A male Māori chaplain provided the following information about how he cares for himself in his role as a spiritual care worker:

It’s a soul self-care thing. I think there are levels of trauma, that we all experience, and some can be very, very high levels and low levels. And so, what, what I do about that, I do work for the Church, recently I’ve just been to Darwin and Sydney (just got back) and spent a week in a monastery. It’s available to me. Then is ongoing support to try and clear my head and my soul really of residue of what’s been happening with it, not just to do with death but all sorts of unanswered questions, you know that I might have. And so that’s what I do. I also ritually I have in the ritual side of things, I have a karakia that we use before we go into anything and when we come out of it which is a ritualistic thing. And that’s normally done with other Ministers, or if you’re by yourself, reciting it yourself, which comes from a Māori background. So, from a Māori framework, I do that. So, there is provision there really but, it’s like anything you’ve got to manage it and make sure it occurs otherwise there’s some things you see, and experience that you can never really get away from, it’s always going to be there in the background. And so, you know it just comes with the territory really. Yeah so you do [have] to watch yourself because people do burn out or you know.

Dr S. commented on the value of engaging in holistic self-care provided through a resent hui-a-tau put on by Te Ora (Māori medical doctor’s):

I think we, last year we had our Te Ora hui here, our Hui-a-tau, and so we had [name] and her rongoā Māori practitioners there. We had a tāmoko practitioner available so that docs felt you know, you could come for the academics, you could come for the educational [but] actually you can use this time to whakawhanaungatanga - find yourself again and just have some time. Yeah, and I’m embracing that more as I get older, as my experience grows, within this practice.

For 'time-out' Joy (kuia, health professional) likes to go to the beach with her whānau to relax. She also enjoys being involved in her rōpū when all the whānau get together. Joy (health professional) talks about wellness and ways to look after yourself:

Yeah [I walk] and I have a little talk with our moana. Good kai, good kai and water…fasting without food for a day, is amazing, does an amazing thing. So, you eat again but you know I think fasting. And I, I would say that to people because, but mind you, as I say I had to nearly die in order to get this, service, this mihi from the mount you know. I had to die. I died actually I think I did die I saw white light. But I came back!!

Matilda (health professional) said she took ‘nanny naps’ to protect herself from getting fatigued:

To protect my, to protect [me] so I don’t get fatigued, I’ve got to have my nanny naps.

Rest and relaxation

Giving to people at end of life can be very tiring emotionally, physically and spiritually. For example, call outs to someone who is ill or dying can occur at any time of the day for some health professionals.

Working in a hospice can be emotionally taxing. Huriana shared how she manages her emotions and self-care by taking time out to cry and she talks to her partner:

Sometimes it’s really hard. Sometimes I go home and just sit there and cry. I’m sad for the family that I might have been working with. Some of them could have been there for a couple of weeks, so you get to know them. Especially if you’re on a night shift. You’re in the kitchen making a coffee and the family’s there and you start having a yak with them. Sometimes it’s just really, really sad and I’ll go home, sit and reflect. I share a lot with my partner. He’s really good at listening. Well I think he’s listening. He nods in the right places. But I don’t draw it out and I don’t tell him the real little ugly bits,  but sometimes I need to share the sadness that I’m feeling and then I’m fine. The next day is a new day!

Huriana (hospice health care assistant) will call on her mother (spiritual care professional) to talk and reflect on what has happened, especially if she has encountered emotional mamae (pain) and needs wairua support:

When I feel sad [I phone Mum]. Pretty much [its] just talking but she’ll also bless me through the phone. She’ll send ‘rays’ even to the Hospice. We both have a laugh as well. Like I’m there while they’re dying and she picks them up at the door and buries them, you know? So, we sort of have that [we’ve got it covered]. It brings out our sense of humour, which sometimes can be a bit dark. That’s how we get by, often using humour to hide really deep feelings of sadness. But I can talk to Mum about anything and she makes me feel better. She encourages me and helps me to know that what I’m doing is worthwhile.  

Huriana talked about the support she draws on from other staff to help her in her role as a hospice health care assistant:

I’m lucky in my role because we have a lot of support. You find out which staff members are going to be the most supportive. There are other people you can go to as well such as Norma Hickland the Māori hospice manager as well as our two wonderful spiritual care advisors.

Some health professionals found that talking and debriefing helped to ease their minds and lighten the weight they carried in their hearts. Sometimes this might include talking with spiritual care workers. Talking with a clergy person was helpful for Matilda (health professional):

I like to talk to the clergy that are around at the time, that’s on the premises. Yeah.

Reflection was one way that Matilda cared for herself when there were challenging situations at work:

I like to just be quiet, just take that moment and just reflect on that - what’s just happened.

Reflexive practice

Reflexive practice and talking about what has happened in the course of their mahi (work) is one method that health professionals use to review their work, and to contemplate and understand specific situations that may have taken place which they may have found difficult or challenging. Reflecting on what has happened and learning the part they played, and what they could have done better, or what could have improved a situation, is a helpful way of processing one’s own thoughts, feelings and behaviours. Having clarity helps the health professional to release any distracting thoughts and feelings:

Working in the wairua space with end of life care, helping whānau transition from te ao mārama towards the ārai is deep wairua mahi. The male Māori chaplain explains he also see’s other whānau who work with wairua to help clear him from the wairua work he does:

The other thing I don’t talk about it often much but I do have a woman and a man (the man’s related to me from Ngāpuhi) who deal with sort of wairua Māori stuff that I go to when I’m really being affected [by] something. And, which sits outside the Catholic position, but they deal with portals and about clearing stuff and reading. And, so I’ve always, probably a bit like you, I’ve always been a receiver. So, I’ve been able to see things and feel things before- sorry see things, see things in another way, and receive things, from an early age. I’ve always had that. And so, becoming an ordained Minister hasn’t changed that. I have a couple from [place [ really, that manage that for me.

So, if I’m really stressed or whatever, this isn’t working I’ll go and see them, and they clear me and read the situation for me so I can get out of that. So, I think that’s another thing. I think that’s a whole validifying [aspect] as Māori as we always have to do about te ao wairua that it’s hard to explain for Pākehās because they just don’t get it. Oh, not all Pākehās, but generally Pākehā people, Kiwis just don’t understand that. Whereas for us it’s a, it’s a day to day thing. It comes with your bread and butter in the morning; it just is us. And how are you going to explain that to a Government Department, or to a so and so? And I think there’s a lot of work to be done there, I think people do the PC thing, ‘Oh we’ve got a, you know, Māori have this thing called wairua,’ you know, but they don’t realise that our people, they live with it. It’s still [there] and we’re part of this land, we’re part of the DNA and makeup of the land. It’s here and that’s not going to change and anyway, I won’t go down that track, but I think there’s a whole area there.

Spiritual self-care

Health professionals who took part in the Pae Herenga study reflected that it was important to care for themselves when they are caring for kaumatua who are ill or dying, and their whānau. Spiritual self-care was viewed as being particularly important.

As part of her self-care routine, Huriana has karakia before and after work:

Yes. I thank him [God] every day I get home and, on my way, to work  I’m saying, ‘Please God help me look after these sick people today,’ and ‘may it go smoothly and help me get home safely tonight.’ And when I pull in the drive, I say ‘thank you,’ but before I even leave work, I use water on my hands and  bless myself before I get in my car. I do not want to take any ghosts home, there’s enough there already.

Huriana [hospice health care assistant] calls on her tikanga (customs) when faced with challenging situations at the hospice where she works, and she talks to God:

I am lucky to have God in my life. I often find myself asking for help for the patient and their whanau, and me. ‘Please God don’t let them be sad for too long. Grief is so different for individuals and whanau alike.

I pull in my knowledge of Tikanga when dealing with Maori patients and whanau. That’s because of what the patient’s whānau are going through. You’re not meant to judge anyone when you work at the Hospice. It can be hard; we are only humans. I love our culture and sometimes I  presume everyone practices it but no, some really don’t…

John’s (Māori spiritual care worker) koroua [grandfather] taught him to trust his feelings and if it didn’t feel right to him, don’t do it:

My koroua always told me, ‘If you get stuck, don’t do it.’ If you feel uncomfortable. That’s what he always told me that because he was a very powerful man in his karakia. Yeah, but you know I’m always trying to prepare myself before I’m on the move.

Along with the karakia, Whaea M used holy water to bless herself. She carried it in her bag and sprinkled it on herself when needed:

I have it in my [bag]… My brother has a place where he goes because he’s Catholic. And so yeah when we’re all māuiui and I’ll go, ‘Have you got your water or anything?’ But if I’m māuiui and I can’t do myself, then I ring him or my baby sister and they do it over the phone.

Whaea M. (community health worker) talked about being able to ‘feel’ the māuiui [illness] of whānau when she enters a room. She emphasised the importance of knowing how and when to bless herself using karakia, and having the protection of her tīpuna with her:

I’m going on the wairua side. As soon as… you come through that door, and you meet your whānau, well we have māuiui [illness], I ‘feel’. And I felt it as soon as I came into the room today. I could ‘feel’ it. And so, I ‘feel’ that until the end… but I know how to do myself. You know? I know how to look after myself… I bless myself and I have my tīpuna[s] around me. They’re with me all the time and I’m very lucky. They’re my protection… I have a karakia and I do myself [clean myself with blessed water]. And then, because I did that before I came in, but when I came through there I thought, ‘Oh something’s [wrong]’ yeah so that’s why I came back out. And if you notice I was by myself. Why? That’s why. I just took a stance back. And then I said to [name of Māori provider], ‘Just give me a bit more. And then I’ll go and have something to eat but at the moment I can’t,’ yeah. And that’s the wairua.

Prayer is a normal part of everyday life for John and Heather and it is what prepares them to do their work:

John: Oh we, we pray, we pray before.

Heather: And, and I think sometimes you just have to take a breath and pause before you go rushing in. Because if you, if you do, you’re not [clear], you clear yourself, you’ve, you’ve got to be, you’ve got to be clear. And that often used to happen in Hospice…

Rawi and Ngawati (rongoā healers) have their own spiritual rituals [whakawātea] they use to cleanse themselves and to clear their whare:

Rawi and Ngawati (rongoā healers) have their own spiritual rituals [whakawātea] they use to cleanse themselves and to clear their whare:Ngawati: We got a little process between us, in terms of cleansing ourselves… after a day, we go through a certain ritual to clear everything out, to clear our whare [work premises]. After each client, we clear. You know, just making sure that the next one is not affected by what’s gone on before them…Making sure everything is clean to our knowledge anyway.

Ngawati: [To remove] negative sort of energy, that could potentially hurt other people….

Karakia is important to Joy (Kuia health professional); in her busy working role she tries to integrate karakia into her work at the DHB:

…. I tell you that’s what I missed when I left [Māori health provider] and went to the DHB because at [name] every morning we had karakia, we had waiata. So, I missed all that and of course you try and integrate it into the DHB services but there’s only so much you can do. But I still do my karakia and that, you know, maintain all of that. And when we have pōwhiri[s] I enjoy a waiata down there.

If Pato is visiting whānau and they start karakia her tikanga (customs) tell her to stop her mahi and join the whānau in karakia:

Mm, karakia aye, the family always has karakia. So, I involve myself in it [karakia]… I join in… you know, I won’t go and do mahi while they’re having karakia… I stop, and I join in.

Karakia is also an important part of Pato’s daily self-care practice:

I do it [karakia] before I even get there… for myself. Yup, before I even… I, I could do it just before when I start the car, warm the car up, to go to work. Ready to go to work, yup.

I just ask the Lord to ‘guide me and to give me that strength, in what mahi I have to do’… and to rid of all the raru [trouble, problems, conflict] that I end up with.

Pato (health care assistant’s) mother taught her the importance of performing a spiritual cleansing ritual after giving someone a mirimiri (massage):

My mother taught me that, she goes, “When you miri [massage] somebody and you’re in a happy environment, and you’re all good, your āhua [appearance, character, condition] is good, it rubs off on them. And if they’re in a bad āhua because they’ve got a bad āhua, and a bad mood, your mirimiri rubs off on you’. So, I take the kaka, if you can say that, and take it with me. And then I go for a swim down the creek… [to get rid of it].

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