4 Culture and Nursing Culture

session outcomes
Session outcomes

At the end of this session students will be able to:

  • Define ‘culture’
  • Examine personal culture and relate to definition of culture
  • Explore the culture of nursing.
  • *What makes up the national identity?
  • What makes up New Zealandness?
  • What are the first things that pop into your minds when you think of New Zealand?
definition of culture
Definition of Culture
  • A set of activities, values, beliefs and experiences
  • ‘Culture’ refers to the beliefs and practices common to any particular group of people (NCNZ, 2011).
  • We evaluate and define people who are members of other groups according to our own cultural reality (so we make comparisons -which can be positive, but are usually negative)

What is your personal understanding of culture?

  • What cultural groups do you belong to?
  • What makes you part of a particular cultural group?
  • What does belonging to such groups mean to you?
  • Is there a connection to your sense of health / wellness?
culture why learn about it
Culture – why learn about it?
  • Each of us is part of some culture or cultures.
  • Sensitivity & curiosity to build competence skills
  • To provide better health care delivery.
  • Equity





……… all learned, shared, and passed on by members of a group

culture shapes our
Culture shapes our…..

experience of the world,


family life,


work & play

life in our communities.

culture is adapted through
Culture is adapted through…

ethnic/racial environment,

language and education,

gender, age, personality

socio/economic status,


every culture
Every culture -

defines health,

determines disease aetiology,

prescribes how distress is defined & signalled,

prescribes medical & social means of treatment

what is your culture
What is your culture?
  • How would your culture affect your service delivery?
  • How do your values and norms affect how you see the cultural practices of others?
  • How do culture & health interact?
power and dominance
Power and Dominance
  • A larger group, or a powerful group has the ability to impose its own norms / values resulting in a state of serious imbalance
  • This threatens the identity, security, and ease of the smaller or less powerful cultural group
nationality and ethnicity
Nationality and Ethnicity

Nationality refers to country of citizenship

  • Sometimes used to mean ethnicity though the terms are technically different
  • So ethnicity and nationality are not always the same

Ethnicity refers to being a member of a culturally and geographically defined group that may share language, cultural practises, religion, or other aspects.



Cultural continuum

Each person is a ‘unique individual’ with cultural ‘layers’

Important to note that cultural identity may not be fixed throughout life

It is fluid / flexible particularly for colonised people

Neither is it homogenous (all people within a specific cultural group are not the same)

Ethnicity versus culture

layers of culture
Layers of culture
  • Seen as different layers of a onion
    • (Trompenaars & Hampden-Turner, 1997 as cited in Hill, Lomas & MacGregor, 2003)
    • Outside skin represents organisation’s artefacts
    • As layers are peeled back to reveal norms, beliefs, and values
    • Further peeling to reveal the basic assumptions
  • Learnt
  • unconscious / invisible
  • living and changing
  • linked to history
  • shared understanding
  • ‘the lens through which we view the world’
  • “our taken-for-grantedness……all these actions we carry out consciously and unconsciously” (Wepa, 2005, p. 31)
personal culture health and wellness
Personal culture - health and wellness
  • What does it mean to experience an interruption to your health?
  • Does everyone have the same experience when they are sick?
  • What does your personal culture have to do with health and wellness?
    • As an adult have you ever required assistance to dress, shower, eat, have things done for you when you cannot do them yourself?
  • Imagine that you were unable to shower and dress yourself this morning………..and had to have those activities done for you by someone else
knowing self your cultural identity
Knowing self: Your cultural identity

“The nurse delivering the nursing service will have undertaken a process of reflection on his or her own cultural identity and will recognise the impact that his or her personal culture has on his or her professional practice. Unsafe cultural practice comprises any action which diminishes, demeans or disempowers the cultural identity and wellbeing of an individual.”

(NCNZ, 2011, p. 7)

nursing culture
Nursing culture
  • Unknown territory
  • Seldom discussed

“Nursing conjures up the image of the ‘caring’, ‘controlling’ female, dependent on the paternalistic management structure of a health care system”

(McMahon 1991, as cited in Hill, Lomas & MacGregor, 2003, p.319).

organisational culture
Organisational culture

“Culture shapes the beliefs and behaviours of people in the workplace”

(Thompson & Learmouth, 2002, p. 211).

Organisations can also consist of a mosaic of subcultures

(Ybema 1997, as cited in Hill, Lomas & MacGregor, 2003).

nursing culture1
“Nursing culture

… is situated within organizational culture that is further situated within the overarching culture of the health care system” (Kaminski, 2006, p.24-25)

professional socialisation into the culture
Professional socialisation into the culture
  • Beliefs
  • Practices
  • Likes
  • Dislikes
  • Norms and rituals
nursing in past 30 40 years
Nursing in past 30-40 years
  • Transformation particularly in education and academic circles
  • Move to professionalism (distinct from medicine)
    • Began to establish roles as scholars, theorists, scientists, and artists – effect to articulate distinct knowledge and role as activists – advocate, health promoter and teacher (Kaminski, 2005).
  • Major paradigm shift - struggling to demonstrate this with consistency

Adamson, A. (Director). (2001). Shrek [Film]. United States: DreamWorks.

Hill, Y., Lomas, L., & MacGregor, J. (2003). Managers, researchers, teachers and dabblers: Enabling a research culture in nursing departments in higher education institutions. Journal of Further and Higher Education,27(3), 317-331.

Kaminski, J. (2005). Editorial: Nursing informatics and nursing culture. Is there a fit? Online Journal of Nursing Informatics, 9(3). Retrieved on March 6 2007, from

Kaminski, J. (2006). Nursing through the lens of culture: A multiple gaze. Retrieved from

Larson, G. (n. d.). The far side gallery 2007 off-the- wall calendar. Kansas City: Andrews McMeel Publishing.

Nursing Council of New Zealand. (2011). Guidelines for cultural safety, the Treaty of Waitangi, and Maori health in nursing and midwifery education and practice. Wellington: Author.

Thompson, C., & Learmonth, M. (2002). How can we develop an evidence-based culture? In J.V. Craig & R.L. Smyth (Eds.), The evidence-based practice manual for nurses (pp. 211-2 39).London: Churchill Livingstone.

United Nations Cyber School Bus. (2008). Student Handout: Definitions. Retrieved from

Wepa, D. (Ed.). (2005). Cultural safety in Aotearoa New Zealand. Auckland: Pearson Education.