Pleasant Point to Great Barrier Island

Its been years since of added to this blog… thought I would start up again and share some new insights

After 10 years at Pleasant Point Health Centre – we didn’t recognise we were ready for a change… but change arrived in the form of an invite to take on the Health Care for the Great Barrier Island community. A brief visit to a place we had never been before and we were sold.

So we sold the practice to a great friend/ colleague; knowing we were handing over 10 years worth of work establishing NZ’s first Nurse Practitioner General Practice to someone who had helped pave the way, and would continue the mahi! It had always been one of my fears- who would I ever be able to pass this model onto that would see it for the special place it is. A culture different to anywhere I’d ever worked before.

The success of the NP model of care is in its continuation well after we have gone! And so it grows, evolves and continues to provide a unique model of care to the people.

Why the move? This opportunity gave us the best if both worlds- rural primary health care AND the ability to live with the bush and have the sea around us. During our time at Pleasant Point we would drive four hours after work on Fridays to our little spot in the bush on the West Coast just out of Greymouth every other weekend to ‘fill thy cup’ and then drive four hours back on Sunday in time for work Monday morning. Aotea gave us this without 8 hours driving!

As we continue to learn a new model of practice with many different components to its make-up, I now reflect on how and why we did what we did in the previous practice. What can I take from past experience and put in place that would add value to the current model? There are things like – telephone triaging by a Registered Nurse (RN), to support the work load. The right patient sees the right clinician at the right time. Often patient issues are sorted without having to see anyone else. The installation of a phone line specifically for prescriptions (rx) was a game changer. Allowing the “rx phone nurse” to process these as able throughout the day, having gone through a check list to ensure a phone script was appropriate. The use of the Health Care Assistant (HCA); a position we made/ built utilising the skills of the individual and what she bough to the role. This off loaded multiple tasks the the RN had done previously – allowing the RN to work more clinically- and extend scope, which was much more rewarding work. The HCA role grew quickly as the more paper based tasks were scheduled into the workplan. This allowed for assessments of patients to be done and notes updated (ht, wg, imms, BP etc) prior to seeing a clinician. Brief but important information that enables streamlined care for pts and time saving for clincians. Added to the HCA role over time were ECGs and phlebotomy, both useful skills to add to a busy clinic. And on this will continue, maximising the unregulated and severely under ultilised workforce.

Our first employment in our current practice … a HCA to support the patients, and clinicians alike to ease the workload of a time poor workforce. More on this to come!!

“Ehara toku toa i te toa takitahi.

         He toa takitini toku toa”

My strength is not due to me alone,

    but due to the strength of many