Aims: Identify the experiences of Māori nurses and priorities for a Māori model of relational care working with Māori patients and their whānau (extended family network) in acute hospital services. Background: Māori, the Indigenous peoples of Aotearoa (New Zealand), have a relational and holistic worldview fundamental to establishing relationships with Māori patients and their whānau. Increasing the Indigenous Māori nursing workforce can improve Māori patient experiences but is challenged by ongoing recruitment and retention issues. Design: A qualitative Māori-centred research methodology with 12 Māori nurses.Methods: Data were collected using wānanga (learning through discussion, deliberation and consideration) using he aha ō hikoi (journey mapping) and kōrero mai (storytelling). Inductive thematic analysis was undertaken using a mahi a roopū (group process) approach. This study was conducted between May 2022 and June 2022.Results: Three key themes: (1) Māori first, nurse second, (2) Cultural loading and (3) Compromised realities were identified. Māori nurses' praxis used their complex cultural and clinical intelligence to engage in a mana-enhancing way (strengths-based) to improve the care delivery for whānau Māori during their hospitalization journey.Cultural loading meant Māori nurses were often burdened with unrecognized workloads as they provided care for Māori patients and whānau, which often compromised their cultural integrity. Conclusion:Nurses' commitment to care for whānau and their assigned patient load created extra burdens and threatened their cultural integrity. Their experiences highlighted modes of practice rather than models of care required to improve healthcare delivery for Māori entering the hospital. These findings signal issues and areas nursing leaders need to heed, necessary for addressing the retention of Māori in nursing and improving workload equity.

Racism and colonisation have caused the systemic exclusion of Indigenous Māori populations in Aotearoa (New Zealand) and the perpetuation of health inequities. Atopic dermatitis, a chronic skin condition, is one such example where Māori tamariki (children) are disproportionately affected. International research highlights the challenges of caring for children with atopic dermatitis; however, there has been no such research in Aotearoa. This small qualitative study, using Kaupapa Māori (Indigenous Māori) methodology, aimed to explore the experiences of Māori parents caring for their tamariki with atopic dermatitis. Cultural engagement was paramount to the research using kaupapa kōrero (cultural narrative) through kanohi-ki-te-kanohi (face-to-face) interviews to explore the lived experiences of six whānau Māori (Māori families). Data were analysed thematically using a kaupapa Māori lens with five overarching themes: 1) the constant hard work of maintaining good skin health for tamariki; 2) the embarrassment is punishing for whānau; 3) courage is required to maintain vigilance; 4) constantly seeking solutions; and 5) whānau/people-focused solutions. Kōrero (conversations) illustrated that whānau Māori experience systemic racism across health, education, and social systems; implicit bias; and differential treatment within health services that impact caring for their tamariki. These findings reiterate the failure of mainstream primary healthcare institutions to enact Te Tiriti o Waitangi obligations and ensure health equity for whānau Māori. To survive and thrive within their contexts, Māori whānau drew on mātauranga Māori (Māori knowledge systems) in their everyday practices. Therefore, strategies to support whānau to reclaim and maintain Indigenous practices, alongside the responsibility of healthcare providers to improve health outcomes, are imperative to achieve health equity for Māori.

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 Mai i te kaimahi ki te tapuhi ā-rārangi: He kōkiri kāhui kaimahi whai painga hei whakapiki i te tokomaha o ngā tapuhi Māori i ngā taurimatanga hauora taketake 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