Cultural and clinical practice realities of Māori nurses in Aotearoa New Zealand: The emotional labour of Indigenous nurses

Abstract
In Aotearoa New Zealand there is limited research exploring the tensions for Indigenous Māori nurses when integrating cultural priorities into clinical practice. This study explores how Māori nurses navigate delivering culturally responsive care to iwi, hapū, and Māori whānau across different healthcare settings. A qualitative Indigenous narrative inquiry was used to obtain data. Semi-structured interviews were conducted with 12 Māori registered nurses and nurse practitioners. The thematic analysis was both inductive and deductive. The narratives provide insight into the nurses’ holistic Indigenous world view by contextualising their professional practice experiences. Four main themes were derived from data: te tuakiri Māori - cultural identity; kawenga taumaha - bearing the burden; te kaikiritanga - racism; and tauutuutu - reciprocity. Māori practitioners routinely experienced compromises within biomedically oriented healthcare services. Practitioners witnessed discriminatory practices that may negatively impact on healthcare outcomes. Sustained cultural dissonance may also negatively impact on retention of Māori nurses. Māori practitioners value tauiwi colleagues who work as allies and affirm culturally shaped care for Māori.

Ngā ariā matua
He iti noa ngā rangahau tūhura uauatanga mō ngā tapuhi taketake Māori ina paihere i ngā whāinga ahurea ki roto i ngā mahi taurima tūroro, i Aotearoa. Tā tēnei rangahau he tūhura he pēhea te hīkoi a ngā tapuhi Māori ina hora i te manaakitanga tika ā-ahurea ki ngā iwi, ki ngā hapū me ngā whānau Māori huri noa i ngā horopaki manaakitanga hauora huhua. I kawea tētahi rangahau paki taketake kounga hei hauhake raraunga. I whakahaeretia ētahi uiuinga āhua ōkawa nei ki ētahi tapuhi rēhita Māori, mātanga tapuhi hoki, 12 huia katoatia. I whāia ngā tikanga waihanga, whakaū i roto i te tātari tāhuhu. Kei ēnei paki he māramatanga mō ngā whakaaro ao taketake o ngā tapuhi, i puta ake i te tāpaetanga horopaki mō ō rātou wheako mahinga ngaio. E whā ngā tāhuhu matua i kārawarawatia mai i ngā raraunga: te tuakiri Māori; kawenga taumaha; te kaikiritanga; me tauutuutu. I pēhia auautia ngā mātanga Māori kia haere whaka-te-taha i roto i ngā ratonga manaakitanga hauora anga ki te tinana me ngā mahi tākuta anake. I kitea e ngā kaimahi ētahi tikanga mahi makihuhunu e puta ai pea he hē mō ngā putanga hauora. Ka pā haere tonu te taupatutapu ā-ahurea ki te puritanga i ngā tapuhi Māori ki tēnei ao mahi. He mea pai ki ngā kaimahi Māori ō rātou hoamahi o tauiwi e mahi nei hei hoa, e whakaū nei i te taurimatanga i āta tāreia mō ngāi Māori.

Keywords / Ngā kupu matua
cultural safety / kawa whakaruruhau; emotional labour / mahi kare ā-roto; Indigenous / iwi taketake; Māori; racism / te kaikiritanga; registered nurse / tapuhi rēhita