The NZNO Young Nurse of the Year for 2014 is Katrina Coleman, 27, a Plunket nurse in Newtown, Wellington.
She works with a large number of new migrant families, and helping improve their health outcomes is just as likely to see her advocating to move them to better housing, as assessing children’s growth and development. The communities have changed since Plunket began over a century ago, but Katrina’s work today in building trust with families, and connecting them with the people and services they and their children need to thrive has a lot in common with those first Plunket nurses. It draws on every bit of her nursing experience across mental health, hospital and public health.
Katrina has won the NZNO young nurse of the year award, but it’s clear the real winners are the new migrant families she works with in Newtown. She learned early on to adapt her schedule to their needs: “I do four to five home visits in the morning, and then four to five in the afternoon, and I remind everyone that I’m coming that morning. Often the people I’m seeing, their lives are so incredibly complex that even if I tell them the day before, they may forget.”
She acknowledges the high number of home visits is unusual for many communities: “It is a high amount of home visiting in Newtown – but it’s definitely the way to maintain engagement. If you imagine being a Somali mum with seven kids under 7, arranging transport to get to a Plunket clinic is just not able to be a high priority, because how could it be? It’s about making the service accessible and comfortable – arranging visits at their home, at a time they choose.”
Newtown is the most diverse community in Wellington, and one of New Zealand’s new migrant centres. Along with Somali families, Katrina works with families from Ethiopia, India, China, the Middle East – some New Zealand/European, and very few Maori and Pacific Islanders. For many, Katrina is often their only link: “We’ve seen women at the most vulnerable time of their life when they’re scared and sometimes they don’t have any real option but to trust you, because they don’t have anyone else.” You only have to imagine for a moment that you’re a newly arrived mum in Newtown, you don’t speak English, you can’t read or write, and you have no local connections, to get a small insight into the difficulties her clients face – and the significance of Katrina’s role.
Her work brings her into the homes of families living in appalling conditions, and a large part of her day is spent working with other agencies to get families’ basic needs met: “I remember sitting with a family last year who had been placed in a horrendous house, they had six kids under six. I was sat on the couch, and the mother said to me – ‘can you help me, there are rats living in my couch’ – the couch I was sitting on. You can imagine, I jumped pretty quickly. The situations people are living in, the poverty is appalling and often, these are people who don’t have a voice.”
She says some of the mums are illiterate: “They will ask me to fill in these forms for everything, not only for health services. It’s not in the role, but at the end of the day that’s why my relationship is strong – it’s about leaving my objectives of the visit at the door and doing what they need me to do, whether it’s filling in a form or looking for lice in people’s hair. It’s not always glamorous. It means having hard conversations with providers of social housing, but I refuse to back to down when I’m advocating for a family.”
It goes beyond the Well Child schedule, but she does it because it’s a determining factor to a child being sick or well: “I can truly say there are families I visit now who would be sick every time I saw them, they’re now in insulated homes, they’ve access to kindy – and their overall health outcomes are improved.”
And it’s how she builds her relationship with a family – and the community. “I always knew when I started the role that it wasn’t just about building the relationship with families but with the broader community. In some cases, I’m the only NZ European person they know, or the only person who can link them in to the system.”
Which means maintaining boundaries can be a problem: “They say - can you stay and look after the kids I need to take this one to the doctors. Or can you drive my parent to the hospital. And I have to say no, and you can see this realization – that we’re not friends, I’m doing a job. It’s an honour that people trust me with their parents and sick children, but it’s important I maintain those boundaries.”
Along with connecting families with services, she works to connect families with the people who have the resources and help they need. Not least, this means drawing on the Newtown Plunket committee of volunteers: “We came up with the idea of Christmas parcels (remove for every child) – sunblock, beach towels, food and gifts. But the winter ones are the best, they have slippers, warm clothes, blankets and nutritious winter food – brand new and donated stuff. Newtown is an amazing place – we got $1000 of toys from the City Mission last year – just incredible generosity.”
And with the help of Plunket volunteers, she launched the Link database at the beginning of the year – a way for women of the same culture to be linked with each other. The idea started when one of her clients, a mum with two children under two, had come out of violent relationship but had no social support, spoke little English, and couldn’t leave the house as she had agoraphobia: “It was tragic – she was in an awful place. I knew another mum who was unhappy in her marriage, she was brought here soon after getting married, and she was living in huge apartment building, she knew no one, she had no transport. I wondered if it would be beneficial to link these two mums together. So I got consent, and over the next 6 months I saw the most incredible transformation in these women’s lives – the mum with agoraphobia was able to get out of the house. The other mum had a purpose to leave the house, and every time I see these families now you can see the change in these women, in how happy they are with their children and how connected they are in the community. I thought - this is totally the most amazing thing I’ve ever achieved.”
She says that sometimes it doesn’t work out because of social hierarchy, but the link database is now offered to all Wellington mums, and run by a Plunket volunteer.
Katrina is celebrating her 3-year anniversary as a Plunket nurse in Newtown this month (5 September) and describes the community support system she’s helped set up as a ‘finely oiled machine’ – though is quick to acknowledge others: “I can’t take credit for the generosity of the people of Newtown. For example, the other day The Warehouse gave me 27 brand new winter jackets. They wanted to help – it’s amazing how many people will say yes when you ask. And five years before I stared, Jess, the Plunket nurse here laid a huge foundation – she built a lot of that trust building in the community – I picked up on her vision and her dream for Newtown. It’s a great place.”
“I came from public health nursing from Waikato – so isolated there, getting to hospital appointments is a nightmare. Here we’re right in the thick of it. If you’ve got a hospital appointment – you can walk there.”
Her enthusiasm isn’t worn by the challenges – instead, it’s clear she loves the job, and thrives on helping the people she works with: “There’s a huge aspect of social work involved in it. Possibly some of the nurses before me would have said ‘this isn’t my job’. I truly believe I have a working relationship with the migrant families – I decided I was going to be “that” person. It’s about triaging the need, meeting their needs one by one.”
She acknowledges it’s an intense role, and has worked out tactics for conserving her energy – like not looking too far ahead: “I never look at what my next day is going to look like until I get there because of how big they’ll be – I don’t want to start the day feeling exhausted by the day’s work I’m about to do.”
But while she takes each day at a time, when she decided to work for Plunket, she took the long view: “I always saw the role with Plunket as a long-term commitment – it’s not like working with the hospital when you have short-term, intense relationships of trust. It takes years to become trusted with in the community and when you take on a role with Plunket, you’re aware that you’re going to invest the time with the community as well as the families.”
“I always wanted to be a Plunket nurse – I was sitting in class and remember the Plunket nurse coming in working with well children in the community – I wanted to gain as much experience as I could and I’d recommend that to all new nurses. I worked in mental health and did my first post grad certificate in mental health – it’s priceless in this role, dealing with mums who are struggling with their mental health and have been through so much.”
As for the future, she’s a year away from completing her masters in nursing: “I don’t know where I’ll go next, but I can’t imagine not being in Newtown. I’m from Hutt Valley originally and I’ve lived on the coast for seven or eight years –I think it helps being so far away. It would be hard to do this job while living in Newtown.”
And news of the award itself still hasn’t sunk in: “I think everyone’s blown away – it’s such an honour. My friends and family are my number one support. They always think you’re the best of the best anyway, but it’s hugely pride evoking. The award is nice because it makes missing out on family functions and catching up with friends only occasionally all for something.”
Tags: Plunket Nurse 0 Comments 19 September 2014