- Kawa Whakaruruhau – Cultural Safety
- Mana Taurite - Pro-Equity
- Ao Mai te Rā - Decolonisation and indigenisation
What is Tikanga Haumaru?
Tikanga are Māori customary practices that set out how to act in various situations and interact with others. Tikanga evolved around concepts of tapu (people, objects, and events considered sacred or restricted) and can be thought of as actions that keep whānau safe. Tikanga is essential at times of birth, sickness and death.
Each iwi will do things differently, so it is best to look at your local tikanga guidelines to see what is recommended in your hospital or rohe (region), but there will be some everyday things you can do to show respect:
- Ensure you ask permission before touching a person’s head – we should always explain what we are doing and why we need to do it. Still, for Māori, this is particularly important for the head as it is considered the most tapu, or sacred part of the body. Your tikanga guidelines will explain the details of why, or you can read more in one of the guidelines in the links below
- Ensure that when a person (especially Māori) dies, correct processes regarding blessings, karakia, and access to water for handwashing are followed. For instance, understand that te tūpāpaku (the deceased) must be never left alone. Please accommodate this requirement respectfully. Again, engage with your Māori liaison to find out more.
- Discourage people sitting on tables or workbenches or putting urinals or body fluids on surfaces used for food, as it is considered rude and unhygienic to Māori patients and staff. You might put some stickers on the food/drinks tables to remind staff and patients to keep bodily fluids off the tables. Here is an example of a sticker used in the ED for tray tables.
Tikanga Haumaru and Health
- Have a kōrero (talk) with your Māori Health liaison person – develop a connection with them.
- Some hospitals will have tikanga documents, such as the ones in the links below. If your hospital does not have a tikanga document, discuss developing one with your Māori Health unit.
- Attend courses and workshops provided by your hospital that aim to promote understanding of Te Ao Māori (Māori worldview) and tikanga and improve communication with Māori patients. You can also encourage other members of your ED team to attend these.
- Contact your Māori liaison team for help whenever you are having difficulty with specific health or cultural issues with a Māori patient or whānau.
Here are links to some publicly available hospital tikanga guidelines – you can see the common themes, but remember that it is best to consult with your local Māori Health team about what is appropriate in your rohe (area).
Applied in Practice
Naku te rourou nau te rourou ka ora ai te iwi
With your basket and my basket, the people will live.
This whakatauki talks about the community, collaboration and a strengths-based approach. It acknowledges that everybody has something to offer, a piece of the puzzle, and we can all flourish by working together.
|
Tīmatanga – Beginning
|
- Introduce yourself, your role and your department.
- Ensure you give all information clearly and the patient and their whānau understand it.
- Understanding that for Māori, the “next of kin” may extend to several people.
- Make sure the patient and their whānau understand what is happening and what resources and support are available, including speakers of Te Reo Māori, patient advocates, Kaiawhina and Chaplains.
- Offer an opportunity for karakia (prayer) to occur
|
- Notifying appropriate Māori staff of the patient in their care as soon as possible (e.g. on admission or referral).
- Process in place to ensure the patient and whānau know the available accommodation services, preferably before admission.
- Keeping an up-to-date list of available resources (e.g. patient advocacy services, whānau rooms and other dedicated spaces, Māori chaplain, external Māori providers and support services) and informing the patient and their whānau about these.
|
|
Painga – Good Practice
|
|
Communicate, communicate, communicate.
- Ask the patient and whānau if they have unique cultural, spiritual, language or other needs.
- Documentation acutely reflects these discussions, including cultural information when recording Clinical Notes, Webpas, SBARR, and ABC (Allied).
- Staff will endeavour to use the patient's preferred name.
- A simple request and explanation will be given, and consent will be obtained from the patient and whānau before touching the patient anywhere on the body, especially on the head, where possible.
|
- Management includes staff in the consultation to implement the Manaaki Mana plan.
- Kaikokiri are encouraged to participate in the national group.
- Records show that management and leaders have completed the organisation's cultural competency training.Clinical and operational forms have fields for more than one ethnicity, and iwi.
|
|
Hiranga – Excellence
|
|
Have an understanding of a pending and following death
Tūpāpaku (deceased)
Where possible, do not leave the body unattended following death. It is acknowledged that this is generally not possible in a Coroner’s Case.
- Be guided by whānau on the cultural and spiritual practices for them at this time.
- Allow whānau to perform cultural and spiritual rites for “karakia tuku I te wairua” before tūpāpaku is removed, and in particular before a post-mortem.
- A karakia should be performed in the area where the patient died as soon as possible after the tūpāpaku is removed. From a Māori perspective, the area/room is not spiritually cleansed until an appropriate karakia and cleansing with water have been performed.
- Do not take food or drink into the area/ room following death.
- Where possible, allow the whānau to take the tūpāpaku to a designated area, e.g., viewing rooms or chapel.
|
|
-
Relevant Resources
