Nurse leadership: having the bottle to make a difference

She was ducking through the car park of a closed-down supermarket on her way to work when “I just happened to turn my head and look over – and I was just outraged”.

The cause of her outrage was the Thirsty Liquor bottle store, a liquor outlet that had popped up between the then pharmacy, and a takeaway store in December 2013. It was just opposite an existing pub, a few hundred metres from Eastcare Health where she worked and only a short stroll from the Aranui primary and secondary schools.

“I felt really angry,” recalls Carpenter. “This is the last thing we need in this area. We are trying to rebuild … I thought, how dare they?”

The Aranui born-and-bred nurse went fuming on her way to work and, after discussing this unwanted new neighbour, decided to do something about it. So while most people were winding down for the Christmas break, Carpenter ‘wound up’ and within a couple of days had launched a petition.

She dropped off paper copies to the local pharmacy, the Aranui Community Trust (whose mission since 2001 has been to nurture the wider Aranui community) and at the practice. She also launched a petition online at www.change.org against the liquor outlet, which she discovered had, through a combination of circumstances, been able to open up without consultation with a 90-day licence (issued under the Sale and Supply of Alcohol Act 2012) but would have to go through a public hearing process if the licence was to be permanent.

Community takes up nurse’s fight

Aranui is browner, younger and poorer than much of the rest of generally whiter, older and reasonably affluent Christchurch. It is also in the heart of east Christchurch that was hit hard by the earthquakes and five years on is still surrounded by dust and roadworks. But that doesn’t mean the community is without heart.

Carpenter returned to work in the New Year to find that she was far from alone in her outrage over the pop-up liquor store. The petitions had taken off – particularly the online one, which had attracted around 100 or so comments from many like-minded people. She found many people agreed that Aranui didn’t need four bottle stores within a kilometre of each other. And with the help of local Christchurch East MP Poto Williams she gained an understanding of the liquor licensing process. She also took her campaign to all agencies and forums she could think of, including the Pacific Reference Group of Pegasus Health, of which she is the Pacific nurse representative (Carpenter is part-Fijian).

By the time a community meeting was held at the school in late January, she had more than 1,000 signatures. At the well-attended meeting it was revealed that amongst the unhappy opponents of the bottle store was an alternative school for teenagers that had unknowingly signed up for a lease in the same building just a month before Thirsty Liquor had opened.

Momentum kept building against the store, helped by social media with some of Carpenter’s old Aranui Facebook mates across the country and the Tasman also taking up the cause.

The initial battle was won when the 90-day licence ran out in March 2014 and the outlet closed. An application was lodged by the owner for a new licence, requiring a liquor licensing authority hearing, but nothing was heard for months and months and it wasn’t until 2015 that a hearing date was set for late April and the community once again garnered their forces ready to give evidence. But just weeks before the hearing date the owner withdrew the application and Carpenter and her fellow bottle store opponents could finally celebrate a moral victory.

“I was on top of the world,” recalls Carpenter. “Very empowered by what we could do as a community. But humbled at the same time.”

Returning as nurse to her childhood community

The victory was all the more special as while Carpenter was no stranger to Aranui, in Christmas 2013 she was still relatively fresh to nursing.

She had worked part-time as a personal carer while her children were little, then, after finding herself a single parent, she decided “to get out and do something” so she could give more of herself than her current role allowed. (She hesitantly told a friend in 2005 that she wanted to be a nurse, at which her friend confessed that she really wanted to be a mechanic. Both succeeded in following their dreams.)

Carpenter said she knew early on in her nursing training she wanted to work in the community. However, on graduating in 2009 she accepted a job at Burwood Hospital until she heard through the grapevine of a job going in Aranui and she successfully applied to join Eastcare Health. Initially two GPs, two nurses and herself, the staff is now four nurses and four GPs.

As a novice nurse she says she was really well supported by her nursing colleagues, GPs and Pegasus Health to develop her nursing skills in her childhood community.

“It means a lot to me, this community… I think growing up here as a kid and seeing what it used to be and what we’ve lost, including through the earthquakes…”

She looks back to the days when it was a lively, thriving community where kids played cricket on the streets. “There were kids everywhere – the park was full of kids playing after school until it got dark and time to head home. Parents always knew were their kids were – now I drive past that park every day and nobody is there. That’s quite symbolic to me of where Aranui was and where it is now.”

Stepping up as a community advocate

Carpenter’s focus has been on helping rebuild the Aranui community and – as a nurse in Aranui, as the facilitator of the Aranui Nurse Network, and as a child who grew up in a family affected by alcohol – she just wasn’t ready to let a new liquor outlet undermine the hard work underway.

“As a nurse I’m an advocate for families and knowing from my own family, where alcohol was a big factor, that children and families needs aren’t always met in that situation.

“So my challenge was from the heart, as an advocate for my patients and for the love of this community and the people who live in it.”

She sees community advocacy as very much part of the nursing role and hopes her story will empower other nurses to follow their heart.

“If we want to changes things for our patients, change things for nursing then we need to share our stories of empowerment and let other nurses know that you can make a difference,” says Carpenter. “And not be afraid or fearful to take that step.”

Though she admits doubts did run through her head at the time. “I can remember thinking ‘oh my gosh, what am I doing?’, but at the end of the day it was a cause I couldn’t let lie. I felt so passionate about it.”

Empowering nurses to act

Carpenter has already been contacted by a person working in another high needs community wanting advice on how to stop a planned bottle shop (see her tips in sidebar). She believes a key to a successful campaign is knowing your community.

“That was one thing I was told when I came into nursing here by a colleague… being a practice nurse is knowing your community.

She believes the time spent getting to know what supports are out there for her patients and linking in with other nurses and people in the community has paid off.

And general practice is more than what happens within the four walls of the medical centre.

“Just sitting in here – we’ve got our own little world in general practice but it’s what is going on outside general practice…” And to Carpenter the potential consequences of increased access to alcohol in the community was something she couldn’t ignore.

“The children that might miss out on groceries in the cupboard, the family violence from alcohol… and (if closing the outlet) made a difference to even one family…

“Because it’s such a big problem – there are things that go on behind closed doors that you don’t see… but you see the consequences in low decile communities like this – food banks, the drug and alcohol problems. Another bottle store would just add extra pressure on the community, health care, police, the court system.

“I remember saying to somebody (about the impact of alcohol), ‘who doesn’t know somebody whose father or brother might be in prison [as a result of drinking] or somebody who has been pulled up for drunk driving? Everybody is affected by it.”

Taking that step out of her comfort zone to be an advocate for a community and cause she was passionate about has had unexpected payback for Carpenter.

Christchurch media picked up on her successful campaign and she was awarded a Public Health Association scholarship to attend and present her story to the Population Health Congress in 2014.

The first scholarship led to another: a University of Otago scholarship to attend a Pacific Health summer school. She then went on to attend a College of Nurses two-day primary health care leadership workshop. “It’s been this constant journey,” says Carpenter, who is still a little taken aback by where her ‘outrage’ has led her.

It was the leadership workshop that cemented for Carpenter that what she had done in fighting Thirsty Liquor was actually leadership. “I was sitting there with these like-minded nurses who were thinking the same way as me and wanting to go forward and make a difference.”

Back in December 2013 she was just driven but now she is growing more comfortable thinking of herself as a leader. “It makes me stand a bit taller,” she laughs. “Not being proud or anything, but it just makes me think I’ve got the confidence to actually do things, and anything is achievable.”

So to any other nurses wanting to step up and make a difference she says “go for it”. “The support comes as you go through your journey and you never know where it will take you.” :