Indigenous Relational Practices as a Strategy to Transform Acute Hospital Settings: A Kaupapa Māori Grounded Theory Study

Relational practice is the basis for human connection and is linked to enhanced healthcare experiences and involvement with healthcare services. Although the nurse-patient relationship is typically built around behavioural communication skills, relational practice requires developing awareness, connectedness and responsiveness to others. The task-oriented ways of working have eroded these attributes. This study explored how Indigenous values and practices can transform relational practice in a publicly funded acute hospital in Aotearoa, New Zealand. Kaupapa Māori (Māori philosophy and practice) and grounded theory were used to generate and analyse data from interviews with Māori staff and consumers. Three culturally informed processes culminated in the culturally grounded theory of achieving a culture of whanaungatanga (belonging and inclusion): tikanga mahi (work ethic), whakawhanaungatanga (developing kinships) and manaakitanga (cultural and social responsibility). The study highlights the necessity of developing and maintaining relationships and creating an environment that enables relational practice. Findings show that developing a sound work ethic supported by solid and committed leadership and espousing Māori values is the catalyst for change. Applying an Indigenous mentoring model like the tuakana-teina (leader-learner) model may create an environment supporting organisational culture change.