Career path: clinical nurse director

August 2015 Vol 15 (4)

To’a Fereti shares her ‘accidental’ career path to be clinical nurse director in charge of 600 nurses – the first Pacific nurse to hold the post.

To a FeretiName: Safaato’a (To’a) Fereti (born in Samoa, raised and educated in Dunedin)

Job title: Clinical Nurse Director, Medicine & Clinical Support Services, Counties Manukau District Health Board

Nursing qualifications:

  • RN 1989 (Christchurch Polytechnic)
  • Postgraduate Certificate in Specialty Care (Pacific Health) 2012 (Whitireia Community Polytechnic/Aniva Pacific Nursing Leadership Programme)
  • Master of Nursing (MNurs) 2013 (University of Auckland)
  • Postgraduate Diploma in Specialty Care (Pacific Health) in progress (Whitireia/Aniva)
  • Postgraduate Diploma in Business (Healthcare Management) in progress
  • Master of Nursing (Pacific Health) beginning in 2016 (Whitereia/Aniva)

Postgraduate study and Aniva Pacific nursing leadership programmes

I started postgraduate study in 2006 as it was expected of me on taking up a senior nursing role at Counties Manukau DHB. In 2012 I also did my Postgraduate Certificate in Specialty Care Pacific Health as part of the Aniva Pacific Nursing Leadership Programme. This programme – funded from next year to master’s level – is special and unique as the focus is specifically on the issues of Pacific peoples’ health and wellbeing and the challenges and opportunities these provide for Pacific nurses. It is delivered by some of the most pre-eminent Pacific health professionals, including Fuimaono Karl Pulotu-Endemann and Dr Margaret Southwick, with the support of Aniva director Dr Debbie Ryan. They have become my mentors.

Next year I am planning to continue my postgraduate business diploma, as well as start my second master’s through the Aniva Fellowship programme. (I’m looking at whether I can cross-credit some of this towards a Doctorate in Health Sciences). Yes, everyone has called me crazy!

Briefly describe your initial five years as an RN

My first job as a new graduate in 1990 was in Coronation Hospital, Christchurch, which was a long-term geriatric hospital. I believe this instilled in me the foundations and essence of nursing. It closed down in December 1991 and I was redeployed to Princess Margaret Hospital AT & R ward until I moved to Auckland in 1993, motivated by wanting to work more with our Pacific people. I got a job pretty much straightaway in Middlemore Hospital’s Ward 8, which was the renal/medicine ward. Back then, there was only a handful of Pacific nurses. It is good to see this number has grown; however, there is still work to be done to increase the Pacific health workforce to reflect our population demographic. In 1995, renal was given its own dedicated ward (ward 15) where I became the ward-based acute haemodialysis nurse and basically remained in the ward until 2001.

Did you have a career plan (vague or definite) on becoming an RN? And how did those first five years influence your subsequent career?

My path to date has been ‘accidental’ – a phrase coined by Matafanua Hilda Faasalele. It was being at the right place, at the right time; however, it was also about having great friends behind me who recognised my potential and my strengths (even when I didn’t) and who pushed and supported me to go for the senior nurse roles – thank you.

In 2001 I felt I needed a new challenge. I applied for senior nurse roles within the renal service but was unsuccessful as I lacked the required qualifications. But as they say, where one door closes another one opens. The ‘new door’ was at Auckland DHB where one of my best friends encouraged me to apply for the renal transplant coordinator role. It was the best thing that happened to me – a new DHB brought new knowledge, skills and networks. It was probably the turning point of my nursing career.

I knew then that my pathway was more leadership/managerial rather than clinical. I returned to Middlemore Hospital as renal services nurse educator at the end of 2006 to be closer to home for my children. I was in this role for 10 months and then became charge nurse manager of the Acute Dialysis Unit, taking up my current role in April 2012.

What led you into your original specialty?

It is ironic that my specialty background has been renal for more than 20 years – this was my worst subject at nursing school. But on seeking a job at Middemore (as I was told it served the most Pacific people) I was given the choice of a job in AT & R or renal and chose renal as I’d come from AT & R in Christchurch.

I soon learnt that Pacific people had a high incidence of diabetes and hypertension leading to renal failure. I loved working with and caring for our renal patients who became like my second family as the hospital was like their second home. I learnt a lot about the different cultures, values and beliefs. From this my understanding of my own cultural values has grown and how these values are translated into and through my nursing practice.

What qualifications, skills or stepping-stone jobs do you think were particularly helpful and/or necessary in reaching your current role?

To best answer this question, I need to quote the ‘3 C’s’ from
Dr Margaret Southwick:

  • Courage: the courage to take the first step into the unknown; stepping out of your comfort zone and getting uncomfortable
  • Credentials: you need to have qualifications behind you to get into the more senior nurse roles.
  • Credibility: standing up and doing what is right, even when everyone thinks you shouldn’t. 

It’s also about relationships – maintaining and sustaining good relationships with everyone.

In June I accepted a Ministerial appointment to the Nursing Council of New Zealand, for a three-year term. I am proud to say I am the first CMDHB nurse appointed to the Nursing Council and only the second Pacific person (the first was Dr Margaret Southwick, who was chairperson from 2009–2013).

I was an independent consultant to the Ministry of Health, Samoa, in 2014 and undertook a review of the National Kidney Foundation of Samoa. I also undertook a review of the Lakes Satellite Dialysis Unit, Rotorua, in 2010.

I have a passion for Pacific health and to increase the Pacific health workforce, in particular nurses. Definitely my journey through the Aniva Pacific Nursing Leadership programme with the guidance of my mentors has enhanced my leadership skills within my current role.

And I remember the journey of how I got to where I am now, and those who helped and supported me along the way. Now it’s time for me to give back and help others pave their way.

What personal characteristics do you believe are particularly important for nurses working in your role?

Definitely the first three would be Dr Southwick’s ‘3 C’s’: courage, credentials, and credibility. Leadership is a key skill in this role, balanced by self-confidence and humility (and a great sense of humour).

Excellent communication and interpersonal skills are a must as you are providing professional leadership and governance over the practice of nurses. Also you need to have a strategic lens, to provide coaching, mentoring, and positive role modelling, and have emotional intelligence, critical thinking, and energy.

For myself, being a Pacific nurse leader in a mainstream role and having a two-world view lens, it is also important to me that I remain authentic and infuse my own Samoan cultural values of faaaloalo (respect), alofa (love), tautua (service) and humility into my role and into my nursing practice.

Also being caring, kind and compassionate towards all people – that’s what I believe nursing to be and why I chose this profession.

Describe your current role and responsibilities

My current role is clinical nurse director of Medicine & Clinical Support Services and I have been in this role for over three years. I am proud to say that I am the first Pasifika nurse to get this role in Counties Manukau Health. I am part of my director of nursing’s (Denise Kivell) leadership team. She is an awesome and fabulous boss and I am proud to be under her leadership.

  • I have over 600 nurses within my division for whom I:
  • provide professional governance and leadership for at a strategic level
  • ensure all nurses perform and conduct themselves in accordance with the DHB vision and values, and Nursing Council requirements
  • ensure strategic and operational plans are successfully implemented with a strong professional nursing and clinical focus
  • ensure patient and family safety and quality agendas within the service are championed as part of Counties Manukau’s quality focus
  • provide clinical advice, coaching and mentorship for all nursing staff within the division to manage complex and difficult professional/clinical situations
  • contribute to the strategic planning process for the workforce, ensuring that nursing professional issues and impacts are considered. 

My career to date has not been achieved on my own. I am here because of all the support and love from my four children, my family, friends, my director of nursing and my mentors. So it is only fitting that they are also recognised for their contribution to who I am, what I am doing and where I am today. As a Pacific nurse leader in a mainstream role my vision for the future is for the Pacific health workforce to make positive changes in the health status of Pacific people in New Zealand.

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Comments

  • well done To'a, so great to see your success. I worked with you over 20 years ago in the renal ward at Middlemore Hospital. Your communication and dedication to patients, whanau and staff has continued and Im sure you will make a difference in your current role!

    Posted by Kylie Hodgson, 24/11/2015 11:15am (2 years ago)

  • Well done to To'a. . It is not everyday that nurses with recognised qualification, leadership skills,good communication skills n good relationships get recognised for their contribution to the health sector most especially primary health care.

    Posted by Lulu padotan , 10/09/2015 10:35pm (2 years ago)

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