Winter’s here but a strengthened relationship between Turanga Health and Curtain Bank Gisborne means more Tairāwhiti families are getting help to stay warm.
Established in 2009 to provide made-to-measure curtains for people and families on low incomes, Curtain Bank Gisborne volunteers are always busy snipping, stitching and sewing to restock their shelves with donated curtains.
Families from all over the district are referred for upcycled drapes and curtains by Plunket, Women’s Refuge, Barnados and Work and Income. But the biggest referrer is Turanga Health. In the past 12 months 40 whānau have received new window coverings as a result of the bolstered relationship between the two organisations.
“We receive referrals from all over but Memory Taylor at Turanga Health has smoothed the way for our organisations to help each other out much more,” says Curtain Bank Coordinator Sharron Hall. “Sixty percent of Curtain Bank’s referrals now come from Turanga Health. Memory is just what we needed.”
Memory is Turanga Health’s Healthy Home Kaiāwhina. Healthy Home interventions include referral to health and social agencies, installing insulation and ventilation, and design improvements to houses. Support can be anything from curtains to draft stoppers, or in some cases, help with transferring a family to more appropriate housing.
Memory sees the culprits of a cold home as soon as she walks in. No curtains, draughts under doors, crumbling insulation, and expensive yet ineffective sources of heat. When she began her job 12 months ago one of her first ports of call was Curtain Bank in the Red Cross rooms on Palmerston Rd.
“My first impressions were ‘what a lovely group of ladies’. All of them giving up their free time to help the community. I wanted to be part of it.” Now, as well as a referrer, Memory is one of seven volunteers who sew curtains every Tuesday.
Once a referral is received complete with window measurements, it takes three to four weeks before curtains are ready for hanging. Memory will hang the curtains herself, or families will call in to the Curtain Bank to pick up their curtain parcel.
Sharron and Memory love the reactions of families. Memory says it makes her feel like Santa “The good thing is that all our clients are appreciative of anything they receive. It’s awesome. And it’s why I love my work. It doesn’t matter if there’s a patch in the fabric or if it doesn’t match the carpet - they are so happy.”
There’s only one problem. “We are always running out of curtains but never running out of needy families,” says Sharron. “Please donate your old curtains if you are refurbishing. We will be able to make something out of them. Don’t chuck them away.”
Anyone with old curtains, rods or racks, fabric or hooks, is encouraged to drop them to Curtain Bank Gisborne, Red Cross, 336 Palmerston Road, any day of the week.
A wee boy with a cheeky smile is a ray of hope for a Gisborne woman with heart disease whose father and brother died from similar conditions.
Maryann Koia, 31, Ngāti Kahungunu and Ngāti Porou, was diagnosed with heart disease in 2014 and now has an internal cardiac defibrillator.
With nephew Lorenzo as inspiration and a little bit of help from Tūranga Health, Maryann has chosen life!
THE years after losing the two most important men in her life: father Jack Koia in January 2013, and brother Tim-Kaui Koia in April 2013 were tough for Maryann Koia. Jack died from heart failure and Tim-Kaui died from the complications of rheumatic heart disease. In late 2014 Maryann received the same diagnosis as her father. She’s received care from the cardiology team at Hauora Tairāwhiti and tonnes of whānau support ever since.
But more was to come.
In an awful spate of circumstances Maryann’s younger sister Oasis lost her young partner Thomas Tipene to trauma and illness the same year. Oasis gave birth to their son Lorenzo just two weeks after Thomas passed away.
“There has been a lot of trauma and sadness in our lives,” says Maryann who lives with her mum, sister, and toddler Lorenzo in Mangapapa. “But during all the time we’ve had Lorenzo. He’s been the biggest part of my life and I get up every day just to be around him.”
Lorenzo seems unaware of the central role he plays in the family. Buzzing up and down in the kitchen on his three-wheeler and due for his afternoon nap, he is all smiles and chatter. During lunch time everyone takes turns helping him out with his kai and he clearly adores them all. Without him, they all say their world would be infinitely darker.
“He brings so much life and health into the house,” says Kathy. “The healing is continuing for us all. It will take a while, it’s been a long process, but we are back on track.”
Also helping Maryann get back on track throughout the challenges has been Tūranga Health, in particular whanau ora kaimahi (community support worker) Maria Samoa.
Maria has helped Maryann wrestle to stay well following her pacemaker surgery. Maryann joined Turanga Health’s fitness classes, learned more about healthy eating , and got help managing her medication. Maria has nudged Maryann along to important health and social service appointments and coaxed her into situations where she can meet more people. She’s always on-hand for Maryann to talk to when the going gets tough. Cutting down from 20 cigarettes a day to 10 with help from Tūranga Health’s smoking cessation programme has been the latest success.
“There have been some dark times for Maryann for sure,” says Maria. “I try and motivate her and get the most out of life. In the past, yes, it’s been a challenge just getting out of bed, but now she is a model client”.
Earlier this year Maryann, her mum Kathy, and Maria, formed a team for the Sport Gisborne Tairāwhiti Do It 4 U Triathlon. Kathy is an avid cyclist, and Maria has done the triathlon before, but for Maryann the event was unique.
“It’s normal in our house for mum to exercise, so I am sure it wasn’t my idea, but we did it!” says Maryann. They called their team Lorenzo’s Angels. “I enjoyed the experience, even if my pants were falling down as I ran towards the pool! The best bit was running to the finish line with Kathy and Maria.”
When asked what she wants out of life Maryann is adamant heart disease won’t define her. She’s sticking around. She would love to be able to do a small amount of paid work and have a family herself one day. And she wants to be at Lorenzo’s 21st birthday.
“Lorenzo has bought joy to our lives and I want to watch him grow. I love all little people but he’s special, he’s got my heart, he’s the nephew and moko that I want to live a long life for. I love him.”
RARE and unique Ngā Taonga Sound & Vision footage of Tairāwhiti whānau between 1919 and the 1980’s will screen at the Lawson Field Theatre tomorrow.
Footage includes the welcome home for the Māori Pioneer Battalion (1919); the funeral of Sir Apirana Ngata (1950); the centennial hui of Ringatū church members at Muriwai (1967); Waihīrere Māori Group (1965); and the Governor General Sir Charles Ferguson at Rāhui Marae, Tikitiki (1926).
In conjunction with Turanga Health the collection of moving images and audio taonga will bring to life the voice of Tairāwhiti Māori during this time.
Ngā Taonga Sound & Vision (New Zealand Film Archive, Sound Archives, and Television New Zealand Archive) will screen the films at Turanga Health’s morning Kaumātua Programme, and then again for the public in the evening.
Turanga Health’s Kay Robin says Ngā Taonga Sound & Vision staff bringing the footage to Gisborne are interested in identifying more of the people in the moving images.
“We hope to fill the theatre. For many it will be a bombardment of memories. For others it will be fascinating look at the way Māori were depicted during the decades.”
Public screening: Tuesday 24 May, 6pm-7.30pm, Lawson Field Theatre. Gold coin donation.
A group of young mums are enjoying this Mother’s Day feeling fitter and better equipped to cope with whatever life delivers after getting some help from Turanga Health.
Mums and Bubs is a weekly work out for mothers of young children who’d normally find it difficult to find a way to exercise. Participants bring their pēpi (infants) in to the YMCA Gisborne and while they work up a sweat their toddlers beetle around the floor and play with supplied toys at the back of the room. At the edge of the class Turanga Health support staff cuddle babies while keeping an eye on fast-moving toddlers.
Mums and Bubs is part of Turanga Health’s Māmā and Pēpi wraparound service for Māori and non-Māori mothers and includes antenatal classes, help with breastfeeding, and social services support.
Turanga Health staff member Grace Donald says finding time to look after themselves can be a low priority for young busy mums. “We wanted to create a positive experience with exercise while eliminating any barriers such as transport, cost, confidence and childcare.”
Grace says sometimes the hardest thing about getting fit while looking after a baby is getting started and having to be separated from your baby. “But if baby is part of the class half of the problem is fixed - the only thing left is to push yourself to start. Just like Mother’s Day we want this programme to be all about the mums!"
While she talks Grace is rocking five-month-old Swayze Boyd-Kitai to sleep. His mother Cheev Boyd-Kitai thinks today’s class, SH’BAM is the ultimate way to exercise. The simple but seriously hot dance moves are set to a soundtrack of popular hits and everyone is having a blast.
“I came because I wanted to get fit and be healthy for my baby. I love exercising like this, I wouldn’t want to exercise in front of other people right now, so this is the bomb. It’s time to work on you.”
Cimarron Apiata is mum to Te Aotaihi. Her five-month old daughter Erana is being held by a Turanga Health staff member. Cimarron says she comes back every week because childcare isn’t a problem and it’s good to get out. “I like coming back. It’s a good work out, on the bike especially, good for my legs.”
As well as SH’BAM, fitness instructors have created spin classes (on stationary bikes) and light weights classes. YMCA Gisborne fitness coordinator Frauke Nieschmidt says she works with a lot of mothers and they are always telling her how hard it is to get back into exercise after you have just had a baby.
“These classes are getting mums back into fitness and giving them a chance to socialise with other mothers.”
She says the 30 minute workouts are created with young, busy, mothers in mind. The dance moves aren’t complex, the weights aren’t loaded up, and the overall aim is to have fun. “Often they have been up for baby at night, they might be breastfeeding, so we take all that into consideration. All day they give themselves to their kids and so this is a treat for them. They deserve this.”
For more information about the Mums and Bubs fitness classes contact Grace Donald.
Car shows are usually the domain of hot roads, street machines, and race cars, but today Turanga Health’s state-of-the-art mobile clinic is on display at Parliament.
Showing off her custom fabricated tread plate and one-off vinyl wrapped graphics, Turanga Health’s bespoke mobile clinic shone like a diamond alongside other mobile healthcare vehicles on display.
Turanga Health’s mobile clinic is in Wellington as part of the 2016 Mobile Health Rural Nurses Meeting. During a break from presentations to rural health staff, a range of the country’s mobile health vehicles went on display for public and politicians to check out.
Mobile health clinics like Turanga Health’s Piki te Ora (or ’The Bus’ as it is affectionately known) are used widely around the world as “patient care anywhere” is becoming the reality, says Turanga Health chief executive Reweti Ropiha.
Turanga Health’s mobile bus was purchased in 2011 and is used to manage patient clinics in rural areas. When people come inside and see it is a fully functional clinic room they are pleasantly surprised, says Mr Ropiha. “As well as nurse clinics, Turanga Health has an easier way of offering influenza immunisation in woolsheds; on-site work place health checks; and drug and alcohol advice to teenagers at sports events.”
Mobile healthcare vehicles have been operating in New Zealand since the early 90’s. These vehicles allow access to health care where the cost of having a bricks and mortar facility is prohibitive or the population is not large enough to fully utilise the service.
The unique opportunity to see inside some very specialised and healthcare vehicles was enjoyed by hundreds of people in Wellington. Piki te Ora was parked alongside mobile surgical and dental units, the mobile Breastscreen unit, a mobile diagnostics vehicle, and a lithotripsy bus.
Turanga Health nurse Liz Mackenzie, and service manager Dwayne Tamatea are attending the Mobile Health Rural Nurses Meeting. They will show off Piki te Ora during open days at Te Papa this Thursday and Friday.
For more information contact:
Reweti Ropiha (06) 869 0457
Stephen Blair was diagnosed with type two diabetes 18 months ago. Despite a long time living with gout, and numerous aches and pains from accidents, he was surprised at how serious this new disease was.
“It was unexpected. And I didn’t realize how big it was going to be. I have it in my family but I didn’t really think it would happen to me. I felt like I was being cursed.”
Because of his gout Stephen was already trying to live a healthier lifestyle. He didn’t smoke and he would try and eat healthy. But the new diagnosis spurred him to a greater effort.
When asked if he would like to take part in Tūranga Health’s Long Term Conditions education programme he jumped at the chance. “My frame of mind has always been to get rid of the diabetes so I said yes.”
Over the next two months Stephen found himself part of a weekly programme with 12 other participants. Each Wednesday morning Stephen and the others would learn more about their disease and how to manage it. The presentation on reading food labels and choosing the right foods to buy has really stuck with him.
“Oh yeah. I read the labels now. I look at the sugar content per 100g and if it’s more than 15g then I don’t get it.” He has also loved the camaraderie and company of the other participants. Stephen says much of his life was spent living in rural Motu and so he enjoys being around people. He now he lives in Ormond and can easily attend the programme.
Stephen was referred to the Long Term Conditions programme by Tūranga Health GP Mark Devcich. Stephen fell into the target group for the programme: men aged 51-65 with at least one long term condition.
Dr Devcich continues to monitor Stephen’s health with regular check-ups. Stephen also sees Tūranga Health nurse Lisa Cottle-Millar, with whom he credits for initially stepping him through his shock diagnosis. He says she helped him understand the ramifications of not doing anything, and showed him how easy it would be to make lifestyle changes.
Another important Tūranga Health staff member has been kaiāwhina Tangiwai Milner. Tangiwai is a little bit like a coach, someone who checks in on Stephen and doesn’t let him miss a medical appointment or any of his Long Term Condition programme presentations. “She’ll make sure I am going – she’ll even pick me up and take me there!”
Stephen’s progress has also been supported by Whānau Ora services. Tangible resources to help Stephen achieve his health goals include a water cooler system, food blender, an air oven, and a pair of good walking boots.
He is incredibly grateful for all the help and support he has received since his original diagnosis. Stephen has lost three kilograms in the past couple of months and is enthused about getting out into his garden and creating a vegetable patch. He is doing more exercise and just last week walked the Gisborne beach board walk.
“This is my new lifestyle. I know what the key messages are and I am going to get rid of the type two diabetes if I can.”
Joint Media Release with Hauora Tairawhiti
The number of children with rheumatic fever, New Zealand’s third world illness affecting mainly Māori and Pacific children, fell in 2015, suggesting the local Rheumatic Fever Prevention Programme is having an impact.
In 2015 there were three confirmed cases of rheumatic fever inTairāwhiti compared with 10 in 2014, and 7 in 2013. “The figures, while not statistically significant, are very encouraging,” says Chair of the Rheumatic Fever Steering Group, and Hauora Tairāwhiti’s Medical Officer of Health, Margot McLean.
“The figures suggest that the prevention programme alongside increased public awareness, and the hard work of our local nurses, general practitioners and community health workers, has started to take effect,” says Dr McLean.
The Rheumatic Fever Prevention Programme is a partnership between Turanga Health, Ngati Porou Hauora, Hauora Tairāwhiti, and primary care (medical centres). Rheumatic fever and sore throat education, as well as free sore throat swabbing services are available for the public in an effort to reduce the rate of acute rheumatic fever in Tairāwhiti.
As part of the campaign Turanga Health supported the implementation of rapid response sore throat clinics in Gisborne’s general practices, and in its own medical centre at Te Karaka. On the east coast, children with sore throats are managed by Ngati Porou Hauora general practitioners and nurses based at the local health clinics. Anyone with a child or young person aged 4-19 who has a sore throat can visit a practice for free and with no appointment needed. A nurse will take a throat swab and offer free antibiotics.
In Gisborne if a throat swab comes back positive for Group A Streptococcus (GAS) bacteria, which can lead to rheumatic fever, and where there is consent, the child is referred to Turanga Health’s Rheumatic Fever Prevention Programme. The child and family receive education and support from the programme’s kaiāwhina. This support service will be extended to the east coast later in the year and be provided by Ngati Porou Hauora.
Between May 2015 and February 2016, of the 5899 throat swabs taken across the district, exactly 1000 were found positive for GAS bacteria. In the same time period Turanga Health received 211 referrals to its Rheumatic Fever Prevention Programme for antibiotic education and support, and or a Healthy Home assessment.
Rheumatic fever is associated with cold and overcrowded housing. Because of this, children who have been hospitalised with rheumatic fever (as well as certain other infectious illnesses related to poor housing) are referred to the Healthy Homes programme. Housing-related interventions include referral to health and social agencies, installing insulation and ventilation, and design improvements to the house. The support given may be anything from curtains, draft stoppers (made by Vanessa Lowndes Centre clients), or in some cases help with transferring the family to more appropriate housing. Turanga Health’s Healthy Home kaiāwhina is currently working with 25 families.
One Gisborne mum to benefit from the Healthy Homes initiative, Faith Rihia, says she and her daughter are much happier, warmer, and healthier in their new home which they moved into late last year with help from Turanga Health.
“It was stressful and I had no sleep,” remembers Faith from earlier demanding days when her 11-month-old baby girl had numerous chest, breathing, and throat conditions, leading to multiple hospital admissions. “It’s had a real benefit for [baby] Kerry-Anne and me, things are getting easier, it was a bit of extra help.”
Dr McLean said rheumatic fever is sometimes described as the disease that casts a long shadow. ”The ongoing consequences are serious. Although initial symptoms of rheumatic fever like swollen joints and fever get better, the heart valves may be damaged and this damage is permanent.”
“Young people who’ve had rheumatic fever need a decade, maybe more, of monthly painful antibiotic injections, to prevent the development of rheumatic heart disease, or to stop it getting worse. Rheumatic heart disease can lead to heart failure, the need for surgery, and for some people, a shorter life.”
Dr McLean said work initially done across this region including the school-based throat swabbing programme, and now the rapid response clinics and Healthy Homes initiative, mean in time it might be possible to rid the region of the disease. However there has already been one case of rheumatic fever recorded for 2016 – a reminder that families and health staff cannot afford to be complacent. “Sore throats matter!” says Dr McLean.
Parents and caregivers are reminded that if your child has a sore throat and especially if your family is Māori or Pacific, you need to take them to a doctor, nurse or community worker and get a throat swab.
For more information contact: Margot McLean, Chair of the Rheumatic Fever Steering Group, and Hauora Tairāwhiti’s Medical Officer of Health, 027 294 9379.
Rheumatic Fever – what you need to know
Turanga Health is blitzing exercise boredom by adding a heritage focus to its exercise programme walks and runs.
Gisborne’s new cycle and walkways have inspired the Turanga Health Heritage Trials and this week Three Rivers Medical GPs, nurses and administration staff experienced the unique way of exercising. “It was a gentle introduction to physical exercise without knowing you’re actually doing it!” says Dr Tom James, who often refers patients to Turanga Health.
Turanga Health chief executive Reweti Ropiha says the issue for many people wanting to exercise is that “it can be a challenge staying enthusiastic. Sometimes just pulling on your shoes is the hardest thing”.
To improve uptake and keep whānau (clients) motivated and interested, Turanga Health has incorporated a heritage focus to its walks, runs, and outside exercise sessions. “We want our whānau to want to come back, and this is just one way to do that,” says Mr Ropiha.
The walks, runs and exercise sessions take in all or some of the following locations: Kaiti Hill, Oneroa Walkway, Wi Pere Monument, the Hirini St Cemetery, and each of the three rivers: Turanganui, Waimata and Taruhera.
Five Turanga Health physical activity kaiāwhina have received education in the history and heritage of the area including the geography, voyaging history, social history, and flora and fauna.
Physical activity kaiāwhina Albert Tibble, who took last night’s Heritage Trail, says it is important local GPs referring patients to Turanga Health’s wraparound services know and understand what’s on offer. “That way they might be more likely to refer. It’s about relationship building with the GPs, and sharing with them the nature of the services we offer here at Turanga Health”.
Turanga Health’s services complement care and treatment patients receive from their general practice. Its wraparound services include health and fitness programmes for whānau each targeting a different group - whether it be people with diabetes, or mums with babies wanting to get back into exercise.
Dr James said this type of activity is a really great option for spending time away from TV and computer screens. “Albert shared lots of historical and cultural factoids along the way. I didn’t know for example, that the Te Poho-o-Rawiri Marae had been on two previous sites.”
Three Rivers Medical Operations Manager Lisa Hamblin said “it was a treat to actually take the time to really look at, and appreciate, the beauty of our area with the added bonus of a knowledgeable narrator.”
Earlier this week Ilminster Intermediate School teachers took part in a Turanga Health Heritage Trail. Turanga Health works in a number of local schools and in time wants to share the heritage trail walks, runs and exercise sessions with more school-aged children.
Thirty cigarettes a day, maybe more in the weekend, was a standard day of smoking for 40-year-old Kane Akurangi (Ngati Porou, Ngati Kahungunu) of Gisborne.
The Senior IT Technician was having a cigarette every half hour he was awake, and it was costing him about $30 a day, $210 a week, $10,920 a year.
Kane says those figures didn’t worry him at the time. “I was a typical Māori male. I didn’t care at all. Even when he was diagnosed with type 2 diabetes and a thyroid disorder in February 2015, he didn’t change his cavalier attitude to life. “I thought bugger it. I will die happy doing what I want to do.”
But then a friend, younger than Kane, was also given a short sharp wake-up call about his health and Kane’s way of thinking began to change. “I saw the transition he was going through, and he was losing weight, and getting healthy, and the penny began to drop.”
Not long after, this father of four and Child Youth and Family in-home transitional carer of six, took part in a WERO Challenge. WERO is about teams of people quitting smoking together rather than individuals trying to go it alone. It was developed by the University of Auckland in a bid to help Māori and Pacific people quit smoking (though anyone can take part). Participants are supported by health practitioners and are tested each week with a smokerlyzer.
Kane said yes to being in a whānau and friends group. Registration involved signing up to a smokefree programme like the one offered at Tūranga Health in Tairāwhiti. It also involved adding one special member to the team – the coach. This person had to be a non-smoker and someone who would support his or her smoking team members 100 percent in their smokefree quest. For Kane, this person happened to be his wife and number one supporter, Maida. “She has been amazing. She was the coach and the hero and I couldn’t have done it without her.”
Every week Kane and the rest of the group were committed to their WERO meeting with Tūranga Health smoking cessation coaches. As well as education, support, and smokefree patches and lozenges if they wanted, group members had to blow into the smokerlyzer machine which would reveal if they have any carbon monoxide on their breath. It was this regular catch up that kept Kane on the straight and narrow.
“I had tried to quit smoking before by myself but this was different. Having to go every week was good for me. I would put it into all my diaries and I knew I had to be there, Tuesday, 3pm, no excuses.”
Tūranga Health’s smoking cessation programme is Aukati Kaipapa. Rather than going cold turkey the smoking cessation coaches Christine Nepia and Mere Waihi developed a plan with Kane to help him reduce his smoking and achieve a target quit date.
Kane remembers the first time he chose NOT to have a cigarette. He was driving to Ruatoria for work and normally he’d reach for a cigarette as soon as he got into the car. This time, with the words of his quit coach ringing in his ears and the united quit group behind him, he held off for as long as he could. He got to Tokomaru Bay before he succumbed. “I was bursting at the seams” he remembers, but it was the first step towards cutting down.
Slowly but surely the cigarettes he smokes has reduced every week. Six months on he has one cigarette a week. He admits it’s an odd number of cigarettes to have, and he doesn’t really know why he is still having it, but it won’t be for much longer.
As well as a smokefree journey, Kane has also taken more interest in his fitness and set himself a goal of dropping to 100kg which he has just achieved. He joined a social fitness group called Mekefit and hit Kaiti Hill and the Oneroa Walkway as often as he could.
With the help of friends, whānau, and Tūranga Health, Kane can’t believe the transformation he has gone through. He says Tūranga Health was “100 percent” important to him.
“They motivated me. They always did what they said they would. They pushed me to come back to the sessions and it’s what I needed.”
“My whole mindset has changed. I am inspired to finish things. You have got to get your mind right and then set a target. It’s about taking one step at the time and surrounding yourself with support.”
Some patients at a rural Gisborne medical centre hesitate when they see St John intensive care paramedic Jackie Clapperton in her distinctive dark green uniform. She’s standing where their GP normally stands indicating they can take a seat and tell her why they’ve come!
“But once I introduce myself and explain that I can help them just like a GP can, they relax. I think the public has come to know and trust the St John green strip for medical emergencies and care, and they know I am a professional.”
Jackie is widely known around Gisborne as a dedicated, brave and extremely professional ambulance paramedic. She’s been dangled out of helicopters, provided life saving care in people’s homes and in remote bush settings, and attended some of the worst car crashes imaginable.
But she is also a nurse practitioner – a nurse who has completed years of advanced education so she can provide a wide range of assessment and treatment, and prescribe medication. Jackie is the only St John intensive care paramedic/nurse practitioner in the country and now she is breaking new ground at the tiny medical centre in Te Karaka owned by Turanga Health.
“Jackie is the first nurse practitioner we’ve employed to back fill a GP on leave,” says Turanga Health Reweti Ropiha. “Our general practice is just over 30km from Gisborne and it’s getting harder and harder to staff when key staff are away. This is the first time we’ve thought to use a nurse practitioner. It’s a huge step forward for seamless provision of healthcare in a rural setting.”
Jackie is working at the clinic for just over a fortnight and was thrilled to take on the role. “I have to admit I jumped for joy when the opportunity arose” says Jackie. I’ve been lucky enough to integrate my nurse practitioner role into what I do at St John, but I didn’t expect to ever be working at a rural general practice, she adds.
As a St John intensive care paramedic Jackie works at the highest level for the ambulance service and is a specialist in critical care and clinical judgement, with a proven ability to manage complex patients. After seven years as an emergency department nurse, and 15 years in the ambulance service, she is capable of delivering a wide range of medicines, advanced airway management, and a number of invasive skills.
Jackie says she took on the challenge of qualifying as a nurse practitioner because someone told her she wouldn’t be able to do it. “That fired me up. I am not an academic, but I am good at practical things, I am good at forward thinking, planning the next step, joining the dots during an emergency situation, and so I kept on doing the papers and reaching the next step”.
The 44-year-old mother and grandmother says she received lots of help along the way and in her new short term role at Te Karaka she is surrounded by a supportive medical fraternity. Senior nurses at the clinic are integral to helping care for each patient; Gisborne Hospital staff know her well and recognise her right to prescribe and order tests and imaging; and now radiology staff in the district, whom she is new to, are also supporting her.
In Gisborne, large general practice Three Rivers Medical is on hand to answer any questions Jackie may have. “I have contacted them a couple of times just to confirm that what I am thinking is correct.”
Three Rivers Medical GP Fergus Aitcheson mentored Jackie’s drug management and prescribing during her nurse practitioner training and is thrilled she has the chance to work in the Turanga Health medical centre.“Her patient assessment skills are very sound and I think it’s an ideal situation out at Te Karaka.”
He says Three Rivers Medical has a long standing relationship with Turanga Health and this, as well as his mentoring relationship with Jackie, means he’s happy to be at the end of the phone should Jackie need.
“I have always thought that any new prescriber, be it junior doctor or nurse practitioner, should have the ability to easily refer to an experienced prescriber when starting out because drug prescribing has pitfalls which can be hazardous. But in this situation, I wouldn’t expect the reason I hear from her to be anything more than a nuance of drug management or test interpretation.”
Dr Aitcheson says it is in everyone’s best interest for each part of the health system to support the other.
Nurse Practitioner New Zealand chair Jane Jeffcoat says what’s happening in Te Karaka is a sign of the “maturity” of the health environment whereby nothing is the sole domain of one type of practitioner. “You’ll find that most people working in health prefer working collaboratively in order to achieve the best health outcome for the patient”.
Ms Jeffcoat says Turanga Health should be applauded for its decision to contract a nurse practitioner to cover for staff away on leave. It may be a unique situation for Turanga Health but there has never been any reason that a general practice team can’t be made up of either a general practitioner and/or a nurse practitioner along with registered nurses and other health professionals. Of the 150 nurse practitioners currently working in New Zealand, about a third of them are working in primary health. However Ms Jeffcoat says nurse practitioners in some places continue to be underutilised in what they can do.
“The nurses are working to their capacity and they can provide a service just as well as the GPs can, within their knowledge and boundaries."
St John Central Region General Manager Dr Sharon Kletchko says Jackie has worked to develop valuable relationships with local health providers and community leaders, ensuring that care and support is available to people in need.
“The role of nurse practitioner provides a vital link between St John and local communities in Gisborne and surrounding areas. St John is pleased with what the role of nurse practitioner has achieved in a relatively short period of time and looks forward to its ongoing evolution.”
Back in Te Karaka Jackie has just helped a mum whose young child who presented with a rash consistent with shingles. After confirming this diagnosis with the help of a GP at Three Rivers Medical and a photograph, Jackie prescribed the appropriate medicines.
She is loving the job and is gaining more experience and knowledge every day. “It’s a lovely environment to work in and it matches my goals which have always been to make the patient experience fluid and seamless whether first contact be in an ambulance or in a general practice.”
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