The 2016 New Zealand Health Strategy emphasises the need for health services to meet new population health challenges, where people are living longer with more complex and chronic conditions. As the largest demographic in the health workforce, nurses are the professional group who are most able to do more to meet projected diverse population health needs. This presentation explores a bi-cultural model for nga momo mōhiotanga or ‘ways of knowing’ in nursing as a unique, culturally inclusive approach to thinking and reasoning for advanced nursing practice in Aotearoa, NZ. Mōhiotanga ā-mahi or experiential knowing represents the ‘ready to hand’ knowledge nurses bring to clinical reasoning. Derived from prior experience of similar situations, it enables nurses to make sense of, and prioritise responses to, clinical situations. Môhiotanga â-taungakitanga or empirical knowing is the propositional knowledge that provides the frameworks, models and best evidence that guide practice.
More autonomous roles require nurses to understand more about the feasibility, appropriateness and effectiveness of evidence-based interventions within the client’s lifeworld.
Môhiotanga â-iwi or contextual knowing requires an understanding of clients’ priorities, cultural practices, capabilities and other interests, including the significance of epidemiological patterns of health and illness and health disparities. Môhiotanga ngaio or professional knowing refers to the professional and organisational contexts that shape clinical reasoning and professional judgement, such as the scope and limits of nursing’s therapeutic mandate with the client, interprofessional collaborations, enabling and limiting aspects of service contracts, and the everyday challenges in managing professional relationships with clients and colleagues.
Key words: bicultural framework; ways of knowing; clinical reasoning; nursing practice advanced roles.