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Journals from NURS 298 PA Health Care in New Zealand

2010-01-24 Queenstown Lakes District Hospital

January 22, 2010 Yesterday we arrived in Queenstown and I was immediately struck by the stunning mountains and iridescent lakes that surround this community. The crystal blue waters provide boating activities during the summer and snow covered mountains are perfect for skiing in the winter months. Adrenaline sports such as skydiving and bungee jumping are also popular attractions to the area. Queenstowns resident population is about 20,000 people although more than a million tourists visit this resort town every year. During our time here, we visited the Queenstown Lakes District Hospital which is a twenty-one bed facility. I was fascinated by the adaptations that were made to compensate for the towns isolated location. During our visit we had the opportunity to speak with Jane Collins, the director of nursing for mental health and her team of mental health nurse specialists. I was surprised to hear that depression and anxiety are two of the most frequently seen conditions. Several of the nurses mentioned that this could be related to the high cost of living and stresses associated with employment. I was taken aback to hear how the recession has affected people in New Zealand because these are also issues we see in the U.S. The nurses also discussed the limited resources available to treat complex conditions in the Queenstown area due to the limited population. This means that severely ill patients must often be transferred to Invercargill for treatment. Janes team had several questions for us regarding the mental health training we receive in our nursing program. I really appreciated their curiosity and enjoyed the opportunity to share with them. The hospital sees 6,000 cases each year and eighty of these must be transferred to a larger hospital for more specialized care. Patients are often taken to the DHBs base hospital in Invercargill, which is almost 200 kilometers away. Ambulances are used for cases that are not as urgent but helicopters are best in emergency situations. These transfers may take several hours to coordinate and weather conditions play a huge role in how they are executed. For elective, outpatient surgeries a mobile surgical bus comes every six weeks. This service provides surgical equipment, operating space and an anesthesiologist which rural hospitals could not fund. I really liked this program because it means that patients who dont need to be in the hospital dont have to travel as far for their procedures which would be an unnecessary, added expense. Lizzy Gunn, the charge nurse for the emergency department (ED) told us that as many as one third of patients in the ED are tourists and that orthopedic injuries are seen most frequently because of the various outdoor activities offered year round. I was shocked to hear that only two nurses work in the ED during peak hours but that in case of a large, traumatic accident every nurse and doctor in the area will be notified and offer their services. Overall I feel that this has been my favorite visit so far. I really liked hearing about how closely the doctors and nurses worked together. This experience helped me to develop a better understanding of how New Zealands beautiful but isolated regions can be problematic when it comes to providing emergency care. The landscape which offers so much recreation can also be a huge barrier. I have great respect for ED nurses in rural areas such as Queenstown because their immediate care can be the difference between life and death. I was very impressed by the nurses wide knowledge base and the number of roles they perform. This experience helped me to recognize the many opportunities health care offers in rural communities in the U.S. As I continue on my path toward becoming a professional nurse I will seriously consider working in a rural setting. I am so grateful to have had the opportunity to explore nursing in this rural setting; it is truly unlike anything I would have experienced in my formal training. Stephanie Anderson- Linfield College nursing student

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