Health on the hoof: Truckie stops

1 July 2013

Truckies are being waved down and pulled off the road in the Bay of Plenty for the good of their health.

Once a year, freezing workers end their shift on the chain to find a tent full of nurses offering fruit kebabs and keen to take their blood pressure.

And kiwifruit packhouse workers are grateful after being shocked into action by an opportunistic on-the-job health check.

Kaitiaki Nursing Service’s readiness to take free health assessment to the people is another reason why Western Bay of Plenty is topping the country’s league table for heart and diabetes checks.

Sue Matthews is the clinical nurse leader for the service, which employs 28 nurses to carry out a range of contracts providing outreach health services, including whānau cancer, whānau nursing and community access nursing services. A major source of funding is the Western Bay of Plenty PHO, which uses its SIA (services to improve access) funding to contract Kaitiaki to improve access to health care in vulnerable communities and to people who aren’t engaged with conventional health services.

This means for the past three years the nurse service has not only been carrying out opportunistic health assessment checks in client’s homes or at its nurse-led clinics in high need communities and local marae (working in close liaison with the local Māori health provider), they have also been setting up one-off annual tent clinics in workplaces, which in some cases is literally the side of the road.

“The best way to actually access men – particularly Māori – in that 35-60 age group is to go to the workplaces, especially where there are low income earners.” Or ­in the case of the freezing works, a rollercoaster seasonal income. One freezing worker told Matthews that he hadn’t seen a doctor for five years as “when he had the money, he didn’t have the time, and when he had the time, he didn’t have the money”.

Truckies can be another workforce hard to pin down and engage with health services. A higher than average truck crash rate in the Bay of Plenty prompted police to approach Kaitiaki to work with them and the ACC injury prevention unit to offer the first roadside health ‘pit stop’ back in April 2011.

High-vis vests and tents

The police set up the truck stop on a busy state highway in the Bay of Plenty and pulled over 75 trucks and offered their bemused drivers a free health assessment by one of Matthews’ waiting team of eight nurses clad in their high-vis vests.

Only three men turned the opportunity citing delivery deadlines, but the rest, says Matthews, were happy and relieved to have a ‘health warrant of fitness’ that checked out their blood pressure, cholesterol, and blood glucose levels and offered them a chance to discuss any health concerns and get health promotion advice on anything from prostate health to quitting smoking.

“I work 16 hour days and there is no way I can get to the GP for a warrant of fitness. It is really important for me to be healthy as I put the food on my family’s table,” said one grateful driver.

Some truckies told the nurses they hadn’t seen their GP for anything from four to 18 years. Matthews says the nursing team she pulls together for the truck stops and other one-off clinics have all completed an advanced assessment and reasoning paper (plus other postgraduate papers) and work hard to make each nursing assessment ‘patient centric’.

For some truckies, the roadside health assessment just provides them with a snapshot of their health and for others it is “a wake-up call,” says Matthews. Many are given referrals for a follow-up visit to their GP usually because of elevated blood pressure, cholesterol, or blood glucose, but also on a few occasions for depression or drinking problems. The nursing service also, with the permission of the client, informs the general practice they’ve carried out the assessment and sends them the results.

“Truckies seem really honest – they will talk about their drug taking, their alcohol consumption, or their smoking,” says Matthews. The roadside warrant of fitness gives the nurses a 30-minute window to give the drivers some health promotion and a “traffic light” assessment of whether their health was green (good to go), orange (need to make some lifestyle changes), or red (need to take immediate action).

Leave with goodies bag and GP referral

It appears that when truckies get back on the road, after their complimentary coffee and picking up their free water, fruit, sandwich and ‘goodies’ bag (complete with freebie chamois, pen and pamphlets), they don’t forget their traffic light rating.

Now on to their fifth truck stop, Kaitiaki nurses are getting drivers reporting back that since the last truck stop, they’ve been to see their GP and are now on medication. Matthews had one GP reporting he had four truckies turn up one morning all waving a Kaitiaki referral note and talking about ‘truck stop’, leaving him intrigued and wanted to know more.

Similarly, setting up one day health assessment clinics each year at some of the Bay of Plenty’s very large kiwifruit packing houses and cool stores has reaped health rewards, including one middle-aged woman who had thought she was hyper-fit but found she had dangerously high blood pressure and cholesterol. The woman credits her now good health on that timely health check, especially as both parents were dead by 65 and she had had close whānau die of strokes. She told the Te Puke Times: “At family tangi, I usually stand up and plead with all present to have a health check. It could save their life like I’m sure it saved mine.” A forklift driver sent for follow-up tests was also shocked to discover he had type-2 diabetes.

Since 2011, Kaitiaki has also been setting up an annual health extravaganza tent at the AFFCO freezing works offering health assessments to workers as their shift on the chain finished. Waiariki Institute of Technology nursing students helped initiate the first extravaganza and were on hand to manage booths providing health promotion material and to hand out fruit kebabs and non-alcoholic drinks to the tired freezing workers at the end of a hard working day. At AFFCO’s invitation, the nursing service now has regular clinics at the works at least once a month to provide health assessment, follow-up monitoring, and cervical smears.

Matthews is passionate about equal access to health care and believes primary health nursing can do even more, with her current dream for the region to have a director of nursing for community and primary health to provide visionary strategic leadership.

“I haven’t gone hoarse yet,” says Matthews, whose services to health were recently recognised by becoming a Member of the New Zealand Order of Merit (MNZM) in the Queen’s Birthday honours list (see June 4 News Feed at www.nursingreview.co.nz).