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Journals from Jan Term - NURS 298 Health Care in New Zealand

2013-02-07 FOUR WALLS


Rotorua Hospital: Lakes District Board and Maori Health Division

These Four Walls

          Today’s visit has been one of my favorites thus far. I loved the warm welcome and traditional Powhiri from the Maori health team; the morning tea was lovely as well. Though the Powhiri was not in a Marae (sacred meeting grounds), this was an exceptional experience and I felt engaged in their culture. It was a great feeling to know that their health team thoughtfully planned out a day for our visit and were just as excited. 

          Their approach to the health care system and community is holistic; they deeply value Maori culture and tradition which is very approachable to their clients. During the tour, they mentioned the significance of having Maori art designed on the entrance doors; this promotes instant comfort for clients. I thought this was significant because the Maori and Pacific populations delay accessing healthcare; by integrating their culture into the healthcare system and facility, they appeal to these populations. The carvings in the main foyer were of great importance as they were the ancestors of the Maori population in Rotorua. The ancestral carvings allow patients in the critical care unit  and intensive care unit specifically to take some time to reconnect with their ancestors. This aided in the healing process for the individuals and families. 

          While touring the critical care unit, we listened to a story about a particular room with a stunning view of the lake; patients requested this room when they were nearing death because it was peaceful and beautiful. The moral of the story is that each room, especially this one, is blessed after each patient dies and before a new patient occupies the room. I loved this idea because the facility ensures that this room is cleansed for the new patient to begin their journey into their next life. 

          Four Walls is the holistic health approach which encompasses Taha Hinengaro (mental/emotional), Taha Whanau (social), Taha Wairua (spiritual), and Taha Tinana (physical) well-being; this method ensures that each patient is unique, and it is suitable for all. This holistic approach may benefit individuals who have difficulty coping with their illness as it focuses on the individual as a whole rather than just the illness itself. The chapel was diverse and involved components of Christian and Maori beliefs. I thought this was great because in the US this is not likely to be seen in a hospital setting. I absolutely enjoyed hearing from the Hunga Manaaki team and learning about their role in the health system. I enjoyed that they were involved from day one and continue to be involved throughout a client's care as needed. 

In the States, holistic healthcare is used but western medicine remains dominant. Holistic care could be assessed and implemented more thoroughly but it is still applicable. There is still a stigma towards holistic health because people think it is all about religion rather than holism. So healthcare professionals fail to discuss psychosocial and spiritual needs of the individual because they may feel discomfort of forget this component. I think if it were incorporated daily, patient satisfaction would increase and eventually health outcomes could increase. If the patient is cared for as a whole rather than just their ailment, their emotional well-being would improve, which may then produce a sense of satisfaction for health care providers. With the holistic approach, care is unique to the patient and enhances the nurse and patient relationship. 

          If one or even just a dominant culture were incorporated into US healthcare, I think tension or animosity would arise because people question it and feel uneasy about it. Not only this but because we are multi-cultural and diverse, and it is difficult to draw out one main religion. I learned that assessing spiritual and social needs is imperative to integrate into my practice because it could change an individual's health outlook tremendously. Also, it is important to connect with patients on a personal level so that care is individualized to them. We get so caught up on the floor that we fail to take that extra minute to assess how the patient is coping and if there are any needs that can be met aside from treatment. 


Sidavanh Rena Chayanam, Senior Nursing Student


Photo: Rotorua’s Tamaki Maori Village

Speed/Agility/Direction Challenge involved concentration; The individual must know right and left and shift over to the next stick before it drops onto the ground. If dropped, the indiviual is eliminated. 

Colin O., Blake H., Chaleah S., Rena C. 

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