Nadine Gray (Te Whakatōhea), a 20-year registered nurse working at Capital & Coast District Health Board, and an academic with a focus on health equity for Māori, spoke at the NZNO conference about her work. Her research is a kaupapa Māori project with Te Whare Wānanga o Awanuiārangi, exploring the privileging of mātauranga Māori and strengthening of cultural identity in nursing education.
Gray said when she started tertiary education she was unaware of any Māori-specific support services. She eventually completed a nursing degree – one of only a few Māori graduates.
As a senior expert nurse she was often asked for cultural advice for caring for Māori patients, and whānau.
“Additionally I’ve encountered institutional racism during handover of care where colleagues display negative attitudes with stereotyped descriptions of Māori or ethnic minority groups or clients. These experiences have been confronting to challenge at an organisational level.”
Working within Māori health had strengthened her practice and awareness of the need for change.
Her research looked at the Ōhanga Mataora programme, a Bachelor of Health Sciences Māori Nursing, at Te Awanuiārangi. The course aimed to meet the growing need to build the Māori workforce in nursing. Māori students made up three quarters of all enrolments in the programme.
Gray’s research aimed to explore how the “interweaving” of mātauranga Māori through the degree influenced the engagement, retention and completion outcomes of the students. It explored the factors students felt helped them to succeed – and what gave them confidence and competence to make a difference in Māori health.
The project used kaupapa Māori methodology, she said. Participants were all Māori women between 20 and 43 years old (no male students chose to participate). They ranged across all three year groups, plus one recent graduate.
Succeeding for whānau
Gray said five themes came out of the research. The first was the drive by participants to succeed for whānau. While many participants talked about not feeling like they were set up to succeed, they were inspired by a collectivist value system – achieving for others.
The second theme was the value placed in the course on mātauranga Māori. It was a process of self-discovery for the students and allowed them to become involved in te ao Māori. “There’s a normalisation of te reo Māori and tikanga as everyday practices.”
The third theme related to participants perceiving themselves as gathering dual competency and “ethnic concordance [alignment]” to Māori people in their care. This strengthened the philosophy of for-Māori, by-Māori care in the health system.
The fourth theme was whanaungatanga. The students talked about the importance of relationships between students, and kaiako – teachers. The students valued accessibility to kaiako for support.
Gray said there was a number of Filipino students in the course as well, and these students were able to share their experiences too.
The final theme was the “threats to success” in the programme. Participants talked about the stigma and racism they experienced by choosing to study at a wānanga rather than institutions such as universities.
“They discussed… having challenging conversations with friends, family, community members… that the wānanga is not a real school, or produces real degrees, or them becoming real nurses.”
This was an example how “privileging a dominant group”, or place of learning, over others meant the students were subjected to racism, via the assumption that wānanga learning was inferior, she said.
“This is a really important consideration for all undergraduate programmes in Aotearoa/New Zealand that offer Māori and Pacific streams in undergraduate health sciences, to really create awareness and conversation about how students might be perceived particularly on clinical practice.”