Walking alongside patients
In this, the International Year of the Nurse and Midwife, East Coast nurse Bobbie Cameron took some time out to talk about her career, how she managed it around her growing family, and the people she has helped along the way. Nurse Cameron (Nga Ariki Kaiputahi) is the primary care manager at Ngati Porou Hauora.
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By the time I was 19 years old, I already had three children and was a busy full-time mum.
I'd seen too many whanau die early from preventable diseases or not get the clinical care they deserved and I wanted to stop this happening for our whanau and others.
We were living in Hawke's Bay. I decided to enrol in the Bachelor of Nursing at the Eastern Institute of Technology (EIT), so I could have some “me time”.
I sat my state registration exam four weeks before the birth of our fourth child.
I've walked across the stage to collect all my graduation tohu — Bachelor, Postgraduate and Master's degrees — right after having a baby or while very pregnant!
I am using all that study, and the 15 years' experience working in Hawke's Bay, managing primary healthcare in my role at Ngati Porou Hauora. It's a broad role, including everything from crunching numbers and ensuring we provide quality care, to setting up new systems.
Primary health is any community-based healthcare.
Ngati Porou Hauora covers a large geographic area. Every community on the East Coast is very different, but all the communities are a long way from specialist and hospital-based services.
Many of our people have lots of social needs as well as complex health needs.
Working with high-needs communities has been part of all my nursing experience.
One year after graduating, I started working at Choices Kahungunu Health Services in Flaxmere.
I thought if I'm going to give of myself as I nurse then this is where I want to give.
It was a fantastic experience and shaped who I am as a nurse.
GPs rotated in from a larger Hawke's Bay practice, and nurses or kaiawhina provided the rest of the services.
Back then, it was a lot of tamariki ora nursing along with school-based, outreach and proactive nursing.
We took every opportunity to add things to our practice, including cardiovascular risk assessments.
Servicing high-needs Maori communities was the focus.
The range of skills I learned, and the exposure to different clinical scenarios was priceless.
Several years later, when I found myself working as a tutor on the Bachelor of Nursing programme, I found many of my real-world clinical practice stories came from my time in Flaxmere.
I eventually became a nurse contractor.
It was a huge risk, but it paid off.
We did before-school checks, outreach clinics and linked up with GP practices.
They referred patients to us who hadn't come into the practice for whatever reason, and supported them in their homes.
It was a huge role. We had clinics in the Ministry of Social Development offices twice a week.
During this time, I chose my own hours.
I would do a smear at 8pm if that suited the whanau.
One routine smear stands out for me as a reminder of why face-to-face time with whanau is essential.
I went into a home to do a smear and found the mum had been getting abused and had a child with asthma.
The mum had many unmet needs and wasn't getting anywhere.
Afterwards, I was able to go to a hui with her at Work and Income, and we got a good result.
That example is why it's essential to have kaiawhina and advocacy in the health system.
Many aspects of a person's health are related to social issues.
Mostly, people just need someone to walk alongside them in their health and wellbeing journey.
I learned a lot about what is needed to make health work in high-needs communities and felt I was making a difference.
However, the late-night calls were a hard combination with a growing whanau.
I took this knowledge into my role as a lecturer at EIT Hawke's Bay working on the Bachelor of Nursing programme.
I loved the challenge of supporting a group of learners to understand important concepts such as equity, and understanding their own unconscious bias.
It was so satisfying when the students got it.
The five years I spent working as a general practice facilitator for Health Hawke's Bay Primary Health Organisation (PHO) gave me the system management experience that is very relevant to my current role.
Hauora Tairawhiti's current planning and funding manager Nicola Ehau was my manager.
It was all about linking in with general practices to see what support they need, whether it be IT, new systems or orientating new staff.
I was responsible for supporting general practices in meeting targets and implementing quality improvements.
I learned about health funding streams and contract negotiations.
My clinical background meant I could understand different scenarios.
When my mother-in-law developed end-stage COPD (lung disease), it was time to bring the whanau home so we could support her and our whanau.
It has been a good move. I am particularly excited about developing our vital kaiawhina workforce.
This work has been recognised nationally and aligns with my other focus.
Nurses are in short supply on the East Coast.
Nurses bring a wide range of skills, knowledge and experience to our population.
Supporting them to work at the top of their ability is essential.