Māori Health Equity & Nursing History in New Zealand
Explore New Zealand's health history, nursing competencies, and Te Tiriti principles through the lens of Māori health equity and rural healthcare limitations.
Te Kōrero o Dion
Introduction and Roadmap
Kia Ora!
Presentation Road Map
Te Kōrero o Dion
New Zealand Health History - Governance, Structure, Inequity
Four Pivotal Moments >> Four Opportunities
1 - Nursing History and Professional Authority
2 - Nursing Competencies and Pou
3 - Te Tiriti Principles, Cultural Safety
4 - SDH, Health Literacy and Rural Limitations
Importance of Māori Health
Summary
References
Te Kōrero o Dion
Image of Dion
Prior to Medical Treatment
Day 0
- rough and tumble rugby
Day 1
- New limp appears
Medical Interactions
Day 4
- First Doctor Visit - Limp and pain
Day 9
- Second Doctor Visit - Warm, urinary symptoms, increased pain
Day 12
- Ominous visions - Care not sought
Day 13
- Third Doctor Visit - Hallucinations, High Fever, Intense Pain, Cannot Ambulate
Day 13-14
: Kawakawa Hospital >> Whāngarei Hospital >> Middlemore Hospital
New Zealand Health History
Governance, Structure and Equity
Health Governance
Health System Structure
Institutional Inequity
Health Governance - 1907: Tohunga Suppression Act
Health System Structure - Dion and Pre-AHB structure
Four Moments >> Four Opportunities
Revisit Dion's Case — Pivotal Moments
First Doctor Visit
Second Doctor Visit
Ominous Visions
Admission to Kawakawa Hospital
Find opportunities for change
Moment 1
Nursing History and Professional Authority
First Doctor Visit - did not set up future care well.
Change in Nursing Power Dynamic
Healthcare was historically doctor led
Nursing evolved as a professional authority
Today nurses are independent practitioners
Change for Dion
Set the next appointment up for success
Moment 2
Nursing Competencies and Pou
Second Doctor Visit - Dismissed signs the condition had changed
Nursing Frameworks Guide Provision of Care
Competencies
Pou
Work hand in hand
Change for Dion
Provision of Care Regulation and Standards
Moment 3
Te Tiriti Principles, Cultural Safety, Hui Process
Ominous Visions - Prior interactions discourage care seeking
1840: Treaty of Waitangi - not put in practice
Bias directed health outcomes
Late 1980's - Cultural Safety (Irihapeti Ramsden)
Today - Te Tiriti and Cultural Safety are specifically embedded in nursing practice
Change for Dion
Cultural Safety
Moment 4
SDH, Health Literacy and Rural Limitations
Admission to Kawakawa Hospital - Could not provide appropriate care
Limitations in Rural Health Care
Health Literacy
Social Determinants of Health
Change for Dion
Whāngarei a better option
Not much changed today
Māori Health
Māori are more likely to be at a disadvantage with all levels
Health governance
System structure
Power & professional authority
Social determinants of health
Health literacy
Cultural safety
Nursing Pou: Māori health - redress equity in outcomes
Partnership
Power imbalance
Advocacy
Personal Summary
Mother's reflections
We've come a long way
Personal practice
- nursing-history
- maori-health
- new-zealand-healthcare
- cultural-safety
- te-tiriti-o-waitangi
- health-equity
- rural-health