Recruitment and Retention of Māori Nurses: Enabling Thriving Within the Indigenous Workforce in Aotearoa.

Abstract

Culturally responsive healthcare for Māori depends on a nursing workforce that reflects and understands the communities it serves. Yet, in Aotearoa New Zealand, Māori remain significantly underrepresented in nursing, comprising 18% of the population but only 7.4% of the workforce as of 2025, a disparity that has widened over time. This study aimed to move beyond deficit-focused narratives to explore the conditions that support Māori nurses to thrive in their practice, identity, and leadership. The research was guided by a dual -framework approach, integrating Kaupapa Māori as the overarching Indigenous research paradigm with Appreciative Inquiry as a strengths-based process model. Data were collected through semi-structured individual interviews (hui) and focus groups (wānanga) with 11 Māori registered nurses from across Aotearoa New Zealand and analysed using reflexive thematic analysis. Findings reveal that thriving for Māori nurses is fundamentally anchored in the affirmation of cultural identity and whakapapa (genealogy), sustained through relational connection (whanaungatanga), and supported by culturally congruent mentorship. Conversely, participants described systemic barriers that impede thriving: institutional racism, governance and leadership deficits, cultural taxation as unrecognised cultural labour, and the persistent need to navigate cultural duality between te ao Māori and Western biomedical systems. The study concluded that Māori nurse thriving is contingent on systemic, not individual, conditions—those that normalise mātauranga Māori (Māori knowledge) within everyday practice and uphold Te Tiriti o Waitangi obligations. Evidence-based recommendations directly address these barriers: implementing Māori-led governance and decision rights; establishing culturally grounded poutama (stepped career pathways) with resourced cultural supervision; embedding cultural safety and relational practice across education and workplaces; and ensuring systemic accountability through robust data and monitoring. This research provides a strengths-based framework for transforming the health system into one where Māori nurses, whānau, and communities they serve, can flourish.