From Kaimahi to Enrolled Nurse: A Successful Workforce Initiative to Increase Māori Nurses in Primary Health Care

Abstract

A culturally competent health workforce is critical to achieving equitable health outcomes for Māori people in Aotearoa New Zealand. Fundamental to this goal is the urgent need to not only increase numbers of Māori nurses but to enable them to deliver innovative models of care that are responsive to the unmet need of whānau (family) and hapori (community). This article describes a national initiative to increase the capacity and capability of the Indigenous workforce by supporting kaimahi (unregulated health workers) to become enrolled nurses delivering holistic care within their own communities. A process of co-design was actively led by, with, and for Māori, and included health providers, kaimahi, nurse leaders and programme coordinators. By using Kaupapa Māori principles, historically negative experiences and discourse for Māori nursing were shifted into a strengths-based framework, focusing on self-determination and validating mātauranga Māori (Māori knowledge). The key components of the Earn As You Learn model are outlined and align with the narrative of haerenga (journey) in implementing this workforce strategy. This article provides timely knowledge of a promising approach to grow the local Māori nursing workforce by investing in kaimahi to work as enrolled nurses in the communities in which they live, work and play. Te reo Māori translation Ngā Ariā Matua He mea tino nui tētāhi kāhui kaimahi matatau ā-ahurea hei whakatutuki i ētahi putanga hauora ōrite mō ngā tāngata Māori o Aotearoa. Tētahi āhua taketake o tēnei whāinga, kia kaua e aro anake ki te whakapikinga i te tokomaha o ngā tapuhi Māori engari kia whakamanaia rātou ki te hora tauira taurimatanga auaha, e urupare nei ki ngā hiahia, kāore anō kia tutuki, o ngā whānau me te hapori. Ka whakamārama tēnei tuhinga i tētahi kōkiri ā-motu hei whakarahi i te raukaha me ngā pūmanawa o tētahi kāhui kaimahi iwi taketake, mā te tautoko i ngā kaimahi (ngā kaimahi hauora kāore anō kia herea e te ture) kia urutomo hei tapuhi ā-rārangi e hora nei i ngā taurimatanga arowhānui i roto i uru ki roto ko ngā kaiwhakarato hauora, ngā kaimahi, ngā kaihautū tapuhi me ngā whakaruruku hōtaka. Nā tēnei aronga whakamahi mātāpono Kaupapa Māori i kawe kē ngā wheako kino o mua, me ngā kōrero e pā ana ki ngā mahi tapuhi Māori ki tētahi anga i takea mai i ngā kahanga, e arotahi nei ki te rangatiratanga, i whakamana hoki i te mātauranga Māori. E tākina ana ētahi o ngā wae taketake o te tauira Earn As You Learn, ā, e rite ana ki tēnei mea te haerenga o te tangata ki tētahi wāhi hou, i roto i ngā mahi whakatinana i tēnei rautaki rāngai kaimahi. Kei tēnei tuhinga ētahi mōhiotanga tino hāngai ki ngā ara whai pitomata mō te whakawhanake i te kāhui kaimahi tapuhi ā-takiwā Māori mā te anga nui ki ngā kaimahi, me te tuku i a rātou kia mahi he tapuhi ā-rārangi i roto i ngā hapori e noho nei, e mahi nei, e tākaro nei rātou. Ngā kupu matua: hoahoa-tahi, tapuhi ā-rārangi, kaupapa Māori, akoranga tapuhi; taurimatanga hauora taketake; whakapakari kāhui kaimahi