A Description of Midwestern United States Nurse Educators' Perceptions of Cultural Safety

Abstract

ABSTRACT A DESCRIPTION OF MIDWESTERN UNITED STATES NURSE EDUCATORS’ PERCEPTIONS OF CULTURAL SAFETY by Kathleen K. DeMuth The University of Wisconsin-Milwaukee, 2025Under the Supervision of Professor Jeana M. Holt Background: Equity-deserving populations often have a long history of experiencing oppression, including colonization, racism, and sexism, factors that continue to shape health disparities today. To address these disparities, the Code of Ethics for Nurses serves as the standard for ethical nursing practice, and the American Association of Colleges of Nursing's Essentials mandate competency-based education. Within these frameworks, culturally humble nurses play a critical role in fostering culturally safe environments through self-reflection, ongoing critique, and egoless engagement. They strive to develop mutually beneficial relationships, treating people with respect and dignity. Consequently, nurse educators are challenged to prepare students who practice with cultural humility and safety. Purpose: Describe Midwestern United States nurse educators’ understanding of cultural safety, point of view on the importance of embedding cultural safety within nursing curricula, and perceptions of facilitators and barriers to implementing culturally safe nursing curricula. Methods: Using a qualitative descriptive design, 35 nurse educators were interviewed, and data were analyzed using thematic analysis. Results: Four themes emerged to answer the nurse educator's understanding of cultural safety. Nurse educators’ interest in incorporating cultural safety into nursing curricula yielded a single theme. Nurse educators' perceptions of potential facilitators and barriers to implementing a culturally safe nursing curriculum yielded eight themes and five subthemes, organized according to the Social Ecological Model. Conclusions: This study highlights that racism can persist through multiple mechanisms, including personal discomfort with confronting internalized biases, systemic racism, institutional inertia, and resistance to acknowledging cultural diversity, even within environments that aim to be inclusive. The results of this study underscore the importance of critical self-reflection, openness, and active engagement with equity work to move beyond superficial inclusion toward authentic anti-racist transformation. Furthermore, policy-level exploration is essential to embed cultural safety into nursing, following the examples of countries that have successfully implemented such frameworks.