Increasing the numbers of Māori health professionals is a recognized method to improve Māori access to health services, and their experience of holistic care (Ratima et al., 2007).
Although, the number of Māori Registered Nurses has struggled to exceed 7% of the overall number of Māori registered nursing workforce for the last decade. Māori nurses do draw upon personal and professional perspectives influenced by unique worldviews, informed by theoretical knowledge of nursing and Māori health concepts. The focus of the Māori nurse is the person and their whanau (Barton & Wilson, 2008) which in turn fosters the connection of their nursing care with that of Māori cultural values and principles of manaakitanga and whanaungatanga (Simon, 2006, Te Pou, 2014).
In studies with Māori nurses, nursing practice is aligned with both western medical aspects and that of the Māori cultural worldview, requiring a constant bridging of two worlds (Saba, 2008; Wilson & Baker, 2012; Brannelly et al, 2013; Te Pou, 2014).
Although, Māori nurses learn early on in their career development the need to develop resilience and to strive for excellence in order to pursue registered nursing as a vocation (Baker, 2008; Huria et al, 2014). The double bind of clinical and cultural aspects of nursing is challenging especially within non Māori institutions where racism exists impedes Māori nursing potential by not recognising the Māori models of care they practice from (Barton & Wilson, 2008; Huria et al, 2014).
Māori nurses have an important role in shaping the way health and social services respond to people with various experiences in supporting Māori whanau in their mission to achieve Whanau Ora (Te Puni Kokiri, 2013). More effort is needed to improve the workforce development of Māori nurses, to aid in their recruitment, retention and ongoing development in roles, for whanau ora to be possible.
Vision of Māori Nurses
Every whanau should have a Māori Nurse...
... recognises the influence whanau have upon Māori who choose to become registered nurses, and subsequently underpins the reasons Māori nurses contribute so greatly to the wellbeing of their people.
For many Māori who choose nursing as a vocation, whanau have often influenced their decisions in some way, be it as users of health services or with health experiences and also with inspiring Māori into nursing (Te Rau Matatini, 2009; Baker, 2008).
The driving motivation of Māori nurses is to assist whanau, hapu and Iwi towards an improved quality of life (Te Rau Matatini, 2009; Huria et al, 2014, p369). The identity and recognition of Māori Nurses with their commitment to whanau wellbeing has begun to establish a knowledge base about its uniqueness. Yet, much of the evidence is combined within that of non Māori literature and materials, thereby masking the uniqueness of Māori nurses. Which suggests although health care and nursing has demonstrated some commitment to Māori, an expansion of knowledge and research is needed about the practice of Māori nurses, and their impact upon whanau.
From the emerging evidence that supports the preferences of whanau for Māori nurses to care for them. In a study of palliative care, Māori whanau felt more supported by Māori nurses; due to the connection fostered by them, and the cultural sensitivity of the Māori nurse (Donnelly & Dickson, 2013). Feedback from a Māori whanau raised the difference in their experience with a Māori nurse who responded to their spiritual needs, the respect shown to their practices, the understanding of their beliefs, the initiation of access to a minister and conduct of karakia with them (Donnelly & Dickson, 2013).
In another study by Port et al (2008), when a Māori nurse was employed to provide advice on tikanga along with genetic counselling to Māori. The accompanying clinical team realised that with the recognition of Māori cultural beliefs that autonomy in regard to decision making did not belong to the individual but to the whole whanau. The implication was a shift of the clinical teams perspective toward whanau with an emerging appreciation of the conflict from a westernised individual rights perspective versus the preferences of Māori whanau in the decision making process.
As Aotearoa is challenged to increase and retain the Māori nursing workforce, various strategies continue to be considered to build on the successes to date in order to secure Māori as a highly valuable indigenous nursing workforce (Te Rau Matatini, 2009).
It is through this message Every whanau should have a Māori Nurse that proposes to see shifts occur with whanau, hapu and Iwi to help further lift the gains of Māori health workforce development strategies, which in turn will assist to increase the numbers of Māori nurses being available for all whanau across the health and disability sector. Within the mental health and addiction context, high numbers of Māori are considered to experience a mental illness sometime in the lifetime (Baxter, 2008). Yet, not all Māori will have access to a Māori health professional let alone a Māori mental health and addiction nurse. It is suggested solutions to Māori wellbeing can be found within Māori models, Māori whanau and within the Māori workforce (Turia cited in Baker, 2010).
Māori Nursing E-Portfolio PDRP - Huarahi Whakatū
Huarahi Whakatū is a Nursing Council accredited Professional Development and Recognition Programme (PDRP) specifically tailored by and for Māori Registered Nurses.
The programme is coordinated by a Māori registered nurse, guided by a cultural and clinical governance board with access to mentors and Māori Assessors. The programme has been running since 2009 and in 2014 was reaccredited by the New Zealand Nurses Council for a further five years. Huarahi Whakatū is the only accredited PDRP programme run outside of the District Health Boards that has been specifically developed for Māori registered nurses.
The Huarahi Whakatū PDRP promotes the philosophy of ‘dual competency', that is clinical and cultural competencies. Clinical competencies are drawn from the Nursing Council of New Zealand, whereas cultural competencies are informed by Te Ao Māori.
A range of Māori Registered Nurses throughout the country are engaged with the Huarahi Whakatū professional development programme.
Māori nurses successfully completing the programme across sectors. A range of Māori nurses are enrolled in Huarahi Whakatū at any one time and there is increasing interest for Māori nurses, nurse leaders and employers.
Huarahi Whakatū is accepted within District Health Boards, as they contribute to the majority of employed registered nurses. District Health Boards, Government and Non Government organisations are allies to ensure Māori Registered Nurses receive professional development hours in order to complete their portfolio as well as receive contractual remuneration payments when nurses achieve: Puna Whakatau, Puna Rahi and Puna Rangatira in Pūkenga Haumanu (clinical).
E portfolio facility is now available for the Huarahi Whakatu programme. Māori Nurses can complete their evidential requirements for their portfolios online, which will accelerate the completion and assessment of portfolios.
PIO has the ability to store information for Nurses to aid in their professional development and career planning needs.
Baker, M. (2008). Te arawhata o aorua. Bridging two worlds. A grounded theory study. A thesis sub-mitted in partial fulfillment of the requirements of the Masters in Philosophy of Nursing. Massey University: Palmerston North, NZ
Baker, M. (2010). Recognising Māori mental health nursing. Kai tiaki NZ. Retrieved from http://www.thefreelibrary.com/Recognising+Māori+mental+health+nursing.-a0227796760
Barton, P., & Wilson, D. (2008). Te Kapunga Putohe (the restless hands): A Māori centred nursing practice model. Nursing Praxis in New Zealand, 24(2), 6-15.
Baxter, J. (2008). Māori mental health needs profile: A review of the evidence. Palmerston North: Te Rau Matatini
Blake-Beard, S. D. (2001). Taking a hard look at formal mentoring programs: A considerationof potential challenges facing women. Journal of Management Development, 20, 331 – 345.doi:10.1108/02621710110388983
Brannelly,T., Boulton, A., & Te Hiini, A. (2013) A Relationship Between the Ethics of Care and Māori Worldview—The Place of Relationality and Care in Māori Mental Health Service Provision, Ethics and Social Welfare, 7:4, 410-422, doi: 10.1080/17496535.2013.764001.
Bodkin, J (2014). Key note presentation. Whitireia Mental Health Nurse Educator Forum, 9th October 2014. Wellington, New Zealand.
Cassie, F (2013). Chief Nurse says current priority finding work for new graduates. Retrieved October 2014 from http://www.nursingreview.co.nz/issue/november-2013-vol-13-7/chief-nursesays- current-priority-finding-work-for-new-graduates#.VDmY2Pm4X54
Donnelly, S., Dickson, M. (2013). Relatives’ matched with staff’s experience of the moment of death in a tertiary referral hospital. QJM doi:10.1093/qjmed/hct095.
Huria, T., Cuddy, J., Lacey, C., & Pitama, S. (2014). Working With Racism A Qualitative Study of the Perspectives of Māori (Indigenous Peoples of Aotearoa New Zealand) Registered Nurses on a Global Phenomenon. Journal of Transcultural Nursing, 1043659614523991.
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Development Plan 2012–2017. Wellington: Ministry of Health.
Port, R. V., Arnold, J., Kerr, D., Glavish, N., & Winship, I. (2008). Cultural enhancement of a clinical service to meet the needs of indigenous people; genetic service development in response to issues for New Zealand Māori. Clinical genetics, 73(2), 132-138.
Ratima, M. M., Brown, R. M., Garrett, N. K., Wikaire, E. I., Ngawati, R. M., Aspin, C. S., & Potaka, U. K. (2007). Strengthening Māori participation in the New Zealand health and disability workforce. Medical journal of Australia,186(10), 541.
Saba, W (2008). Walking in two worlds. A Kaupapa Māori Research Project examining the experiences of Māori Nurses working in District Health Board, Māori Mental Health Services. Victoria University: Wellington.
Simon, V. (2006). Characterising Māori nursing practice. Contemporary nurse,22(2), 203-213.
Te Pou. (2014). supporting seclusion reduction for Māori: “Taiheretia tātou kia puta te hua”. Auckland, New Zealand: Te Pou o Te Whakaaro Nui.
Te Puni Kokiri (2013). Whanau Ora. Frequently Asked Questions. Retrieved January 2015 fromwww. tpk.govt.nz/_documents/whanauorafaq.doc
Te Rau Matatini (2009) Ngā Tapuhi Māori Engagement Report Responses from Māori Nurses and Midwives Nationally. Wellington.
Wilson, D., Baker, M. (2012). Bridging Two Worlds: Māori Mental Health Nursing. Quality Health Research. 22:1073. DOI: 10.1177/1049732312450213
Māori Mental Health Nursing - Growing our Work Force
Nga Manukura o Apopo: http://ngamanukura.nz/
Tuia Te Ao Marama: Oral History of Māori Mental Health Nurses: http://www.Māori nursinghistory.com/
Links to Māori Nursing Roopu
NZNO: Te Runanga: http://www.nzno.org.nz/groups/te_runanga
Te Ao Maramatanga: Māori Caucus- http://www.nzcmhn.org.nz/Māori -Caucus
Te Kaunihera o nga Neehi Māori: http://www.Māori nursescouncil.org.nz/index.php/2-uncategorised