Just recently an experienced postgraduate nursing tauiwi (non-Māori) student reflected to one of us:

Now has never been a more poignant time to challenge ourselves and question belief systems as we ride the wave of a new government set on making some big changes that will have a big [negative] impact for Māori. As we witness the disestablishment of Te Aka Whai Ora [Māori Health Authority], I ask myself, “What is my role, my responsibility as a health professional to help improve Māori health and well-being? What does the future look like for Māori?”

The recent fast-tracked changes to the Aotearoa New Zealand health system continue to create turmoil, distress, and uncertainty, particularly as recent advances to improve Māori health are under threat. However, unrest is often the catalyst for transformation, and it is time for nurses to carefully re-evaluate our role in challenging the structures that continue to hold racism and inequity in place. Nursing is an inherently caring profession, but as advocates for social justice, nursing is also political (Foth & Holmes, 2017).

Recent healthcare cuts, implemented by the incumbent coalition government (formed November 2023), are deliberately divisive, pitting health providers against each other to compete for limited funding, scramble over the insufficient workforce, and argue about ideological models of care (Pitama et al., 2024). Over decades, the evidence has been that Māori experience worse health outcomes because of a complexity of barriers, including inequitable access to care, inappropriate models of care, poorer quality of care, and racism (Hunter & Cook, 2020; Pene et al., 2023; Sheridan et al., 2024; Waitangi Tribunal, 2019). The sad reality is the health system has not worked for Māori and has been found to be in direct breach of Te Tiriti o Waitangi (Came et al., 2020; Waitangi Tribunal, 2019).

Following the Health and Disability System Review (2020) efforts to address equity and embed Te Tiriti o Waitangi, through a series of health system reforms, were signalled in the Pae Ora (Healthy Futures) Act (2022). However, these attempts to level the playing field with structures like Te Aka Whai Ora and models of co-leadership have been stymied by recent political interference and a series of policy changes, which are not based on any kind of evidence (Radio New Zealand, 2024). This editorial is a call for nurses to consider how they might be part of a different way forward.

In our recent paper (Wiapo et al., 2024), we explored racism in nursing and solutions for anti-racist nursing praxis. Too often, attention continues to be diverted towards “Māori as the problem”, instead of recognising how health and professional policies and practices perpetuate persisting racism and inequities. Māori would define themselves as a culturally rich people who offer inclusive, authentic, and collaborative ways of being. The aspirations of our ancestors to ensure future generations flourish together in Aotearoa, offers solutions and potential for everyone (Rolleston et al., 2022). Indigenising spaces recognises that both Māori and tauiwi have roles to play to promote a fair and just workplace and healthcare system (Hoskins & Jones, 2022).

Māori nurses ask tauiwi nurses to courageously walk beside them to cultivate a sense of social justice, self-reflection, and active allyship that supports an equitable and flourishing environment for everyone (Wiapo et al., 2024). For tauiwi nurses, allyship asks that they become comfortable with being uncomfortable and seek ways to amplify the voices of Māori nurses who offer essential knowledge required for systemic change (Wiapo et al., 2024). Understanding the colonial history of this country - and how nurses maintain racism as the status quo in these Western structures (often with silence or inaction) is the first step (Wiapo et al., 2024). Nurse leaders need to commit to growing and strengthening the Māori nursing workforce in their teams through intentional culturally safe pathway strategies. Nursing education programmes need to prioritise pedagogy, that is creative, consistent, continuous, and centres Indigenous knowledge and expertise (Wiapo et al., 2024).

Nursing is inherently a caring profession and, if we are truly advocates for the people we serve, it is also a political one. In a recently implemented postgraduate nursing course to strengthen whānau ora (healthy families) in nursing practice and to promote Māori health, we intentionally indigenised learning spaces, by connecting with each other through pepeha (who we are) and whanaungatanga (relationships); engaging with te taiao (our natural environment); demonstrating manaakitanga (care for each other); and developing kotahitanga (unity) and rangatiratanga (leadership) (Davis et al., 2024). Marae-based learning upheld tikanga to validate Māori nurses’ knowledge and enabled the safe exploration of how te Ao Māori (Māori world) and mātauranga Māori (Māori knowledge) can be embedded in everyday nursing practice. Just as nurses undertook a hikoi to the top of the maunga (mountain) as a collective (see Exemplar), placing ourselves deliberately in spaces to become stronger and clearer in our vision for a more caring, equitable healthcare system, it is time to ask ourselves, “Are we up for the wero (challenge)?”, or will we bow to the political pressures that are divisive and competitive and force us not to care? We suggest that nurses always choose to care despite the challenges. Now is our opportunity to collectively and purposely create a more inclusive and safe healthcare system for everyone. We are so much stronger together than against each other.

We leave you with this whakataukī that speaks to our desire for lofty goals, despite the current challenges.

Whāia te iti kahurangi, ki te tuohu koe, me he maunga Teitei
Seek the treasures that you value most dearly, if you bow your head, let it be to a lofty mountain