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Journals from NURS 298 PA Health Care in New Zealand

2010-02-12 A Day in Dunedin

Angi Tobias Journal: Dunedin Hospice At the bottom of what New Zealand claims to be the steepest street in the world (Baldwin Street) lies Dunedin Central Otago Community Hospice. Dunedin is the last healthcare visit on our journey through New Zealand. It is a larger city with a Scottish influence, and it is surrounded by mountains. Originally it was named Edinburgh and changed its name to Dunedin, which is Gaelic for Edinburgh. It is the second largest city on the South Island with a population of 115,000 in the city. My first impression as we drove through it was how much larger it was than the other cities on the South Island; it was a bit overwhelming since coming from Queenstown, which is a much smaller town. As we entered the hospice center we were warmly greeted by Sharon Stewart, who is the nursing director. She took us into a large naturally lit room with large windows and skylights throughout, and I was aware of how peaceful and quiet the environment was. Claire Greensmith, the family support team leader, and David MacIntosh, the doctor and medical director, came to join us and gave us an overview of their program. They are under the Otago District Health Board. They have been running this program for twenty years; it is a 12-bed unit. They are funded 70% by the government and 30% from private donations from the community. Their focus is on the family as a unit, not the individual client. This facility does not look medical in nature; it is full of natural light, artwork, and large single suites with patios and flower gardens throughout the surrounding area. It also has a playground for families with children to play, and 3 family lounges, a kitchen for families to use at anytime, and a sanctuary room that is nondenominational where anyone can go and relax. There is a room with a large bath that the staff has turned into a spa-like atmosphere including aromatherapy candles, music, soft lighting, and a nice screen for privacy. Sharon told of a male patient that was in the bathtub with his wife, and the staff brought in glasses and champagne and gave them some privacy. This is all within the scope of practice that they support the family and want the client's stay to be as close to their own home lives as possible. The hospice team is also very culturally sensitive; they have staff that work with the Maori clients that may come in as well. As with every site weve been to, Director Stewart referred to the Treaty of Waitangi and the cultural safety commitment New Zealand has made to the Maori population. The hospice center provides care for people who have an illness in which there is no further curative treatment and who have approximately 12 months of life. The client or family can self refer or be referred by their doctor. The center provides community care coordination, which is the link between client/family/ and providers. Telephone consultation is available 24 hours per day with a registered nurse, outpatient clinics, family support, inpatient care, rural outreach, and education. The hospice support team also sees families up to a year after their loved one passes on. While we were at the hospice center someone did pass on. When we asked what happens next, we were told the family is allowed to stay up to 24 hours afterwards. Before the room is used again it is blessed usually by a chaplain but it can be done by staff as a cleansing. The family can join as well for closure. This is done by talking about the client and the staff that took care of them, as well as the future clients to come into this room. I think this is a very meaningful process for the family as well as the staff who have spent so much time with the client. It seemed that everyone that worked at the hospice center was a very giving and compassionate individual who enjoyed the work they did, and had connections to those they came into contact with. I think the students that visited this facility were touched and inspired to give the type of quality care they witnessed today. I feel grateful to have been in the company of such caring and compassionate individuals who work every day as a team to promote the best quality of life to those clients they serve. I also appreciate Linfield Colleges strong International Studies Program and the opportunity to participate in it.

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