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Becoming culturally and clinically competent

15 November 2017

Director of Nursing Ngaira Harker and Nursing Student Puti Keane.

It’s a significant year for Te ôhanga Mataora Paetahi, the Bachelor of Health Science Mâori taught in Whakatâne, as the first intake of students looks forward to graduating.

Producing culturally and clinically competent nurses who are responsive to the needs of Mâori is the aim of the first Mâori nursing degree progamme delivered within a wananga.

Te ôhanga Mataora Paetahi Bachelor of Health Science Mâori (nursing) degree was launched two years ago at Te Whare Wananga o Awanuiaranagi in Whakatâne. The first intake of students are completing their third year of study and will sit state finals in November. According to the school’s director of nursing, Ngaira Harker, having the first cycle of students completing their degrees this year will be a milestone for the programme.

“This year has been very busy for us, with students enrolled across the three years. We take around 30 students a year, although we may accept a few more, knowing not everyone will complete the course,” Harker said. “We will also run the bridging course in February where we upskill students in science, maths and literacy, and support them in clinical experience. We have had around 100 students on campus for these programmes this year.”
Thirty-four students began the degree programme in February 2015, with 25 remaining in the third year – an 83 per cent retention rate. Given that Mâori nursing student attrition rates are traditionally quite high, the school is proud of this achievement.

“We aim to deliver a quality course and for that we need very strong candidates,” said Harker. “We also provide a very supportive environment to help them achieve. But in the end, public safety is paramount and we want to do the best for the nursing profession as a whole. This means not every student who begins the programme will complete it. However, working within a tikanga and kaupapa Mâori framework, as we do, means it’s important we maintain the dignity of the students if they do not make it or have to repeat a paper. In such situations, we invite the whole whânau to join us in working out a way forward.”

Some students from outside the area are also attracted to the programme – Mâori and non-Mâori students – who want to enrol in a programme taught within a wananga and that meets their future aims and aspirations. Other students might have completed degrees in other disciplines, eg social sciences, before choosing to go nursing.

Going on a hikoi

Early each year, a kaumâtua leads first-year students in a hikoi around the area. This is to familiarise them with the history and customs of the local region.

“The students are involved in a lot of local health promotion initiatives and kaumâtua days on marae,” said Harker. “Ngâti Awa hapû and iwi see the students as very much ‘theirs’. Having and acquiring this level of understanding means our students bring a point of difference in their interpersonal skills. They instinctively understand the importance of whânau, hapû and iwi to an individual’s health care.”

Staff at the school include five registered nurses, including Harker, Kaumâtua Rere Moana Pitau, two psychologists who teach Mâori health, and a surgeon and a scientist who teach anatomy and physiology. In addition, the school employs a te reo expert, Haturini McGarvey, and has employed a mental health nurse. “The staff includes a number of Mâori nurse educators, but it is hard to get them. This is a tough job, with much expected of our educators,” said Harker.

All staff are developing within tikanga hauora and te reo. Staff and students begin each day with karakia and môteatea [chants] to support their collective knowledge and growth. Workshops and other activities encourage staff and students to embrace a dual worldview, becoming comfortable in both te ao Mâori and te ao Tauiwi. Waiata classes are held regularly. The school hopes te reo will be incorporated increasingly in anatomy and physiology classes from next year. In other courses, te reo is commonly used, with some student’s fluent speakers.

“Most of the staff have been trained within mainstream educational environments, so seeing tikanga become a living, breathing part of our students’ learning is so encouraging. We want our students to take this point of difference with them, wherever they end up working, whether for Mâori providers or DHBs. They will become leaders, helping change practices and policies on wards and in clinics.”

“No one is training enough Mâori nurses, so it is important we support each other. We all have the same aim – to increase the number of Mâori nurses in the nursing workforce.

“Other schools have longer experience than us in delivering nursing degrees, so they have much to teach us. What we all have in common, of course, is a huge commitment to our students, and desire for them to achieve and become leaders in the worlds of health and nursing.”

This article was originally written by Kai Tiaki Nursing New Zealand co-editor Anne Manchester and published in February this year. The text as presented here has been updated and reduced in parts.