Preparing a pacific nursing workforce: this month sees the first graduates from the country's first nursing degree programme for Pacific students. How successful has the new programme been?

Three years ago, Whitireia Community Polytechnic Launched its Bachelor of Nursing Pacific programme with an intake of 26 students. It was, and still is, the country's first nursing programme designed specifically for Pacific students. This month, 19 of the original intake will graduate, and 18 have already found employment in the Wellington region. Two others are taking a little longer to complete their studies and only five dropped out of the course along the way.

"This is a remarkable result, compared to completion and success rates for Pacific students in most mainstream nursing programmes," said programme initiator and dean of the Faculty of Health, Education and Social Science at Whitireia, Margaret Southwick.

Southwick's inspiration for establishing a Pacific-focused degree came from her PhD studies, which she completed in 2001. Over almost 20 years' teaching experience at Whitireia, she had developed a concern that, despite the polytechnic being an institution that provides programmes reflecting its local community, it was still not getting Maori and Pacific students through the nursing programme in the same way it got Pakeha students through. Was this was the fault of the students or of the programmes?

"My PhD thesis took a small cohort of ex-students and asked them what the experience of being a student had been like. I was very moved by some of their stories. The message was that to be successful, they had to become 'Pakeha'; they had to put aside their own culture, values and beliefs. Originally, I had thought we would adapt our mainstream programme to meet the needs of these students, but I realised it was about the way we taught and that we needed to take a different approach. The challenge was overwhelming, but I felt I owed it to my research participants to make this happen."

Southwick believes the experience of Maori and Pacific students is similar. "The issue is realty about life experience, rather than ethnicity. We are finding that increasing numbers of Maori students want to enrol in the BN Pacific rather than in the mainstream programme. But Pacific students have priority on the places available." Southwick, who is part Tuvaluan, is aware that people outside the polytechnic will ask one of two questions: has the faculty cottoned onto something? or has it lowered the degree standards in order for the students to succeed? Her answer is simple. "I have nothing invested into putting poorly prepared registered nurses (RNs) into the community. We want capable nurses who will eventually become leaders in their communities. We want to address the poor health status of Pacific people and the best way to do that is to increase the numbers of Pacific health professionals."

All the nursing tutors (four identify as Pacific, three as Pakeha and one as Maori) have been involved in teaching the programme. One real advantage is the smallness of the classes, which enables the tutors to get to know the students very well. Once a relationship of trust is established, the tutors can make demands of the students that might be more difficult in a larger group. A system of both cultural and academic mentoring ensures the students are well supported throughout the programme.

Different teaching and learning styles

Programme leader and tutor Wendy Scott loves the teaching and is passionate about the programme. "I began teaching in the BN mainstream programme and would do a lot of work with the Pacific and Maori students after school. These students have so many other responsibilities outside their studies. They also respond to different teaching and learning styles. Pakeha students come with the cultural capital that is required to succeed in the mainstream. I believe there are more demands placed on Pacific and Maori students because they have to travel in two cultural worlds.

"I passionately believe Pacific and Maori students need equal opportunities to education and that there are not enough succeeding in mainstream programmes. I also believe the more Pacific RNs there are out there, the greater difference they will make to the health status of their people."

Southwick is delighted that a good number of the students have been accepted into first-year of-practice programmes at Hutt Valley and Capital and Coast District Health Boards (DHBs), including mental health programmes. She believes it is good for the new graduates' own professional development to work in the mainstream, though some may choose to work for Pacific providers later in their careers. "The students are feeling pleased with their success, but also a little scared as they venture out into the nursing world. It has been a very safe environment for them here at Whitireia."

Karoline Lal was the second oldest student in her class and is now on the mental health new graduate programme at Hutt Valley DHB. She believes she was very fortunate to be a founding member of the programme and appreciates the cultural support she received. "There was so much love in our classes and so much determination to succeed. The course was a real challenge for those of us with English as a second language, but we supported each other."

Fiona Tautua, also from Samoa, is now working for Cavil ABI Rehabilitation in Porirua. She, too, says the course was wonderful preparation for her new RN role. "It was very helpful having some of the terminology translated into our own languages. I found the Pacific heritage paper, which looked at cultural beliefs about health among Pacific people, particularly helpful."

This year 30 students, five of whom are Maori, are enrolled in the first year of the BN Pacific programme, with around 78 students altogether. Southwick says she is in no hurry to expand the numbers, as she would like to ensure the programme consolidates before considering whether to expand it.

"If we look at the demographics and project out 10 years, it is clear we won't have a health workforce at all if we don't address the health education needs of Maori and Pacific students. In 20 years, the majority of first-time entrants into the workforce will be Pacific and Maori, because they are from younger population groups. The Pakeha population is greater numerically, but it is ageing. Establishing the BN Pacific course in 2004 felt the right thing to do. Three years later, I am just as convinced."

By co-editor Anne Manchester