Nurses in Schools: Aranui Neighbourhood Nurse

1 November 2013

Aranui Neighbourhood Nurse: Kids open the doors to families in need

Jenny Herring’s nursing day starts each morning at 8.30 with a stroll through the playgrounds and classrooms as children and their parents flock through the school gates.

“Kids come to me to show me anything from a picture they have drawn to a sore on their knee,” says the Aranui neighbourhood nurse.

“One student told me about their mum who is at home with a sore chest and asked if I could go and see her.”

The latter conversation was particularly poignant as the child had lost their father to a heart attack about six weeks previously and was understandably frightened for their mum.

Being a familiar face in the schools and preschools opens doors into homes for this neighbourhood nurse, whose working day includes school sores to blood pressure and getting children to specialist appointments to hanging curtains in cold, draughty homes.

The first Aranui neighbourhood nurse role was former nurse academic, Jackie Cooper, who won three-year pilot project funding from the Canterbury District Health Board to deliver health care to high need, low socio-economic community based at the Aranui Community Trust office.

When the project funding ended in mid-2006, neither the district health board nor the local primary health organisation were ready to step in to continue funding. But Aranui Community Trust manager Rachael Fonotia says the position had proven its worth to the community so the trust went hunting for funding and Herring’s salary is 45 per cent paid for by the Canterbury Community Trust and topped up by money from other trust contracts.

Aranui is browner, younger, and poorer than the generally whiter, older, and reasonably comfortably-off Christchurch. It has five times the city average of Pacific people and three times the city average of Māori. It is also in the heart of east Christchurch, which was hit hard by the quakes – losing water for three weeks and the first portaloos not arriving for a fortnight – and it is still surrounded by dust and roadworks.

Herring has been the neighbourhood nurse since 2007 and visits the community’s primary schools weekly – Aranui, Wainoni, and more recently, Avondale primary school (all three primary schools are to merge into a “super school” on the Aranui High School site in 2017), and she also visits neighbouring St James School. Aranui, Wainoni, and St James have roughly 400 pupils between them and Avondale has a further 350 pupils. 

For the first two and a half years she would take the trust’s colourful Rotary-funded van to the schools which was an initial drawcard for children to come and see the nurse but it now only gets an airing once a month.

“The reason for doing that is because with the van I had to wait for people to come with me – and I was getting the same children every week,” says Herring. But she does take the van to Avondale school as she is still building relationships with children and families at the the new school and the van is a focal attraction. “It’s a bit like Mr Whippy!”

Her last port of call during her morning school visits is to pop in to the school office to see what children need to be seen, and on average, she has one to three children to see with boils or school sores or an ongoing head lice problem. Some will need follow-up visits to meet with the family.

Fonotia says it is often the children who invite Jenny into the home to follow-up their scabies or head lice. Once through the door, there may be a baby, pregnant teenager, or grandfather with heart problems she can talk to about their health needs and refer them to relevant health providers or agencies.

Herring also regularly visits three local preschools.

“At the kindergarten, I usually sit and play with the kids for an hour or half-an-hour. So the children get to know me, to want to meet up with me each week to tell their stories, and once again, the children lead into the households if I feel anything needs to be followed up.”

Now that she’s a familiar face in the community, most days she gets stopped by a parent in the playground or on the street – or they pop in to the trust office to find out when Jenny will be available, like the older man who had popped in that day to discuss his recent emergency visit to hospital.

Herring works closely with the hospital paediatric departments and local practice nurses to try and ensure the children and their families get to their specialist appointments. Sometimes, she takes her patients to appointments herself.

Fonotia points out that none of this is funded by the DHB, but there’s an expectation from the general practices and schools (particularly as the area at the time was one public health nurse short) that Jenny as neighbourhood nurse will step in.

The quake aftermaths have added a new level of complexity to the work, but Fonotia and Herring say Aranui is a resilient and connected community, with the trust having first opened its doors a decade earlier, so it has been a natural home for coordinating local responses, support, and community-building events.

From the start, Cooper and then Herring after her have also been keen to avoid doubling-up of services and to facilitate a two-monthly nursing network meeting at the trust’s office of 30-plus local practice, Plunket, district, and public health nurses, with often a guest speaker and always a chance to network and discuss families they are working with. Herring says the meetings are popular and her role is a welcome addition to the high needs community.

“I’m the only one of a kind in New Zealand,” says Herring.

“Well you are darling – you are different,” says Fonotia – only mildy tongue in cheek.

Having spoken about the neighbourhood nurse model around the country many times, she says the audiences’ consistent response is “yes, that’s how it should be”.