The Ministry of Health announced this week that Broodkoorn, of Ngāpuhi and Dutch whakapapa, had been appointed to the role. She is believed to be the first chief nurse of Māori descent since the forerunner of the role was created nearly a century ago. Her appointment follows the resignation of Dr Jane O’Malley, who left the Ministry in February to take up the role of Plunket’s first chief nurse.
Broodkoorn, who has been director of nursing and midwifery at Northland DHB since 2010, told Nursing Reviewsaid she was feeling very excited – and a little nervous – about the opportunities and potential of the senior national role, but also sad at leaving Northland.
“It is an honour to represent nursing and be the first Māori nurse to be appointed to a role like this,” said Broodkoorn. She said she had also been humbled by the amount of texts, emails, phonecalls, tweets and Facebook messages from colleagues, friends and family from across New Zealand but also overseas.
New-look Ministry
In February she will join the country’s first Chief Allied Health Professions Officer Martin Chadwick and Chief Medical Officer Dr Andrew Simpson in the new ‘Clinical Cluster’ created as part of a restructuring of the ministry management team, carried out by new Director General of Health Dr Ashley Bloomfield, that came into effect in October.
Broodkoorn, is excited to be joining the Ministry under Bloomfield’s leadership and said she shared his commitment to achieving health equity in outcomes across the country which would also be one of her big priorities in her new role.
“I believe nursing is well placed to contribute to that – I think we need to ensure that nursing is leading that change and in order to do that we need a sustainable nursing workforce that is future focused and prepared for that change.”
She said to do that nursing needed a robust workforce pipeline from ensuring future nurses have the right school preparation through to supporting new graduate nurses once trained and retaining them in the workforce. Also on her agenda was how to further develop more advanced and expanded nursing roles in the three scopes of practice – registered nurses, enrolled nurses and nurse practitioners. “And of course on the radar is (doing the same) for our Māori and Pacific nursing workforce.”
“Also how do we add value as a profession where we work as a team and work with our other professional colleagues and clinical partners to contribute the leadership of the health and social sector as a whole.”
Wearing two hats
Broodkoorn said she applied for the role for a number of reasons – including being encouraged by a number of people – and the chance to represent nursing as a Māori nurse. She has been clinical lead for Ngā Manukura o Āpōpō – the national Māori nursing and midwifery workforce development programme.
“It is my passion to encourage others to be able to be ready and step up into roles like this. And if I wasn’t prepared to do that myself I shouldn’t be asking that of others.” Also she recognised the importance of having a New Zealand and a Māori nurse in the role.
“I think Māori nursing has been asking for it for some time – in terms of having a Māori nurse leader in the Ministry and I suppose the Ministry and the health sector gets a “two-for-one deal,” she laughed.
“Having a bicultural heritage – having grown up with both Dutch and Maori heritage – I feel I’ve grown up with the best of both worlds and bringing an inherent equity focus into the chief nurse role is timely and a great fit.”
She said she had learnt to combine the synergies between her two cultures and her profession and was looking forward to demonstrating how that can work. “Not just from being a Maori nurse but how I can share that understanding with others and other clinicians.”
Broodkoorn graduated as a nurse from one of the last hospital-based training programmes at the former Greenlane Hospital School of Nursing. She has a Master of Health Science (Nursing) with 1st class honours from the University of Auckland. Apart from a variety of clinical nursing roles, she had education roles at MIT and University of Auckland specialising in kawa whakaruruhau (cultural safety) and Te Tiriti o Waitangi training.
From education she progressed into management and leadership roles as the assistant director of nursing Māori with Auckland DHB, managed a Māori health provider service, and had returned home to Hokianga as a community development manager before taking up the Northland DHB director role in 2010.
Excited at new role but also a little sad
Broodkoorn says one of the sad aspects of her move will be the need to step down from some of her current roles that she has loved being part of, including being on the executive of the National Council of Māori Nurses and her role as sponsor lead of Nga Manukura.
“While it’s sad it is also exciting in terms of the added-value I can now provide to the development of the Māori nursing workforce – just now wearing a different pōtae (hat).”
Broodkoorn is looking forward to working with her national nursing organisation colleagues and working with the yet to be announced new chief executive and registrar of the Nursing Council.
“I am excited but also have mixed emotions as every day that goes past is a day closer to my leaving my role here and that does sadden me because I’ve got such an amazing team here. I work with amazing people in Tai Tokerau who are commited to addressing health inequities in Northland which are significant for our population. …No time is a good time to leave but I just feel there is so much more work to do that I would love to be part of. But I will be home again.”
Broodkoorn said her partner and two young adult children are very proud and supportive of her new role. “I couldn’t and wouldn’t be doing it without their support.”
She starts her position on February 11. She will be joining nursing advisors Jane Bodkin, Kathy Glasgow and Ramai Lord and executive assistant Debra Begg in the Office of the Chief Nurse. She was also delighted to hear of the appointment this week of Martin Chadwick, who she has worked with him before, and was looking forward to working with him and chief medical officer in the Ministry’s new clinical cluster.
Bloomfield has said the new Clinical Cluster, with a combined staff of about 11, will be responsible for contributing strategically to understanding how services can be better planned and delivered including “identifying and promoting innovations at a national level, providing oversight and direction on clinical and professional issues across the sector, and supporting the response to current and future workforce demand”.
]]>The appointment of Tracy (Tūhoe, Whakatōhea and Ngāti Kahungunu) – who is in her second year of nursing study at Te Whare Wānanga o Awanuiārangi in Whakatāne – has come at a pivotal time for Māori nursing.
A more than decade long campaign to close the 25 per cent pay gap faced by nurses working for underfunded Māori and iwi health providers compared to their DHB colleagues is in front of the Waitangi Tribunal.
Māori nurses are to share their frustration and argue that the Crown’s failure to address the pay disparity – despite repeated submissions on inequitable funding – is evidence of institutional racism in the health sector. Also pointing to the ongoing gap in health outcomes betweenMāori and non-Māori and the need to boost the Māori nursing workforce as an important step to help reduce the disparity.
“Like it or not we are the future of nursing,” says the new student leader. “Only a few hours
after I was elected Kaiwhakahaere Kerri Nuku organised myself and another to talk to two Ministry of Health representatives aboutissues that students faced, one which is what can be done to train more Māori nurses and then retain them. We will be going to talk to them again in Wellington soon.”
Whānau heartbreak
Tracy’s journey to studying nursing has been, at times, arduous. “I’ve seen first-hand the barriers Māori are faced with, when in hospital. My dad passed away recently (due to cardiac issues). He was my biggest supporter. I’ve met with some personal challenges on the way to achieving my dream of becoming a Māori registered nurse, but I know he will always be with me spiritually.
“Kei te hotuhotu te ngākau mou pāpā, a tonā wa ka tutaki taua ano. Moe mai ra toku pāpā I roto I ngā ringaringa o te Atua”
Her son was diagnosed with rheumatic heart fever at the age of 12 and Tracy spent three months at Starship Hospital with her boy.
“That’s where I saw how amazing nurses are. I didn’t know anything and they were so calm sitting day after day with us explaining what was happening.”
Tragedy struck again when three years ago, Tracy’s brother passed away from cardiac issues when he was aged just 41.
“It was the final push I needed. I decided then and there, that I didn’t want any more whānau to pass away from illnesses that are preventable and treatable. If I can prevent one whānau from going through the heartache my whānau has been through, this would be worth more than any amount of money anyone could give me.
Inspired to study nursing
“I knew if I wanted to help my whānau I needed to get educated. When I looked into the possibility of studying again it was quite daunting because I was an older student, I had limited knowledge of anatomy and physiology, and it had been a few years since I’d left high school.”
Tracy began a Te Reo Māori course at Te Whare Wānanga o Awanuiārangi in 2015.
“That gave me the grounding and confidence to progress to the half-year bridging programme to nursing in 2016. I started in Te Ōhanga Mataora Paetahi – Bachelor in Heath Science Māori Nursing – in 2017.
“At my instituition Te Reo Me Ona Tikanga is a living, breathing part of our nursing journey it is just as important as the clinical skills we learn. Cultural and clinical competences are interwoven into our curriculum and are designed to ‘inhibit’ differences in ethnicity, this is the point of difference that our programme offers.
“Another key part of our programme as tauira (students) we are not just an ID number; we are real people who can talk and engage with our lecturers if we need any support whether it’s academic, pastoral care, clinical support or just someone to confide in.”
Cultural dimension
She says she looks at things from a Māori lens – rather than from an outsider looking in at Māori. She says this is partly why Māori patients and their whānau respond differently to Māori nurses.
“Recently at a hospital, a Māori patient wouldn’t touch their food. When I came in I saw there was a urine bottle near where their food sat. It was that easy and that profound.”
Perhaps unlike many of those who step into more political roles, Tracy said she does not see herself as a leader. After people pointed it out she realised that people listened (to her) but it was with “a lot of encouragement” she “hesitantly” put her name forward.
“I have a strong voice that I can use to support and advocate for students. Prior to the election, I had been attending hui in Tauranga for Te Rūnanga, I sat and listened to, and was inspired by, Māori registered nurses encouraging and inspiring students to keep pursuing their dreams to become registered nurses.”
Tracy is passionate about providing cultural support for nursing students.
“At the recent student hui a tau, multiple issues of concern were identified. One of those voiced was the withdrawal of/limited cultural support/services available to nursing tauira.
“I am reluctant to identify the schools that have removed cultural services as this could possibly affect the tauira that raised the issue. I can confim that only five nursing schools identifed that they have strong cultural support within their institutions.
“Tauira also identified another eight nursing schools where the cultural services offered were limited, or in fact, non-existent. I was saddened when one tauira said: ‘If cultural services were to be removed no one would notice a difference’. It made me realise that the services we are offered at my instituition are not the norm.”
“Chairing Te Rūnanga Tauira gives me the opportunity to support and advocate for nursing students to make a positive change. I have been able to listen and speak to delegates across the country to gather their views as Māori student nurses. I carry these views when I campaign, to make changes.”
And the mother of four says that while her life experiences saw her dream about being a cardiac nurse, her dream now is to be a Māori registered nurse.
“I know the rest will fall into place from there. Where my people need me is where I’ll go.”
*NZNO’s National Student Unit has two parts – the National Student Representatives (NSR) and Te Rūnanga Tauira (TRT). Dion Reid is Chair of the NSR and Tracy is Chair of TRT.
]]>Māori nurses are to share their frustration and argue that the Crown’s failure to address the pay disparity – despite repeated submissions on inequitable funding – is evidence of institutional racism in the health sector.
The nurses will be speaking up in support of the Wai 2713 claim made by NZNO Kaiwhakahaere Kerri Nuku and Hineraumoa Te Apatu on behalf of the Te Rūnanga o Aotearoa of Tōpūtanga Tapuhi Kaitiaki o Aotearoa (NZNO). Their evidence will follow the two claims by two Māori and iwi health provider groups who started giving evidence on their similar funding and institutional racism grievances at the start of the historical Waitangi Tribunal hearing at Tūrangawaewae Marae this week
The nurses and providers claims are part of the global Wai 2575 Health Services and Outcomes Inquiry that groups together the more than 200 individual and group claims seeking the Crown to address a wide range of health-related grievances that are broken into three stages – the first focusing on primary health.
Nuku has twice taken the case for Māori nurses to the United Nations after saying “enough is enough” following the failure of the long-running Te Rau Kōkiri campaign for pay equity for Māori and iwi provider nurses that has been ongoing since the DHB ‘pay jolt’ of 2005 created a pay gap that continues to grow.
A petition was presented to Parliament in 2008 calling for the Government to work with NZNO and the providers so that pay equity could be funded but a Health Select Committee recommendation to look into the petition issues was vetoed by the Government in 2009. The Rūnanga has also raised the issue at International Labour Organisation forums and lobbied and met with the Human Rights Commission, Ministry of Health and four health ministers.
“No one within the New Zealand government is listening, despite the fact that we have raised this issue numerous times,” says Nuku in her evidence statement filed with the Tribunal. “This is why we have had to take such expensive and dramatic methods (i.e. presenting at UN).”
Their claim says the pay disparities – which will increase with the recent DHB nurses pay settlement – are a by-product of how the Crown funds the Māori and iwi providers differently from general practices belonging to large primary health organisations. They say the funding fails to address the differences in infrastructure investment required for Māori versus other larger health providers. Also that funding contracts awarded to Māori providers did not allow for pay equity nor recognition of the dual competencies of many Māori nurses.
“Each year this issue remains unresolved Māori whānau continue to receive less income than the families of nurses working within district health boards and other parts of the health sector,” says the claim.
One of the Māori health provider claims also point to a 2007 Deloitte Report – prepared in response to an initial Waitangi claim made in 2005 – indicating Māori PHOs and providers were being collectively underfunded by $21.77 million a year and they say nothing has been done by the Crown in the decade since to remedy that underfunding.
The nurses’ claim has three recommendations with the first two being for a systems-change based action plan to eradicate institutional racism across the health sector and for the “detection, prevention and eradication of racism” to be built into all health sector quality assurance systems.
The last asks that “urgent action and leadership be taken by the Minister of Health and/or the Ministry of Health to reconfigure contracting and funding processes to ensure pay parity for nurses working in Māori and iwi health providers with those elsewhere in the health sector”.
The Wai 2575 Health Services and Outcomes Inquiry, primary health claims, are being heard in a series of hearings in October and November at Tūrangawaewae Marae, in December in Wellington and finally in March next year to hear closing submissions. The stage two claims will cover three main areas with the first being mental health (including suicide and self-harm, the second being Māori with disabilities, and the last encompassing issues around alcohol, tobacco, and substance abuse. That stage is expected to begin midway through next year. There is currently no start date for the stage three claims which will cover the remaining national significant issues and eligible historical issues.
]]>Giving out plasters, soap and antiseptic cream, along with friendly, repeated advice, is part of a nurse-led project in schools in the Eastern Bay of Plenty town of Kawerau that’s making a major difference to skin infections in children.
The Kiri Ora Healthy Skin project is one of the initiatives prompted by the region’s public health service, Toi Te Ora, after concern at the start of the decade at the high number of children being admitted to Bay of Plenty DHB hospitals with preventable skin infections – from infected scabies to eczema and nappy rash to cellulitis.
The DHB’s serious skin infection rates peaked at more than 80 per 10,000 children in 2009–10, far above the national average and costing the DHB more than $1 million a year, not to mention the trauma for the children and families involved. The rate was much higher for the region’s Māori children – 140 per 10,000 children – again much higher than the national average for Māori, raising issues over equity, poverty and access to health care, in particular some of the region’s rural towns and communities.
Having arrived from Scotland only a few years previously, where rheumatic fever was virtually unknown and skin infections like impetigo (school sores) rare, the region’s statistics in both were worrying for Dr Jim Miller, a Toi Te Ora medical officer of health.
In 2011 Toi Te Ora communicable disease nurse Lindsay Lowe and colleagues carried out a skin infection health needs assessment, which confirmed that serious skin admissions were on the rise in the region. James Scarfe, a Toi Te Ora public health analyst, says research in neighbouring Gisborne also indicated that the hospitalisation statistics were the tip of the iceberg, with for every child hospitalised around 14 cases of skin infections being seen by general practices.
The public health team set in place a range of strategies to meet its goal of reducing the human and financial cost of child serious skin admissions by two-thirds in five years. It is not there yet, but the latest Bay of Plenty statistics available (from 2015–16) show the rate dropping from the peak of 80 in 2009–10 to 54 per 10,000 children – the lowest this century.
In addition, the rate for Eastern Bay Māori, the region’s highest, dropped from more than 160 to 100 over the same time period. Part of that success story is the Kiri Ora project launched and led by Sandra Innes-Smith.
Plasters a ‘luxury’
When talking to mums about their children’s impetigo, it became increasingly clear to district nurse Innes-Smith that for many homes a box of plasters is a luxury.
“I know these are really good mums but their budgets are just zero,” she says. She would be sharing clean-skin messages with these mums and realise that buying even basic products like plasters was beyond their budgets.
So when Toi Te Ora set a goal of reducing skin infections she was adamant that equally important as educating parents and kids was providing basic skin care resources to families in need, so they could put the education into action.
Toi Te Ora were in agreement and the DHB’s planning and funding manager came on board to fund healthy skin packs – built on a Wellington Regional Public Health initiative. Inside the pack is soap, plasters, chlorhexidine wipes, toothbrushes, nail clippers, nit combs and family-friendly health information.
The region’s skin packs have played a key role in the Kiri Ora project since Innes-Smith first carried out her pilot skin clinic in Kawerau schools back in 2014, with the support of Lizzie Farrell, the public health nurse leader for the Wiri School skin clinic programme that inspired the Mana Kidz programme in South Auckland schools.
The pilot built on the Eastern Bay of Plenty Primary Health Alliance’s Rheumatic Fever Prevention project, which Innes-Smith is clinical lead for, with the twice a week nurse-led skin clinics at each school coinciding with the throat swabbing team visits. A successful pilot evaluation led to a nurse being funded to continue the project which has since expanded from the original primary schools in the Kawerau area to include schools in Edgecumbe and Whakatane, bringing the number of schools to 10 and the children under the programme to about 2,000.
Some of the first children Innes-Smith saw at the pilot school clinics had got used to managing their scrapes, grazes and bites without plasters. She says it was matter of some friendly retraining that if they got a scab or sore they needed to clean it and cover it with a fresh plaster every day rather than just pulling their jersey down to hide it. They were then sent home with plasters and maybe cleansing wipes and antiseptic cream too – while the full skin packs are only given out once or twice a year, the project makes sure that no child leaves a clinic with simply advice, but also with the products they may not have at home to help them heal without infection. If a sore requires antibiotics, the clinic nurse refers and works with local general practices to ensure the child gets a prescription and follows up with the family.
Clean, cut, cover and check
The Toi Te Ora clean skin key message consistently delivered to all children and families across the DHB is “clean, cut, cover and check” – or clean hands and nails regularly, keep nails cut to avoid scratching, wash and cover any sores and cuts with plasters, and check sores and seek help if they don’t get better, increase in size or have pus or red streaks coming from them.
Friendly and fun repetition of the message is essential, says Innes-Smith, as once is never enough for children. So nurses will praise and endorse the child who returns to the school clinic with a clean wound covered with a fresh dressing, but they will also give a warm welcome to the child who returns with an open wound that’s still struggling and happily talk them through the message once more.
“What they learn is that we really like seeing them, we’re really friendly and we will give them positive reinforcement when they do ‘get’ it.”
Sometimes the project’s clinic nurse has had to battle for a month or two to heal kids who arrived with as many as 10 infected school sores and new ones still popping up. Until comes the day the kid knows to return with just a single wound – a fairly minor school sore – at just the right time to be treated before it cascades and the nightmare starts all over again. “With lots of positive reinforcement the kids really, really do learn how to nip things in the bud,” says Innes-Smith.
“I can hardly express how amazing it is when kids come back proud as Punch of how they’ve managed their own scrape, scratch or sore,” says Innes-Smith. “They know they’ve done the right thing and they are just grinning from ear to ear. That’s when you know you’ve really cracked it.”
She stresses again that she believes education is not enough on its own for financially struggling families. “It was disempowering them not to provide product (like plasters, wipes and creams), she says. “If you just provided words all you were going to do was make them feel guilty.” And kids respect their product – telling her it has a special place in their drawer or the fridge.
The potential link between skin infections and acute rheumatic fever is also another motivation for Innes-Smith for bringing home the clean skin message. “Even if there’s not a direct pathway between skin infection and acute rheumatic fever, at least if you are not carrying strep bacteria on your skin it’s got to be a win,” she believes.
Innes-Smith would also dearly love to be able to expand the skin clinics to kohanga reo and to more schools – particularly in the Opotiki area – but skin packs are distributed to children via other schools and early childhood centres in the throat-swabbing programme and the team works closely with the public health nurse team. She says on average the area is giving out nearly 40 skin packs of various types a day.
Toi Te Ora strategies
Catching and treating more skin infections in the community – like the Kiri Ora project does – before they became so serious children needed hospitalisation was a major aim of Toi Te Ora’s serious skin infection prevention and education strategies.
Jim Miller said Toi Te Ora’s statistics focused on serious infections that ended up in hospital as those were the infections the DHB could count but they also gave an indication for child skin infections across the wider community. “You are never going to get rid of all serious skin infections – but a lot we were seeing were quite clearly preventable by good hygiene and skin care and should be easily managed in the community.”
Lindsay Lowe said one of their three key strategies was on increasing awareness and understanding in the community about skin infection prevention and management. “Some people didn’t even recognise it as a problem,” says Lowe.
Children were turning up at schools with infected sores and while it fell short of being considered normal it was getting to the point of being too accepted. Toi Te Ora adapted Wellington public health resources to promote and share the healthy skin messages with parents, whānau and early childhood centre staff along with the skin packs.
The second strategy was focused on health professionals – and Toi Te Ora held a series of workshops to highlight not only the local health burden of serious skin infections but also increase the skills and responsiveness of nurses and GPs when they saw children with skin infections.
The third strategy was to improve the effectiveness of primary and community health services in preventing and managing skin infections including promoting the use of community pharmacies, developing closer collaborations between providers, continuing to provide skin packs to high incident communities and focusing interventions on those highlighted at most risk from their analysis, which were babies and Māori children aged up to four years in particular. (The high baby statistics were thought to be partly due to the lower threshold for admitting babies to hospital with infections that included infected eczema, insect bites and nappy rash.)
Reducing serious child skin infections is to date the most successful of the three child infection reduction goals set by Toi Te Ora in 2012 along with rheumatic fever and respiratory infections. All three are often linked through the underlying factors of poverty and deprivation with families living in overcrowded conditions in often damp and cold houses more at risk. With progress in reducing respiratory and rheumatic fever more mixed Miller says Toi Te Ora is also trying to support housing initiatives that can help reduce some of those risks.
Meanwhile, with kids in Kawerau treasuring their plaster packs, and families and health professionals getting the clean skin message, it looks like reducing skin infections is on track for a start.
]]>The 25-year-old of Ngāti Awa, Tuhoe and Te Arawa descent was announced as joint winner with Annie Stevenson at the annual NZNO awards dinner last night
Ruha-Hiraka now works as a practice nurse at Kawerau Medical Centre, where she had also worked part-time as a healthcare assistant throughout her three-year degree. The majority of the centre’s patients are Māori and the centre nominated their young protégé – who is fluent in te reo – for her passion for improving the health status of Māori through prevention and education, and her work as the centre’s smoking cessation champion with the COPD management programme.
She says that when her boss nominated her she didn’t believe she had a chance of winning as “the calibre of the past winners was so high”. So she was so very excited to find she had won. “I was, like, stoked…I couldn’t believe it! I was so thankful, honoured and proud.”
Ruha-Hiraka grew up with her first language as Māori and said speaking te reo meant she felt she was able to connect and build rapport quite quickly with her Māori patients. “And we do have some kaumātua who struggle to understand consultations done in English so I do some of my consultations in Māori, which is easier for me and for them. So it’s a win-win.”
She says her Te Ōhanga Mataora Paetahi (Bachelor of Health Science Māori Nursing) at the wānanga was amazing, including its holistic focus on using the te whare tapa whā model to make them consider all four sides of Māori health – tinana (physical), wairua (spiritual), whānau (family) and hinengaro (mental) – when working with Māori patients.
“I’ve been brought up with te reo Māori and with the Māori world view, so I have basic knowledge of tikanga and I apply a lot of that into my practice as well. Which I feel our Māori patients appreciate.”
Though originally from the Bay of Plenty, Ruha-Hiraka had full te reo-immersion schooling in Wellington from kohanga reo, kura kaupapa and on to wharekura. A new job saw her nurse mother bring the family home to the Bay of Plenty, where Ruha-Hiraka decided to enrol and be part of the first Whakatane cohort of the wānanga’s kaupapa Māori nursing degree. She gave birth to her daughter Tewaituarangi in her second year but was so determined to finish her degree on time that she went straight back to school the day after giving birth as she had an assessment.
“I just continued my studies with no break,” she says. “I was working part-time as a healthcare assistant, was a full-time mum and did full-time study all at the same time.” “But I couldn’t have done it without my whānau – they were my number one support system. Without them, I don’t think I would have been able to continue that quickly.”
Ruha-Hiraka says after leaving school she had been contemplating medicine but having shifted back to the Bay of Plenty she had been keen to stay there to study. Now midway through her new graduate year, she says she wants to continue studying and is considering starting on the nurse practitioner pathway in her chosen field of primary health care.
But first she is looking to celebrate her win and says as it is her partner’s birthday the day after the awards they might head off with their baby for a weekend away.
At the awards, NZNO kaiwhakahaere Keri Nuku acknowledged Ruha-Hiraka’s use of tikanga and te reo to create a safe and respectful environment when working with patients and their whānau, and said she truly deserves recognition for her hard work and dedication.
“You are a wonderful role model for young and Māori nurses, and we couldn’t agree more with staff at Kawerau Medical Centre, who say they are lucky to have you.”
Runner-up Te Rongopai Clay-Mackay, a young Plunket Nurse working in Porirua, was also acknowledged for her work in improving health for Māori. She is the first Plunket nurse to deliver both Well Child and B4 School programmes in te reo Māori and Nuku said Te Rongopai stood out for being “a vibrant, committed and caring young nurse who has demonstrated an incredible amount of maturity and professionalism in her work”.
The 2018 award winners and runners-up were chosen from 14 nominations. The judging panel consisted of representatives from all district health boards, the Office of the Chief Nurse (Ministry of Health), the NZNO President, kaiwhakahaere and nursing staff, and last year’s winner Jess Tiplady.
]]>The Tapuhi Kaitiaki Awards recognise Māori nurses who are furthering their studies, clinical practice and professional development while continuing to support the wellbeing of whānau, hapū and iwi.
“Māori nurses play a unique role in the health sector in that they are both clinically and culturally competent health professionals,” said NZNO Kaiwhakahaere Kerri Nuku on the new awards.
Alison Hill, Pharmac’s Director of Engagement and Implementation said a Pharmac goal was eliminate inequities in access to medicines by 2025, and improving Māori health outcomes was a key focus.
“Māori health professionals have a pivotal role in helping Māori understand and access the medicines they need,” said Hill.
“We were really pleased with the quality of the applications, which painted a vivid picture of the deep understanding and strong commitment these nurses have to serving their communities through their profession. I was impressed to see how much these nurses fit into their daily lives, juggling their studies, tamariki, home and professional lives.
She said each of the nine winners demonstrated strong connections and dedication to their whakapapa and community, while continuing to strive towards excellence in their studies or professional practice.
Recipients of the 2018 Tapuhi Kaitiaki awards each received $2000 to $2500.
The award was presented by Kerri Nuku, the kaiwhakahaere of the New Zealand Nurses Organisation, and adds to the New Zealand Order of Merit that Milne, a Māori mental health leader and consultant of Ngāti Hine and Ngāpuhi descent, received in the Queen’s Birthday Honours last year for services to Māori and health.
Milne, who trained as a mental health nurse more than 40 years ago, said she believes the people currently in mental health nursing are just as passionate as her generation.
“We [mental health nurses] were always the poor cousins [of nursing] but now we’re actually the distant cousins … Because the whole ethos around mental health nursing has really, really been diminished in the last decade.”
Milne says part of what makes mental health nursing unique is that “you are the tool of the trade”. “How somebody moves through from mental illness to mental wellness is dependent on you.”
She says her generation was forced to do things without permission because there was “nowhere to go but up” because of the unsustainable pressures on health services. “I have to actually say – if we don’t watch out …we are going back to that same crisis-driven environment again.”
Nuku said Milne’s dedication was a gift to all New Zealanders. “I was very proud to present this award to such a great person who is so dedicated to Māori health needs and education.” She said Milne had provided significant leadership through her working career and generated the same aroha, manaakitanga and commitment to her people as the award’s namesake – Akenehi Hei – who was the first Māori nurse to register under her Māori name back in 1908.
Milne’s previous awards also include the College of Mental Health Nurses/Te Ao Maramatanga Māori Mental Health Nurses Award and the RANZCP Mark Sheldon Award for her contribution to indigenous psychiatry, both presented in 2016.
Milne said her recent submission to the Inquiry into Mental Health and Addictions called for a kaupapa Māori framework for services for Māori and arguing the better resourced kaupapa Māori services were the bigger difference they could make to consumers.
Milne’s mother was a registered nurse, but it was the mental illness of a teenage classmate that first drew Milne to working in mental health. She first trained at a psychopaedic hospital in Mangere, before completing her psychiatric nurse training at Nelson’s Ngāwhatu Hospital, where she and colleagues also formed a kapa haka group of patients and staff that competed in local competitions.
She returned to Auckland to nurse at Kingseat, and spent some time nursing in Scotland in the mid-1970s before returning to nurse at the former Carrington Hospital. She retrained as a teacher in 1980 but returned to her first love of mental health, including working as a kaiwhakahaere for the Health & Disability Commissioner.
After becoming a consultant in 2000, in 2001 she developed a framework called Nga Tikanga Totika or Best Practice Guidelines for Kaupapa Māori Mental Health Services. She also contributed to Te Hau Marire (the national Māori addiction strategy), developed education programmes addressing Māori health, and contributed to Maori research through her membership of the Health Research Council and chairing of the group that developed Te Ara Tika to improve research ethics with Māori.
Milne has been a member of the Māori committee of the Royal Australia and New Zealand College of Psychiatrists (RANZCP) for almost 20 years and is active in the International Network of Indigenous Health Knowledge and Development.
]]>Nominations for the first Tapuhi Kaitiaki Awards will close on July 10 and announced at the Indigenous Nurses Conference in Auckland on 11 August 2018.
Pharmac and Te Pōari o Te Rūnanga o Aotearoa of the New Zealand Nurse Organisation launched the awards recently with Pharmac chief executive Sarah Fitt saying the awards acknowledged the role that Māori nurses have as key influencers and role models.
“For whānau, the Māori nurse with the knowledge, expertise and understanding of tikanga, kawa, Māori health needs and practise is an important advocate and support person,” said Fitt. “These awards are a financial contribution for all Māori nurses to further their studies and clinical practise, and can be used by nurses to help support their work load and whānau commitments.”
Kerri Nuku, NZNO’s Kaiwhakahaere, said the awards were a great opportunity to acknowledge Māori nurses’ uniqueness.
“Undertaking further academic study and training to become nurse prescribers and nurse practitioners is a huge commitment on top of everyday mahi and whānau life,” said Nuku.
“Te Rūnanga are extremely proud of the support and investment PHARMAC is providing with the Tapuhi Kaitiaki scholarships and we believe this will help whānau, hapū and iwi to access and understand their medicines.”
“Māori nurses are great innovators, it’s a great opportunity to showcase ways in which they work day-to-day for the betterment of their people, hei oranga motuhake mo ngā whānau, me ngā hapū, me ngā iwi.”
The scholarships will be awarded in two categories:
- Nurse prescriber/nurse practitioner – to support nurses on the journey to become RN prescribers or NPs by offering financial support for their study and clinical practice requirements
- Māori nurse Mātauranga Award–to support nurses wanting to further their study and/or would like to develop an innovative way to assist whānau, hapū and iwi to access and understand their medicines. It is also available to enrolled nurses who wish to study toward registered nurse status.
Application forms and more information can be found here
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She was honoured at the 2018 Minister of Health Volunteer award ceremony at Parliament on June 18 alongside Pacific nurse Sonya Apa Temata, who won the Pacific Health Volunteer Individual award for her work both here and across the Pacific, and wound care nurse consultant Pam Mitchell, a longstanding member of the New Zealand Wound Care Society, who was a runner-up in the Long Service awards.
Gosman who was born in 1936 of Ngā Puhi, Ngāti Kahungunu ki Wairoa and Ngāti Tautahi descent, has been doing volunteer work since 1974. She trained as a registered nurse in Wellington Hospital in the mid-1950s and later trained as a registered midwife and Plunket nurse. Now in her 80s, the foundation member of Te Kaunihera Neehi Māori o Aotearoa (The National Council of Māori Nurses) and inaugural vice-president of the College of Nurses Aotearoa continues her volunteer work, including posts on a number of iwi/ Māori councils and as a board member of the Rural General Practice Network.
Health Minister Dr David Clark said the judges were impressed by the depth and range of Gosman’s volunteering work over 44 years and the impact it has had on improving Māori health outcomes in particular.
“I would like to thank Kim for her contribution to the health and wellbeing of others. Her commitment at a strategic level and to training and mentoring new staff has enabled the expansion of frontline health services and improved health accessibility for Māori in the Lakes District Health Board region,” he said.
Her volunteer work began in the 1970s and later as a foundation tutor at Whitireia’s School of Nursing in the 1980s, she began undertaking papers in Māori Studies and learned te reo Māori. She also stepped up her volunteer work in firstly Porirua and later Turangi, where she was the inaugural managing director and chief executive of Tuwharetoa Health Services.
Gosman’s voluntary work has included maternity services and marae-based ear health clinics, and extended and improved the development of a wide range of health services. She is described by Lakes District Health Board as being a champion of improving Māori health outcomes and reducing inequalities.
Clark presented the Minister of Health Volunteer Awards in Parliament yesterday to mark National Volunteer Week and congratulated all those recognised as outstanding achievers.
Pacific nurse Sonya Apa Temata won her award for her exceptional work to improve health outcomes for Pacific patients and their families, both in New Zealand and in the Pacific. As 
a volunteer, she drew on her nursing background, which includes cardio-thoracic surgery, district nursing, sexual health and adult sexual assault services. As well as being a proactive member of a number of boards and advisory groups, she volunteers in communities and universities to ensure a Pacific perspective is reflected in the delivery of health services. This year she has volunteered as part of the Fiji of Friends Foundation Cardiac Missionary team in Samoa and Fiji, and in the Cook Islands. She also gives a lot of her time to the LGQTBI Rainbow space for Takataapui, Pasifika Rainbow.
The work of Pam Mitchell, a Christchurch wound care clinical nurse consultant, particularly her work as a recognised leader in pressure injuries, was honoured with a long 
service award. Mitchell has been an active member of the New Zealand Wound Care Society for over 19 years, at times holding executive positions. She has represented the New Zealand Wound Care Society nationally and internationally, including work on developing pressure injury guidelines. She has been involved with national initiatives to improve clinical outcomes across New Zealand, collaborating with ACC, the Ministry of Health and the Health Quality and Safety Commission. She is also on the organising committee for the New Zealand Stop Pressure Injury Day.
Health Volunteer of the Year Award
Winner – Kim Gosman, Turangi
Māori Health Volunteer Individual Awards
Winner – Kim Gosman, Turangi
Runner-up – Jean Te Huia, volunteer CEO for Nga Maia o Aotearoa Māori Midwives.
Pacific Health Volunteer Individual Awards
Winner – Sonya Apa Temata, Pacific nurse
Long Service Awards
Runner-up – Pam Mitchell, wound care nurse consultant and member of NZ Wound Care Society
See the full list of winners and runner-ups at the close of this Health Central article.
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“I had a friend who was doing her training here and she had enough of me because I always talked the talk and I was too scared to walk the walk,” she said.
Larkin had always wanted to be a nurse but believed at 33 and with seven children she had missed her opportunity.
“One day we drove down to UCOL, she went inside grabbed an application form … she filled it out and I just signed it.”
It was anything but plain sailing from there.
“I wanted to quit the very first week. I just thought I can’t do this. I thought what the hell are molecules and compounds … if this is what nursing is about, I’m too dumb.”
Life also dealt some rough hands to Larkin. Since her journey into nursing began her mother, father and husband have all died.
But she never wavered in her drive to becoming the best nurse she could be.
This Saturday is International Nurses Day and Dalreen Larkin, with nurses from around the country, will be celebrated for the work they do.
Larkin is an enrolled nurse at Whanganui Hospital where staff describe her as a ‘treasure’.
Not long after she started working there she realised she was one of the few hospital staff who really understood Māori patients and their needs.
“I see me walking through the door, especially with Māori.
“Given my background as a little girl growing up … I didn’t like who I was. I didn’t like being a Māori.”
Larkin said her parents and grandparents’ generations had their Māori culture “smacked out of them”. “I was brought up like that.”
“It’s probably been the last 10 years where I’ve come to accept I’m brown and I’m proud. I love who I am.”
She said she would see Māori come into the hospital looking frightened and made a point to make them feel welcome.
That led to her quashing the rate of people not attending hearing appointments, often Māori children whose parents couldn’t get to the hospital.
Typically about 40 per cent of patients were not showing up to those appointments. Now everyone attends.
“I ring them a day before the appointment. I can pick up in slight pauses in their voices … that okay they’re not going to come – I’ll dig in a little bit more.”
Larkin said the hospital paid for taxis where parents were unable to make the journey to the hospital for financial reasons or if their car couldn’t fit all their children, often an obstacle for bigger families.
Despite balancing the pressure of supporting seven children with the rigours of the job, Larkin remains upbeat always.
“Being a nurse is not about me or whatever is going on in my life. As soon as you hit the door, that’s it – you leave all that behind. It’s about the person and the patient.”
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