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Nurse Practitioner closer to home
The Ngatai whānau ’ s world turned upside when patriarch , Enoka had a stroke late last year leaving him unable to walk , speak or swallow . The close knit Matapihi whānau was told he needed 24 hour care in a nursing home .
“ That was never an option for us . We ’ re a close whānau . Our mokopuna live on our property and Enoka gets great pleasure from them running in and out of the house – it ’ s all part of his recovery ,” says Ataraita Ngatai .
Enter Nurse Practitioner ( NP ), Theresa Ngamoki ( Te Whānau-ā-Apanui ). Theresa ’ s higher level of skill base means she ’ s able to prescribe medications , and order diagnostic tests . For the Ngatai whānau that ’ s enabled them to care for Enoka at home . In the last financial year four Māori nurses gained Nurse Practitioner status . They are working in rural high need communities across the Bay of Plenty .
Theresa qualified as a NP last year after more than twenty – five years working as a Registered Nurse . For the past six months she ’ s been doing weekly visits to the Ngatai home .
“ It was such a huge relief when Theresa started coming into our home . When Dad had his stroke not only was it a shock , it was a steep learning curve . I ’ m not a nurse . But pretty quickly I ’ ve had to learn how to tube feed , operate hoists and recognise changes in Dad ’ s health ,” says Enoka ’ s daughter , Tei who has become her Dad ’ s main caregiver .
“ Theresa has given me confidence . In the beginning it was very stressful . There were daily changes in Dad ’ s health . In the early days we had home based carers but at night we were on our own . I had many sleepless nights , I ’ m sleeping better now .”
Not only has Theresa provided peace of mind , but her home visits have meant less travel and upheaval to get Enoka to his GP .
“ To get Dad up and into his wheel chair and out the door it ’ s a good three hours . With Theresa coming to our home we don ’ t have to do so many trips .”
Theresa follows a Whānau Ora care model ; putting Enoka in the centre and co-ordinating with other agencies for the care he needs . She has also identified and supported the whānau with other health issues .
“ You can ’ t ignore the other people in the house . It ’ s a privilege to be invited into someone ’ s home . It wouldn ’ t be right to leave without looking at the health of the household .”
Theresa works for the Western Bay of Plenty PHO specialising in long term conditions . Aside from doing home visits in the more complex cases , she also has a weekly marae-based walk-in GP / NP clinic .
She sees her role as supporting Māori to access the health services they need in a more timely way . And she ’ s had some rewarding results .
“ I had a patient who was a long-term smoker and he said from the onset he wasn ’ t interested in being told yet again to quit . I told him , he wanted the half-pai service , and I don ’ t do half-pai . I said I was going to raise the topic but perhaps not at every visit but we both know that quitting smoking is one of the best things he could do for his health . It took a while , but eventually he quit . I was rapt .
“ Everyone wants to be well . The challenge is to support people to access the health services they need without taking away their sense of control . It ’ s important to establish a good rapport and gain trust .
“ Having the cultural knowledge coupled with the health expertise is where I believe I can make the biggest gains .”
Theresa Ngamoki ( left ) who supports Tei ( right ) and Ataraita ( centre ) to care for Enoka ( front centre ) at home
Hospitals ’ safe staffing and healthy workplaces programme attracts international attention
BOPDHB CEO Helen Mason left , with Hillary Graham-Smith project manager New Zealand Nurses ’ Organisation , Linda Silas president , Canadian Federation of Nurses ’ Unions , Debbie Forward president Registered Nurses ’ Union – Newfoundland and Labrador , and Julie Robinson BOPDHB Director of Nursing .
The success of an initiative matching the right staff at the right time to safely meet patient demand at Whakatāne and Tauranga hospitals is attracting international attention .
A group of 13 nurses from the Canadian Federation of Nurses Unions visited Tauranga Hospital recently to see how the Care Capacity Demand Management ( CCDM ) programme works on the wards .
CCDM aims to match the right number and skills of staff to the particular health needs of the patients on the ward at the time .
This is achieved by drawing on information provided by TrendCare - an electronic patient acuity tool as well as Hospital at-a Glance – an on screen tool measuring patient flows across the hospital .
Bay of Plenty DHB was one of three early adopters of the system ; it ’ s since been rolled out to other District Health Boards .
The Canadian nurses first learnt about the system when BOPDHB Director of Nursing , Julie Robinson along with the New Zealand Nurses Organisation Professional Advisor Hilary Graham-Smith , were asked to present on the system at the International Council of Nurses conference last year .
The nurses were able to see the system working in the Orthopaedic and Kaupapa wards at Tauranga Hospital .
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