International Nurses Day Heroes

1 April 2013

To celebrate International Nurses Day this year Nursing Review invited district health boards across the country to contribute stories on nursing ‘heroes’ in their region. We got stories back on just some of the unsung, innovative, compassionate, high achievers and dedicated nurses that make up the New Zealand nursing workforce.

NAME: Ngaire Murray
DHB: Auckland
JOB: Clinical charge nurse, Starship

Ngaire Murray uses distraction, fun and fairy dress-ups to help reduce the anxiety that some paediatric patients feel before visiting theatre.

The Clinical Charge Nurse has implemented nurse-led care in Starship’s Operating Rooms (OR) and added sparkle to journey of patients like Claudia (pictured with Ngaire).

Claudia was diagnosed with acute myeloid leukaemia at age three and developed Graft Versus Host Disease following a bone marrow transplant. With large non-healing wounds on her scalp and thighs, Claudia needed numerous skin grafts and twice-weekly dressing changes under general anaesthetic. As Ngaire recalls, “Claudia was always upset coming into the theatre environment and would scream and hide under a blanket.”

Things came to a head when the surgical team declared that Claudia’s wounds could not be cured and that ongoing treatment would be palliative. Ngaire proposed that nurses, rather than registrars, be responsible for Claudia’s ongoing OR care.
Prue Hames, Starship’s OR Manager says nurse-led care is extremely rare in the OR environment. “Ngaire consulted widely across the multidisciplinary team, including paediatric anaesthetists, specialist surgeons, child psychologists and wound care experts in her decision making.”

Ngaire’s team put holistic patient-centred care into action and made it their mission to make Claudia’s treatment as painless as possible. They talked to her about her interests, involved her in treatment decisions and allowed her to sit with her cat in the ‘pet corner’ during pre-operative checks. There was dancing, singing and dressing up – and the development of a family-like bond.

As a result, Claudia is no longer afraid of the OR and her health and quality of life have improved dramatically. Claudia’s mother has “no doubt that without the fantastic team looking after Claudia she would not be where she is today”.

“Ngaire goes the extra mile for our fragile patients like Claudia”, says Prue Hames. “She is definitely a nursing hero.”

NAME: Tony Loversuch
DHB: Hawke’s Bay
JOB: Diabetes clinical nurse specialist

Delivering a streamlined, seamless service to diabetes patients is now part and parcel of Hawke’s Bay clinical nurse specialist Tony Loversuch’s job.

He has prescribing rights after being one of the 12 nurses involved in the diabetes nurse specialist prescribing demonstration pilot, which he describes as a landmark for New Zealand nursing.

Tony says times had certainly changed since he began working in diabetes 13 years ago. Not only were his twin daughters born that same year, but he became adept at using a computer and can now prescribe insulin and oral agents, as well as medication to manage hypertension and dyslipidaemia. 

 “Patients can now be seen, assessed, and a care plan implemented in a seamless way,” he says.

“While lifestyle changes may be integral to diabetes management, pharmacology is often required. Nurse prescribing has increased the “team approach” to managing patients with diabetes in Hawke’s Bay.”

When the pilot programme began there were strict supervision requirements, with each DHB involved providing a physician supervisor. These weekly team meetings were vital for learning and sharing knowledge, he says.

“Nurses were forced to upskill and take a holistic view to managing the complexities of diabetes and the metabolic syndrome. It has been great for patients and has meant time with a specialist can be better used.”

There have also been other spin-offs associated with the project, Tony says, such as closer collaboration with other specialists, particularly renal and primary care.

Tony says he and his colleagues are now working along side their primary care colleagues so they can learn more about the patient and provide a better and more well-rounded service that meets more of the patients needs.

NAME: Jane Bocock
DHB: Taranaki
JOB: Neonatal Unit head nurse

Taranaki neonatal nurse leader Jane Bocock’s research work with teenage mothers recently gained her a research excellence award.

She took first place in the 2012 Wintec Postgraduate Research Excellence Awards that celebrate the contribution masters’ students make to the research environment across a range of disciplines at the Waikato Institute of Technology.

Jane’s research project the experiences of teenage mothers in the Neonatal Unit was undertaken as part of the Master of Nursing programme.

“The purpose of the study was to hear and value the stories as told by the teen mothers; inform and strengthen health care practice, and identify areas of change if necessary,” said Jane.

A key finding of Jane’s research was that teenage mothers, despite their developmental stage, had similar experiences to those of older mothers in the same situation.
Jane was nominated by her senior lecturer

Sallie Greenwood who said Jane’s strong commitment to neonatal nursing was evident in her research topic.

“While Jane does all this she works full time at Taranaki DHB as head of the neonatal unit.” The nurse leader finished her master’s degree last year and has also over the last 11 years found time to spend two weeks a year volunteering in Vietnam.

NAME: Betty Gilsenan
DHB: West Coast
JOB: Immunisation outreach coordinator

Bouncing along rural tracks trying to find houses with only a number as a reference can be challenging but when it means a baby will be immunised, it is worthwhile.

West Coast District Health Board immunisation outreach coordinator Betty Gilsenan says she’s often come home with her petrol gauge on empty after taking a few wrong turns trying to find families in remote locations.

Betty, who started working on the West Coast in 1968, covers the area from Karamea to Haast.

“There are long distances between houses and with the remoteness, you can’t just pop in to a store to ask for directions or into a neighbour’s house to ask where someone is,” she says.

Parts of Betty’s geographic area are so remote she has to negotiate with families to meet them at a relative’s home or encourage them to attend an outpatient clinic. Immunisation is important everywhere, but the West Coast has had multiple outbreaks of pertussis (whooping cough) in the last 18 months so it has been particularly crucial.

Betty recalls how delighted a mother in a very remote area was to have Betty turn up at her home recently to vaccinate her newborn baby.

“It was a gravel road with lots of pot holes and dips that were full of water and you can never be too sure how deep it is,” Betty says. 

 “Doing home visits means you can spend a little more time answering the parents’ questions in a relaxed setting without them feeling there is a waiting room full of people,” she says.

The West Coast DHB’s immunisation team’s hard work has resulted in a significant improvement in the immunisation rate of eight-month-olds.

NAME: Jo Vigenser
DHB: Whanganui
JOB: Critical care and emergency department nurse coordinator

Jo Vigenser would be the first to say she doesn’t see herself as a nurse hero –but she is to the many who view her as an inspiration at Whanganui Hospital.

Employed as Whanganui District Health Board’s critical care unit and emergency department nurse coordinator, Jo has 20 years’ experience in critical care – six of them as critical care nurse educator.

When asked to described her qualities, WDHB director of nursing Sandy Blake said Jo’s always calm, very patient focused, a leader with the gift of seeing the big picture and someone who is always happy, where possible, to drop everything to support nurses on other wards if they’re dealing with a difficult situation..

“She sees what’s needed and has the confidence to quietly make it happen,” Sandy says. “She’s a team player through and through.”

When told this, Jo said she’d been lucky to have wonderful mentors who’ve nudged her along during her 30-year career as a registered nurse. She does admit that one of her strengths is driving initiatives which she sees to the end. One such example is seeing the opportunity for a nurse educator role in critical care and going for it.

Jo has assisted to develop and drive the acute coronary syndrome pathway for the DHB, which involved getting buy-in of staff across the board from medics to social workers. She led and provided the nursing perspective for the WDHB’s Central Line Associated Bacteraemia (CLAB) project, for which the team’s CLAB poster recently won a regional award, and she also sits on the Clinical Board.

NAME: Maria van den Heuvel
DHB: Canterbury
JOB: Clinical nurse specialist at Burwood Spinal Unit

Empowering people with spinal cord injuries is a key driver behind Christchurch clinical nurse specialist Maria van den Heuvel‘s volunteer work in Samoa.

Maria and Burwood Spinal Unit colleagues first travelled to Samoa in 2010 to support Ben Lei and his family who was an inpatient in Tupua Tamasese Meaole Hospital following a rugby injury that resulted in tetraplegia.

Since then, Maria has made four visits back to Samoa. Other spinal specialist health professionals - from consultants to physiotherapists - from the Altus Resource Trust also travel to Samoa each year to support individuals with spinal cord injury (SCI) and their families.

Maria says it’s been an amazing journey to help empower individuals with SCI, their families and the newly formed Samoan Spinal Network to work together for better outcomes.

When she first travelled to Samoa it was unknown how many people living in Samoa have spinal cord injuries.

“We now know of at least 35 individuals with SCI, thanks to the established Samoa Spinal Network (SSN) and the hard work of its president, Epenesa Pouesi Young. She said the ongoing involvement of the kiwi team and the sharing of best practice, on areas like pressure relief and bladder and bowel regimes, was reducing secondary complications common to SCI

However more support is needed, she says as equipment and consumables needed by people with SCI were scarce.

The New Zealand team are heading back to Samoa to provide further education and support at a three day workshop and undertake fale [home] visits this June.

“If anyone has consumables (does not matter if expired) they would like to donate these would be greatly appreciated by the SSN. In particular; wound care products, bandages, and uridomes, indwelling catheters, catheter bags, gloves and lubricants,” Maria says.
Maria first qualified as an enrolled nurse in 1984, gained her nursing degree in 2003 and has most recently been doing research towards a master’s degree in rehabilitation.

NAME: Margot Love
DHB: Southern DHB
JOB: Charge nurse manager, internal medicine ward

Margot Love’s “outstanding clinical leadership” in initiatives from e-prescribing to linen and laundry innovation has won her a hero nomination from the Southern DHB.

The charge nurse manager at Dunedin Hospital completed her postgraduate certificate in leadership and management from Otago University in 2011

Since then Margot has been clinical leader for a number of initiatives including leading the pilot ward for the e-prescribing nationally and rolling out a standardised patient transfer communication tool between rest homes and the main hospital.

Margot’s latest project is providing clinical input into the South Island Alliance project on linen and laundry in conjunction with Health Benefits Ltd (HBL). She uses her ward as a “linen laboratory” where she tries out new products or processes to improve hospital linen provision for patients ensuring the linen is fit for purpose, individualised for the patient as well as saving health dollars.

Margot has provided a testing site for initiatives such as blue polar fleece blankets, fitted sheets and a return to cloth flannels from disposables and is still on target to save over $10,000 dollars off her linen budget this financial year.

In her own time she has created a promotional video called “Love your Linen” which is being shown in DHBs around the country and is also now working with HBL to promote South Island Alliance concepts nationally.

NAME: Pauline Tout
DHB: Nelson-Marlborough
JOB: Diabetes clinical nurse specialist

Pauline Tout was a pioneering diabetes nurse specialist in Nelson and with her master’s degree under her belt is keen to also add prescribing to her practice soon.

It is over 40 years ago since Pauline started her nursing training at Nelson Hospital. After gaining her overseas experience in London hospitals she returned to Nelson to nurse, raise two children, become a nursing school tutor and in 1993 returned to hands on nursing as a diabetes nurse educator. She progressed to becoming a clinical nurse specialist in diabetes in 1996 - the sole diabetes nurse for the Nelson area at the time.

Pauline has been a national executive member for the Diabetes Nurse Specialist Section (DNS) of NZNO (1997-2000) and a member and chairperson of the DNS Accreditation Board (2000-2003) for which she is still an assessor.

She says it has been interesting watching changes over the years in her diabetes CNS role which was initially across primary and secondary then the focus changed as resources became constrained. Now the push is once again to bridge the continuity of patient/client care across community, outpatients and inpatients and extending more support to primary care.

Pauline completed a clinical master’s in nursing degree in 2009 and is keen to pursue nurse prescribing. She facilitated a diabetes course in 2010 and 2011 for primary care nurses at Nelson Marlborough Institute of Technology and assists with the development in the diabetes specialist nursing team.

Pauline says that diabetes is a fascinating area to work in and although challenging is rewarding. She believes the demand for diabetes care will be overwhelming in the future, and health services must prepare for the diabetes epidemic.

NAME: Sera Tapu-Ta’la
DHB: Capital & Coast
JOB: Diabetes nurse educator

Sera Tapu-Ta’ala was drawn back from nursing in Melbourne to pilot a diabetes nurse role for Pacific people.

She had graduated from Whitireia’s mainstream nursing programme in 2002 and worked in Melbourne for a year with neurosurgery and rehabilitation but she missed New Zealand.

“I knew there was a need for this kind of service so I worked extremely hard to prove it to the Ministry of Health, and to ensure patients were followed up intensively. I can’t take all of the credit though – I was just one of many in a much bigger team.”

After taking some time out to start a family she returned to practice as a diabetes nurse educator. Sera grew up in Samoa and believes that her fluency in her native language makes all the difference to the work she does.

“It’s given me a really good grounding – there are casual and formal layers to the Samoan language, and being able to address elders in the correct way establishes that I’m here to help them understand their condition, not tell them what to do.” Sera has also taken her message to the airwaves via a weekly Pacific Radio health programme.

In 2011 she completed her Masters of Nursing (Clinical), which looked at the experience of Samoan people transferring to insulin therapy.

“My study reminded me to be mindful of the fact that we can sometimes rush people. The health environments we work in can be constrained at times by demand, but the clinical and social health needs of our people are also complex.”

Sera also volunteered to assist with the clean-up following the 2009 earthquake and tsunami, an experience she describes as “heartbreaking”.

“One of the cases I was allocated was a complex wound management case on top of existing diabetes. There was very little I could do clinically with the limited resources, it was kind of like Florence Nightingale, but the Samoan nurses appreciated the knowledge we brought regarding wound care and diabetes management.”

NAME: Helen Snell
DHB: MidCentral
JOB: diabetes nurse practitioner and nurse leader of MidCentral diabetes and endocrinology service

MidCentral DHB says its nursing ‘hero’ Dr Helen Snell is recognised as making an outstanding contribution to her specialty, her profession and to the health of New Zealanders.

Helen was the country’s first diabetes nurse practitioner in 2003 and most recently has been instrumental in implementing and leading the national diabetes nurse specialist prescribing demonstration project and now its managed rollout to more nurses across the country.

She is also actively involved in clinical practice and is the nurse leader of the MidCentral’s health diabetes and endocrinology service.

Helen has been described as a leader, mentor and expert clinician and embodying the attributes all nurses endeavour to hold. She was the lead author of the pioneering 2009 National Diabetes Nursing Knowledge and Skills Framework with the structure of her framework forming the basis of knowledge and skills frameworks of other national nursing groups in New Zealand.

In 2005 Helen was a visiting scholar at Yale University where she met and worked with other internationally recognised scholars on diabetes-related research.

She has also served on a wide range of local, regional and national working groups and committees including leading the former Nurse Practitioner Advisory Committee of NZ and being a member of the New Zealand Society for the Study of Diabetes (NZSSD)executive committee.

In recognition of her work in 2011 Helen received the MidCentral DHB Directors of Nursing Pre-eminent Award for a “significant impact on the New Zealand health system”.

NAME: Arun Valiyaveetil-Raju
DHB: Waitemata
JOB: Medical ward RN at North Shore Hospital

Arun Valiyaveetil-Raju’s sensitive care of the family of a dying patient earned his nursing hero nomination from Waitemata DHB.

Arun is aware when nursing a terminally ill patient that he also has to take care of the family. As while caring for patients in their last days is part of what nurses do, most families do not experience death often.

“Along with the patient, it’s the family that matters,” says the Ward 2 nurse. “For them this could be the first experience of seeing a person die.”

Arun recently nursed the father of a staff member, who was struck by his consideration for the family and how he explained what was happening.

“For renal patients, there are lots of things the family may have to witness when the body is trying to shut down,” says Arun. “The health professionals know what’s happening most of the time, but the family might not. In that situation, I really try to make sure I explain everything.

“It just takes me five or 10 seconds to explain to the family what I’m going to do.”

Although Arun was not nursing the patient when he died, he made a point of giving his condolences to the family – a gesture that touched them.

“I will always make sure I express my condolences,” he says.

It is important to acknowledge the family. And, he says, it’s also personally important – he was chatting and laughing with this man just a week earlier. “We are nurses, and we are also human.”

NAME: Judy McHardy
DHB: Northland
JOB: Until recently PHC nurse coordinator of the B4 School Check programme for Northland

Judy McHardy’s long commitment to improving child health was rewarded recently with a travelling fellowship to explore other countries models of care.

The Margaret May Blackwell bequest funds an annual fellowship to enable a nurse working in early childhood health to increase their knowledge by visiting and experiencing child health initiatives in other cultures.

Judy was the worthy recipient of the 2011/2012 fellowship (administered by the NZ Nursing Education & Research Foundation, and the NZ Nurses Organisation) which was seen as a just reward for a nursing career that focused primarily on the health and well-being of children.

She used the fellowship to travel to Europe and North America in 2012 and explore overseas models of care for three months. The award also affirmed Judy’s leadership role.

Judy has worked as a Plunket and Public Health Nurse in the mid and Far North regions of Northland, and until recently was the coordinator for the B4 School Check programme (B4SC) in Northland. She set-up the B4SC programme (the universal health screening programme for four-year-olds) and has coordinated the successful multi-provider model for the past four and a half years.

Mary Carthew, associate director of nursing for Manaia Health PHO, says Judy is widely respected and admired for her nursing knowledge and skills, and her tenacity and determination to deliver a high quality service to the children of Northland.

NAME: Janine Colpman-King
DHB: Lakes
JOB: A nurse leader at Lake Taupo Hospice

Janine Colpman-King believes all nurses have a responsibility to mentor the next generation of nurses.

The Lake Taupo Hospice nurse was the winner of the 2012 Lakes DHB Nursing/Midwifery Leadership Award.

“I believe that all nurses are leaders from new graduates to nurse leaders practising at a higher level.

Janine trained in Palmerston North Hospital and has been a nurse for 30 years working in a wide range of health care settings and in recent years has worked in specialist palliative care. She has a Masters in Nursing with a focus on palliative care, is a Liverpool Care of the Dying Pathway facilitator and a licensed Flinders self-management trainer and PDRP assessor.

She has developed a robust, evidence-based range of education services focusing on palliative care and plays an important part in educating health professionals working across primary, community and hospital services.

“People think working in the area of palliative care would pull you down, however during sad and challenging times we also do have a lot of fun. Walking along side patients and their families, supporting them to fulfil their bucket lists and live life every moment as opposed to waiting to die is a privilege.”

Janine’s nomination said she was a transformational leader who encourages staff development, influences changes, provides academic stimulation and contributes widely at local, regional and national levels.

International Nurses Day 2013: Closing the Gap

This year the theme slogan is Closing the Gap: the Millennium Development Goals 8,7,6,5,4,3,2,1 to highlight the countdown to 2015 when the eight goals to reduce poverty and its impacts were meant to be achieved.

The Millennium Development Goals (MDGs) aim was to create a framework to galvanise development efforts, set priorities and focus attention, action and resources on meeting the targets set for each of the eight goals.

Key successes to date reported to the UN include reductions in levels of extreme poverty, halving the proportion of people without access to drinking water, and increasing the numbers of girls enrolled in primary schools but much work is still needed to be done.

“As the largest health care profession in the world, there is no doubt that nurses are key to the achievement of the Millennium Development Goals,” says ICN president Rosemary Bryant and chief executive David Benton.

“Nurses are often the only health professionals accessible to many people in their lifetime,” says the pair. “So nurses are particularly well placed and often the most innovative in reaching underserved and disadvantaged populations.”

In particular nurses have a role in achieving the three health related goals: goal 4 to reduce child mortality, goal 5 to improve maternal health and goal 6 to combat HIV/AIDS, malaria and other diseases.

ICN reports that while there has been significant success in reducing global deaths of children under five, the majority of the 7.6 million child deaths that occur every year could be prevented using effective, affordable interventions. Also while there has been an almost halving in the number of women who die during pregnancy and childbirth there were still significant regional variations, with 56 per cent of maternal deaths occurring in sub-Saharan Africa.

The final health goal also shows significant regional variation with some successes but no room for complacency because of increased reports of resistance to anti-malarial treatments and multi-drug resistant tuberculosis.

ICN as an organisation has established five wellness centres for health care workers in sub-Saharan Africa and its MDR-TB project has educated and supported tens of thousands of nurses and health workers on helping combat the threat of multidrug-resistant tuberculosis.

It said another example of nurses working to meet the goals is the Southern African Network of Nurses and Midwives that works across national boundaries to maximise its resources and impact on health challenges like HIV/Aids.

“The countdown is on. The clock is ticking and we are running out of time. Each and every one of you can make a difference,” says Bryant and Benton. And they quote the words of UN Secretary General Ban Ki-Moon, ‘There is no global project more worthwhile. … Let us keep the promise’.