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Cultural practice and clinical practice go hand in hand

Waikato DHB Maori Pasifika cohort Sept 2017

Photo: Several of the September 2017 new graduates intake. Back row L-R: Janaya McFarlane, Awhina Hawkins, Mary Mau, Kelsey Ngapo, Kayla Cochrane-Potter. Middle row L-R: Takenikoora Raoren, Kate Potaka, Caela Cranch. Front: Laura Davis.

In a health district where 23 percent of people identify as Māori (up to 40 percent in the Waitomo district of Waikato), and where health issues and hospitalisation is significantly higher for Māori than for non-Māori, a term like “health inequities” is much more than a trendy phrase.

It is about real people, real patients and their whanau, struggling to engage with a health system that has its deep roots in European culture.

At Waikato DHB, the Professional Development Unit’s Cultural Support team has a clear kaupapa – to cultivate the connection of clinical practice with that of Māori cultural values and principles such as manaakitanga and whanaungatanga. This also reflects one of the DHB’s strategic priorities: Enable a workforce to deliver culturally appropriate services.

For team members Chris Baker, Nicky Nelson and Faye Blossom this means offering a supportive environment for those Māori nurses and midwives who come into the workforce, nurturing them and giving them the confidence and skills to use both their cultural practice and their clinical practice.

“Often Māori and Pasifika health professionals feel they have to leave one of these at the door, and that is usually their cultural practice,” says Nicky Nelson. “That’s no longer the case. They go hand in hand, and that benefits our patients and the whole organisation.”

At a national level, the Ministry of Health’s Māori nursing strategy is to increase the Māori nursing workforce from 7 percent to 16 percent by 2028. In the Waikato, where the Māori population sits higher than the national level, the aim is greater – to move from the current 7 percent to 23 percent by 2028.

Baker explains that it is much more than a numbers game. “It’s about how we train them and sustain them, the learning models we use that embrace cultural practice with clinical practice rather than side-line it.”

The team provides mentoring programmes and wananga (learning forums) through the year for the intakes of trainee nurses who come to the DHB to get work experience and the newly graduated nurses who apply for jobs at Waikato DHB.

As one nurse who was part of a recent cohort of Māori graduate nurses at Waikato Hospital says: “It’s been super-supportive. This little group has become my whānau. It’s a great place to work…I couldn’t imagine being happier.”

Waikato DHB is also strengthening links with training institutes so there is a “pipeline” for Māori and Pasifika nurses and midwives that sustains and supports their cultural identity through their clinical training and into the workplace.

The goal is for Waikato DHB to become a place where they feel safe, supported and empowered.

The Cultural Support team also helps all clinical staff to practice in a culturally appropriate way, using online courses, tikanga best practice guidelines and formal policies. This builds on the work being done by Te Puna Oranga,the DHB’s Maori Health service to transform the organisation into one which addresses health inequities and is culturally appropriate and responsive in the way it delivers health care.

Alongside this work with Māori and Pasifika nurses and midwives, the DHB has started a range of activities to support its growing internationally qualified clinical workforce, many of whom come from culturally and linguistically diverse places.

Chris Baker says there is still a long way to go before the DHB as a whole makes the significant cultural shifts that are needed, but things are moving in the right direction.

Thanks to the work of this team and others in the organisation like Te Puna Oranga, Waikato DHB is starting to be seen as a preferred place to work for those who have so much to contribute to the health and wellbeing of our communities, our patients and their whānau, and to the organisation itself.

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