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Journals from NURS 298 PA Health Care in New Zealand

2010-01-28 Culteral Diversity and Healthcare in New Zealand

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New Zealand (Aotearoa)

Emily Mackie 1/28/10 Cultural Diversity and Healthcare in New Zealand After a long and exhausting journey to get to New Zealand - beginning with an arduous application process nearly a year ago, and closing with an endless day of traveling less than a month ago - the final moment of arrival in Auckland was accompanied with a sigh of relief, sheer ecstatic anticipation for the upcoming adventures, and a breath of fresh New Zealand air. Throughout our 24-day long tour of New Zealand, there were many recurrent themes that emerged both within the healthcare settings as well as in the culture. The cultural influence of New Zealand is evident in their overall healthcare system in a number of ways. By examining the culture, their easy-going, yet amazingly comprehensive, approach to healthcare becomes more comprehensible and the diversity between New Zealand and the United States grows more apparent. After reflecting on the various sites we visited through the North and South Islands, I have pinpointed five major themes that stood out to me: an emphasis on primary and preventative care, a collaborative and team-oriented approach, the influence of a bi-cultural society and the focus on cultural safety through the Treaty of Waitangi, the importance of holistic care through the ubiquitous Whare Tapa Wha (four sided house) model of care, and finally the prominence of patient and family centered care as a priority. In Auckland, we visited Starship Childrens Hospital and the Auckland City Hospital. At Starship, they stressed teamwork, holism, and the Maori influence was present throughout the facility in the artwork and even the colors that were used in rooms. I was impressed at the presence of family support at the city hospital and the steps staff were willing to take to allow family to be present and included in care as much as possible. Again, an interdisciplinary team effort was emphasized as they mentioned that no one member of the health care team was more or less important than another. At both these sites, I was also impressed, and a bit envious, at the 10-month preceptorship and support program they actually require of all new nursing graduates. Perhaps this will not be my last time in Auckland. Rotoruas hospital visit was all about the bicultural partnership and the Maori influence, including how the Treaty of Waitangi has impacted healthcare throughout the country since its origin in 1840. The Maori have a very holistic approach and we became familiar with the Whare Tapa Wha model of healthcare that reappeared at nearly every site thereafter. This model has four aspects of well-being: Taha Wairau (spiritual well-being), Taha Hinengaro (mental well-being), Taha Tinana (physical well-being), and Taha Whanau (social well-being). Whanau means family in Maori, and therefore refers again to the importance of family support on health and well-being. Also included in the Whare Tapa Wha model is the incorporation of alternative treatments which the Maori hold in high value. This is a prime example of holistic healthcare, and served as a mere introduction to the Maori cultural influence in this countrys healthcare system. The relaxing, soothing, spa mud baths in the famous Rotorua mud werent bad either. As the landscape changed with our passage to the South Island, the themes remained the same and continued to further illuminate themselves. In Nelson, the sunshine capitol of the country, the city hospitals rehabilitation and physiotherapy unit was remarkably patient centered. The healthcare providers put the patient in control of their own outcome in order to better individualize their recovery. Later that day, learning about the voluntary service of parish nursing further highlighted the significance of teamwork through the need to collaborate with General Practitioners and other healthcare providers. The PHO (primary healthcare organization) stressed preventative care through community services and, again, team cooperation. I will continually refer to the patient centered ideology in my future nursing career as this is such an important aspect to include with care. Considering the United States high-quality technical care, greater empathetic and patient centered care is exactly what should be integrated to produce the perfect care combination. Our visits in Christchurch were inundated with valuable information; yet, the themes nevertheless corresponded. Nurse Maudes community services were comprehensive and combined preventative care with taking action. The proactive changes that have been implemented in the regions healthcare system were impressive and due, in part, to members of the Nurse Maude organization. The Christchurch city hospital emphasized teamwork, community involvement, primary prevention, as well as taking charge to initiate progression. The information from the Plunket nurses we spoke with aligned with the previous perspectives regarding community well-being and especially preventative measures through education and support services for families of all different backgrounds. I, for one, was blown away with Plunket! This is the type of service so many families could benefit from in the United States, and yet may never understand. I couldnt help but consider my oldest sister who, by this summer, will have three children all under the age of five. Where are the Plunket nurses when you need them? The small, rural and remote city hospital of Queenstown was very community oriented and stressed the fact that all members of their healthcare team work together in a competent manner to provide the best and most comprehensive care possible considering their limited capabilities related to their remoteness. Thanks to services such as the mobile surgical bus that circulates the country every six weeks, rural facilities like the Lakes District Hospital in Queenstown can thrive despite what they lack. In Dunedin, we visited the community hospice center where family was of utmost importance to the well-being of their clients. What good is the care they provide without the support of families? The majority of the work they do takes place out in the community. Again, a holistic approach was evident as we spoke of the Whare Tapa Wha model and how this relates to the Treaty of Waitangi. Also pointed out was the fact that every member of their team; the medical doctor, patient and family support service director, community counselors, and inpatient nurses, were all on an equal ground. A hierarchy of value or importance simply did not exist. This was a good way to wrap up our study of the healthcare system in New Zealand as each and every theme resurfaced in this wonderfully touching and warm environment. All of the themes I noticed in the healthcare settings weaved and intertwined throughout the overall culture of New Zealand. They have a competent, relaxed, patient centered and compassionately holistic view of healthcare and the laid back and hospitable Kiwi way of life reflects these findings. I, personally, will remember all of these recurrent themes and apply them to my future nursing career. New Zealand has a progressive and admirable healthcare system and it was a privilege to learn from the healthcare professionals directly about how they go about providing such all-embracing and holistic care. I am so appreciative to have had this opportunity to learn about healthcare in such a wonderful country. The most valuable learning did not solely come in the form of planned healthcare visits, but through unplanned and informal interactions with this truly kind and generous culture. I feel I experienced complete cultural immersion while in New Zealand, and for that I am eternally grateful. I will not soon forget Aotearoa - land of the long, white cloud. New Zealand (Aotearoa) Beauty at Milford Sound

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