For future research, investigators need to develop more objective measures which capture delays in the treatment and inappropriate or inadequate management of acutely unwell patients. This should occur through critical focus on the antecedents to suboptimal care.

New writings broadening the construct of cultural safety, a construct initiated in Aotearoa New Zealand, are beginning to appear in the literature. Therefore, it is considered timely to integrate these writings and advance the construct into a new theoretical model. The new model reconfigures the constructs of cultural safety and cultural competence as an ethic of care informed by a postmodern perspective. Central to the new model are three interwoven, co-occurring components: an ethic of care, which unfolds within a praxiological process shaped by the context. Context is expanded through identifying the three concepts of relationality, generic competence, and collectivity, which are integral to each client-nurse encounter. The competence associated with cultural safety as an ethic of care is always in the process of development. Clients and nurses engage in a dialogue to establish the level of cultural safety achieved at given points in a care trajectory.

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<p><b>Because little is known about why and how nurse educators teach for social change, this research breaks new ground. A review of the general literature on teaching for social change revealed that few educators have attempted to analyse and understand it in relation to personal narrative inquiry. However, critical feminist educators provide a useful framework for theorising about teaching for change that addresses issues of hegemony, agency, praxis, individual voice, difference, justice and equity.</b></p> <p>Six women Pakeha/Tauiwi nurse educators from throughout New Zealand volunteered to participate in this research and share their lived experiences of teaching for social change. In-depth conversations over two years unfolded new and rich material about how and why these six women continue to teach the evaded subjects, like mental health, women’s health, community development and cultural safety. All teach in counter-hegemonic ways, opening students’ eyes to the unseen and unspoken.</p> <p>Among the significant things to emerge during the research was the metaphorical construct of shape-shifting as an active process in teaching for social change. It revealed the connectedness and integrity between life as lived and the moral imperative that motivates the participants to teach for difference. Shape-shifting was also reflected in other key findings of the study. As change agents, the participants have had significant shape-shifting experiences in their lives; they live and work as shape-shifters within complex social and political structures and processes to achieve social justice; and, they deal with areas of health practice where clients are socially and politically displaced.</p> <p>The research also generated new methods for gathering life-stories and new processes for analysis and interpretation of life-stories. It is hoped that this research will open pathways for other nurse educators to become shape-shifters teaching for social change.</p>

<p><b>Because little is known about why and how nurse educators teach for social change, this research breaks new ground. A review of the general literature on teaching for social change revealed that few educators have attempted to analyse and understand it in relation to personal narrative inquiry. However, critical feminist educators provide a useful framework for theorising about teaching for change that addresses issues of hegemony, agency, praxis, individual voice, difference, justice and equity.</b></p> <p>Six women Pakeha/Tauiwi nurse educators from throughout New Zealand volunteered to participate in this research and share their lived experiences of teaching for social change. In-depth conversations over two years unfolded new and rich material about how and why these six women continue to teach the evaded subjects, like mental health, women’s health, community development and cultural safety. All teach in counter-hegemonic ways, opening students’ eyes to the unseen and unspoken.</p> <p>Among the significant things to emerge during the research was the metaphorical construct of shape-shifting as an active process in teaching for social change. It revealed the connectedness and integrity between life as lived and the moral imperative that motivates the participants to teach for difference. Shape-shifting was also reflected in other key findings of the study. As change agents, the participants have had significant shape-shifting experiences in their lives; they live and work as shape-shifters within complex social and political structures and processes to achieve social justice; and, they deal with areas of health practice where clients are socially and politically displaced.</p> <p>The research also generated new methods for gathering life-stories and new processes for analysis and interpretation of life-stories. It is hoped that this research will open pathways for other nurse educators to become shape-shifters teaching for social change.</p>