Let's get constuctive, not destructive

In New Zealand some the media are telling us the some Maori like to call the health system racist. They say their needs aren't being met.

Now let's just think about this a moment.

1. Some individual people may be racist, but how can you call a system racist when all it tries to do is help the sick.

2. No system is perfect, and people from all backgrounds probably feel at some stage or another that their local hospital doesn't quite meet their needs.

3. How is calling the system racist help anyone? Think about it a bit. Whether it's meant to or not, all talk like this is going to do is make a lot of good, caring, hard working nurses upset. Nurses take this personally, at least every single nurse I've worked with does.

4. Wouldn't it be more constructive to say "Hey, we've got a big problem with whatever..." be it with drinking, smoking, diet, access to health, heart disease etc. And then say "What can be done to solve these problems?"

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We're all oppressors... at least I'm told so

The Kamatua ground his thumb on the table, his eyes locked onto mine "See that thumb, that's you white people, and all Maori are under it" his voice quavered as he said this, seeming to struggle to contain his righteous anger. Somehow dinner had turned into a confrontation between the head of the local Maori tribe and myself.

How exactly did I end up in a confrontation with the head of the local Maori tribe? Well, as part of our nursing training the graduating class had to spend a night on the local Marae. The goal of the visit was to discuss ways in which we could help Maori people feel more comfortable in the white world of modern medicine. We were learning how to make Maori patients feel more comfortable in such an alien envirnoment, how to meet their cultural needs.

The confrontation began innocently enough. The kamatua decided to sit with me at dinner, and as happens with a group of people sharing a table, sharing good food, a conversation soon ensued. "This is a special place" he began, glancing round at his surroundings, his eyes lingering on some of the Maori carvings. I nodded my head. "It effects everyone, even Pakeha people like you" he said, obviously referring to being on the Marae. Pakeha is the Maori word for people of European, or white decent. "What do you mean, people like me?" I had to ask as his wording almost seemed to border on insulting. It seemed as if this was just what the Kamatua had been waiting for he answered without hesitation "The people in charge, our oppressors."

I sat there in silence, too shocked to be angry. I briefly wondered what this had to do with nursing. I wondered how this would make me a more caring nurse, but came up blank. I didn't need this confrontation, not now at the end of my three years of training. I didn't need to be labelled as a stirrer, a trouble maker, or even a racist. I tried to be diplomatic "Well, I'm just here to help people, that's what nurses do. I'm not into all this politics and stuff" I replied. My response seemd to anger him as his eyes narrowed, his face deepend into a frown "Fighting for our land, our culture isn't politics" he then ground his thumb on the table "See that thumb, that's you white people, and all Maori are under it."

So that's how I ended up here, on the receving end of a Maori leader. But I wasn't going to do down without a fight.

"To be honest, I really don't think this has anything to do with nursing. I don't need to be told how to care for Maori patients, least of all by such an unpleasant host as yourself." By this time we had attracted a small crowd of onlookers, amongst them two frowning nurse tutors. But I hadn't finished.

"As I see it, I'll treat anyone, from anywhere, on an individual basis. If I have a Russian, Korean or even a bloody Martian, I'll base my care on their individual needs." The Kamatua's face was filled with rage, but I wasn't worth further time. He rose from the table and walked away without another word.

It was an interesting experience spending the night on the Marae. This part has now been stopped as too many students were complaining that it had nothing to do with nursing, and I happen to agree. The biggest shock of all was what I can only describe as hate from my hosts.

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Where's the racist?

My eyes practically bulged out of my head as I read that last phrase again "...nursing staff, medical staff and environment systemically racist." The letter was signed by Marore family which I had come to know very well over the last two weeks. Helen Clarke leant forward in her chair, her arms resting on her desk "You were Mr Marore's primary nurse, so we're talking to you first. Nothing much specific has been said, and no names mentioned, but perhaps you could explain why the Marore family has sent this letter."

I sat there in silence, my mind a complete blank. I want to be honest, but I don't think it will work. The family wouldn't send a letter like this for no reason, but that's just the problem, I couldn't think of a reason. I couldn't think of a single reason why the Marore family found the care of their recently deceased father racist. "Sorry Helen, I don't have a clue. I acutally liked Mr Marore, hell, he even requested me to be his nurse every time I was on. Maybe it's just the family grieving, I mean they knew he was eventually going to die, but still, that doesn't make it a whole lot easier. Perhaps it's grief talking." The words seemed to slip out of my mouth on their own, and it took me a few moments to digest just what I had said. The more I thought about it the more my suggestion sounded plausable.

Helen nodded her head thoughtfully, "Perhaps you're right, but are you sure you can't think of anything specific, any reason why they would send a letter like this?" I took another look at the letter, "Well, it does say here that they feel the hospital policy of allowing only two visitors in at a time prevents them from healing in a traditional family way" I noted. "And was that enforced?" asked Helen. "C'mon Helen, you know it's never followed, as well as the visiting hours that are never followed. We always make exceptions. Hell, the minimum visitors that Mr Marore had were two. I swear we've had all his immediate family plus every cousin in there sometimes." Helen managed a brief smile before her face turned somber "But these are very serious allegations, it still has to be dealt with." I shrugged my shoulders "Sorry, can't help anymore."

I read through the complaint letter again, but it didn't help anymore. "Look Helen, the only specific thing they've complained about is the offical numbers of visitors allowed, the rest vague, it doesn't acutally complain about a specific person, just everyone. Perhaps you should request something specific from them, perhaps word it in such a way that you want their input so to make the system better."

Helen was in agreement and let me head back to work.

Over the next several weeks everyone in the department was questioned, and everyone came up blank. It caused a lot of stress and left a sour taste in everyone's mouth. Helen was no further ahead and did send a letter as I had suggested.

We'll hear the reply to that letter in a future blog.

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