NGAIRA HARKER says a plan to foster and grow the Māori nurse educator workforce is critical to meeting future health workforce needs.
As one of three Māori board members, my worldview always navigates me towards the current state of Māori nursing workforce development. Are we on track to support growth and sustainability for Māori? Current evidence suggests there are major issues impacting Māori nursing workforce growth that need to be addressed1.
The number of Māori nurses in the workforce has remained static for over a decade. Māori represent 7.5 per cent of the total nursing workforce2. In contrast to this, the Māori population is projected to grow at a faster rate than the total population. It is expected that Māori will make up 16.6 per cent of the New Zealand population by 2021, thus Māori health consumers will make up a larger portion of the population in the future.
A growing number of DHBs now recognise the benefits of having a workforce that mirrors the local community and they are actively working to make this happen3. Ensuring there is a workforce plan that addresses growth and supports the increased visibility of Māori nurses is critical to help meet future health workforce needs.
The right undergraduate environment
A key area that will impact on the future growth of the Māori health workforce is the undergraduate nursing environment. If we are to see growth over the next 30 years in the Māori nursing workforce, we must promote retention and success at the nursing school level by ensuring this environment is supportive and relevant. To this end, it is critical that Māori nurses and educators are visible throughout4.
I have the privilege of teaching and facilitating learning within Te Ōhanga Mataora Paetahi/Bachelor of Health Science Māori Nursing. This is a unique kaupapa Māori nursing programme based in Whakatane and delivered at Te Whāre Wānanga O Awanuiārangi. This development was in response to the ongoing need to develop the capacity of the Māori health workforce, and to address the recruitment and retention issues of Māori in nursing.
The programme values te reo me ōna tikanga (the Māori language and its customs) and incorporates Māori teaching and learning methods. Because Māori learners are more likely to engage and become connected with a programme when they consider it to be culturally relevant to them5, providing nursing programmes that are kaupapa-based may help to retain Māori nursing students and increase their chances of success.
Māori success requires educators who can facilitate these experiences, validate the students’ worldview, and prepare them to work effectively within Māori communities6. This requires a sustainable pool of Māori nurses, within both education and clinical settings, so Māori students can see nurses like themselves who work and care for whānau, hapu and iwi and deliver healthcare within this kaupapa. Given the limited pool of Māori nurses nationally, it is a very real possibility that a nursing student during their three-year nursing programme may have very limited to no exposure to Māori nurses.
Māori students will be shaped by their experiences within both classroom and clinical environments. Without Māori nurses delivering nursing education, the reflection, understanding and validation of health experiences from within a Māori worldview will be compromised7.
Creating a Māori workforce strategy
Currently there is no specific workforce plan for growing or mentoring Māori nurses within education. It is essential to create pathways where Māori nurses are supported in developing these skills. A first step for developing an education pathway is identifying the number of Māori nurses currently working within undergraduate education. Groups such as Whārangi Ruamano could provide insight into the national picture for Māori nurse educators and the factors that support Māori success within the educational environment. Other Māori workforce groups and organisations should also be supported to lead a collective evaluation of the work already done to grow the workforce. This combined work is essential in creating a Māori workforce strategy.
We pride ourselves as global leaders in cultural safety and indigenous ways of knowing. Nationally and internationally, nurse educators celebrate this point of difference. However, with a limited supply of Māori nurses nationally, and no pathways identified to encourage Māori nurses to enter into undergraduate education, our input in supporting nursing development is being increasingly diminished.
Ensuring students have the opportunity to engage and grow knowledge from within a Māori worldview is essential in the delivery of undergraduate education in our country. As a member of the College of Nurses, my ability to discuss these issues is empowering. The input and discussion from our group will potentially contribute to the establishment of a future workforce plan that can meet this and other Māori workforce issues.
Author: Ngaira Harker, RN MN, board member of the College of Nurses Aotearoa (NZ) Inc.
- Nursing Council of New Zealand. The New Zealand Nursing Workforce: The future Nursing Workforce Supply projections 2010–2035. Wellington Nursing Council of New Zealand 2013.
- He Pa Harakeke Māori Health Workforce Profile by MOH in 2007.
- Central Regions DHB Māori Health Workforce Development Plan 2012.
- Ministry of Education. Ka Hikitia – Managing for Success: The Māori Education Strategy 2008–2012. Wellington: Ministry of Education, 2012.
- Wilson D, McKinney C, Rapata-Hanning M. Retention of indigenous nursing students in New Zealand: a cross-sectional survey. Contemporary nurse. 2011;38(1-2):59-75.
- Greenwood J, Te Aika L. Hei Tauira: Teaching and Learning Success for Māori in Tertiary Settings. Ako Aotearoa, 2008.
- Future Workforce DHBNZ. Report on Support for Māori and Pacific Nursing and Midwifery Undergraduate Students. Wellington, New Zealand: District Health Boards. New Zealand, 2009.