Too few Māori nursing students: action needed

1 April 2013

Reena Kainamu, member of the Māori Caucus of Te Ao Māaramatanga New Zealand College of Mental Health Nurses (NZCMHN), shares the concerns about the under-representation of Māori students in nursing programmes and Māori nurses in the workforce.

Prior to formal nursing registration in New Zealand, Māori people were ‘caring clinically and culturally’ among their communities. Manākitanga, tiakitanga, and wairuatanga were traditional practices associated to Māori wellbeing underpinning healthcare and were valued and nurtured in whanau from a very young age*, continuing to the present day. Māori were providing ‘maternity and nursing care’ in colonial history during a climate of institutionalised racism, where barriers prevented access for Māori to hospitals, doctors, and healthcare*.

Since formal nursing registration in New Zealand, the nursing profession has been valued among indigenous Māori communities, commencing with the early registered nurses Mereana Tangata and Akenehi Hei*. Perhaps there were others like Tangata who chose to use Pākehā names in disguising their ethnicity to minimise the effects of racism in nursing education and training.

In negating an unhelpful and incorrect ‘myth’ that nursing is undervalued by Māori, the Caucus is unequivocal that nursing remains valued among Māori communities and the cultural concepts of manākitanga, tiakitanga and wairuatanga are a match for the core nursing tenet of ‘caring’.

National Māori mental health workforce development initiatives like Te Rau Puawai and Te Rau Matatini provided mentorship, financial grants, and a professional development programme for Māori mental health nurses at postgraduate levels. However, the numbers of Māori nurses exiting having completed nursing programmes is underwhelming, and the numbers entering into mental health is reflective of low numbers of Māori nursing graduates.

The 2011 research lead by Denise Wilson, Retention of Indigenous nursing students in New Zealand urges the development of strategies to address attrition and failure at undergraduate levels inclusive of culturally relevant content in nursing curricula and the creation of supportive and culturally safe learning environments grounded in the cultural and learning needs of indigenous nursing students.

Historically, the education environment was a place of power and dominance over indigenous knowledge in New Zealand*. Academic and educational institutions continue the practices of hegemony in suppressing the emergence of ‘many’ truths of minority peoples*. ‘Whiteness’ or Western ways of knowing are privileged over indigenous epistemology and the knowledge systems of minorities in tertiary education environments.

Anectodally, Māori nursing students and Māori nurse lecturers face ‘micro-aggressions’ daily in undergraduate nursing programmes. To complain is to risk further aggressions or made ‘invisible’ by dominant others. Education should be liberating.
To this end, Māori Caucus supports:

  • investigating the numbers of Māori nurses required to match the healthcare needs of the Māori population (ethnicity percentages)
  • extrapolation of the numbers of Māori entering undergraduate nursing programmes
  • extrapolation of attrition rates of Māori nursing students
  • identifying the numbers of Māori exiting with completed nursing degrees.

As spoken about at the National Nursing Organisations meeting held December 2012, let us not look offshore to solve nursing workforce issues in New Zealand. Let us increase the numbers of nurse practitioners, inclusive of Māori nurse practitioners by “growing our own”. 

About the author: Reena V. Kainamu (Ngā Puhi,Ngāti Kahu ki Whangaroa) RPN, MN, doctoral candidate



WILSON D, MCKINNEY C & RAPATA-HANNING M (2011) Retention of indigenous nursing students in New Zealand: a cross sectional survey. Contemporary Nurse (2011) 38 (1-2)59-75

MAKERETI (1986) The Old-Time Māori. Auckland: New Women’s Press Ltd.

MASTERS D (2001) Mereana Tangata – the first Māori registered nurse. Nursing New Zealand, Sept, 7, 8 pp.14-15, 27.

SIMON J & SMITH LT (2001) A Civilising Mission? Perspectives and Representations of the New Zealand Native Schools System. Auckland: Ministry of Culture and Heritage.

HOOKS, B (2003) Teaching community. A pedagogy of hope. Great Britain: Routledge