With shared lived experiences, cultural knowledge and language proficiency, Pacific nurses bring all kinds of benefits to their communities, Sela Jane Hopgood writes.
A Pacific family living in a small Auckland apartment sandwiched between two others is struggling to cope with their current living situation. Neighbours are fighting and swearing, and the argument can be heard clearly through the walls as the family tries to put their children to sleep. Another neighbour is blasting loud music, a child has fallen down the stairs multiple times and in the congested street, filled with similar apartment blocks, a car has bumped into a parked vehicle and left the scene.
It may go beyond what many would consider a nurse’s role to be, but Mutu’i Temukisa Alao-Snyder has helped many Pacific families in situations like this over her 25-plus years in nursing – mental health inpatient nursing for Plunket, wellchild nursing for various Pacific providers, youth forensic nursing, tele nursing. She has also been a nurse educator. Alao-Snyder is now a health improvement practitioner at South Seas Healthcare, where she sees patients after their GP or practice nurse appointment and talks to them in depth about other personal issues such as stress, sleep anxiety, depression, physical health conditions and drug and alcohol concerns – anything the patient was not able to discuss fully during their 15-minute consultation.
“It’s a new model that South Seas has implemented to include mental health into the primary health setting and it’s a free service,” Alao-Snyder says via a video conference call from her workplace, where I can see a fine mat hanging on her wall and a kava bowl on her shelf. “I like to make my room reflect my culture and the community I serve, so that they feel welcomed and at home in this space.”
The distressed Pacific family who comes into South Seas Healthcare chats with Alao-Snyder about what’s happening at home, as well as added cultural responsibilities such as fa’alavelave, or donating money for a family event. “The family didn’t need to feel ashamed to bring up fa’alavelave or explain what it is to me. I immediately get it, being a Sāmoan from Ōtara, and I am able to advise the family on what wraparound support we have available and coping mechanisms when feeling overwhelmed,” she says.
Alao-Snyder is pleased to see the current government announce its Pacific health workforce investment, including scholarships awarded to 220 Pacific health students for tertiary study and a new alternative pathway for Pacific-trained nurses. Associate health minister Barbara Edmonds says it’s about having more Pacific nurses within predominantly Pasifika communities, who speak the language and understand the culture, and can attend to their patients’ health needs more efficiently. Alao-Snyder agrees, saying she is also able to better support her non-Pacific work colleagues on how to navigate certain conversations with Pacific patients. “In western practices, an 18-year-old is considered an adult. However, I had a patient remind me that for Pacific people, you’re not an adult until you leave home, and so we had this 20-year-old ask if his mum could come with him to his appointment and I didn’t find it strange, but I can see how someone who doesn’t know that about Pacific people would raise an eyebrow at that.”
“As a registered nurse in the mental health space, I have opened and closed my sessions with Pacific patients in prayer as I know that is a comforting, grounding way for them after sharing such heavy feelings and experiences. I am also mindful that if there’s a 30-minute appointment booked in for a Pacific patient, that it may go for an hour as I encourage talanoa (talk) and when Pacific people feel comfortable in their setting, they embrace it,” Alao-Snyder says.
“I think I speak more Sāmoan than I do English in most of my daily consultations, which is one of the joys I have with the work that I do. Then there’s the knowledge of traditional healing practices such as the fofō massage that I understand, and I am able to navigate conversations around that as well as the importance of medication.”
Te Whatu Ora’s interim national workforce lead for Pacific health, Pauline Fuimaono Sanders, is also a registered nurse, having practised for over 25 years in renal services hemodialysis, primary care, setting up community Covid testing centres in South Auckland and in managed isolation and quarantine. Sanders says that Pacific nurses are able to better support the Pacific community, using clinical knowledge, cultural knowledge and language proficiency to engage in a meaningful way. “Pacific health workers can pick up the cues that we are familiar with such as body language or when they say they have got family obligations, which is nonspecific, we understand the magnitude of how those obligations will impact family life, school, work, church, sports and so forth.
“It’s asking the right questions when seeing Pacific patients, such as do you do shift work? Are you working two jobs? Who else lives at home? Do you have one car? Other health professionals won’t have that innate knowledge about intergenerational households, which is common for Pacific families,” Sanders explains.
Being the eldest in her family, Sanders says she has naturally always cared and supported her family and her community through leadership. For her, entering nursing wasn’t just natural progression personally, but an excellent professional decision too. “Nursing is a flexible profession where there are many fields you can go into and specialise in. You can also be an educator or a manager, but more importantly for many Pacific nurses, it’s the opportunity to create environments that our Pacific patients feel comfortable in, supported and understood.”
As an example of how Pacific nurses can have an outsized impact on their community, Sanders tells a story from her own career. She was taking part in the Aniva Future Pacific Nurse Leaders programme and one of her first assignments was to explore an issue that was causing her frustration at work. She had noticed that the number of Pacific patients on hemodialysis accessing podiatry services was dropping off because these patients had so many other appointments to attend, which was leading to many Pacific people needing foot amputations. “The issue I had with this is that it’s preventable, so I sought funding and I was able to get a podiatrist to come onsite in the dialysis unit, so that people didn’t have to go to their clinic. After a year, amputation rates reduced, and this taught me that there’s always something more we can do for our community, especially when we have the data on hand.”
Part of the government’s investment into the Pacific health workforce includes funding 35 students in a new graduate diploma programme in Pacific nursing at Te Pūkenga, Whitireia. “This is an alternative pathway to getting your New Zealand registration, recognising nurses from the Pacific and their experiences and it’s one way to increase the much-needed Pacific nursing workforce,” Sanders says. The students’ fees and course-related costs will be covered for the 18-month programme.
“I have lost count of how many times my aunty says, what are you doing for our Pacific community?” Sanders says. “Seeing the investment made by the government and how it reflects the importance of strengthening our Pacific health workforce is good motivation for me to do more.”
This is Public Interest Journalism funded through NZ On Air.