Just recently, Nurse Practitioners New Zealand named her the 2024 Mātanga Tapuhi/Nurse Practitioner of the Year.
But rather than talk about why she thinks she got the award, she prefers to focus on using it as a way to shine a light on, and give voice to, the challenges of the people she treats at the health service run by Te Hau Awhiowhio o Otangarei Trust in Whangarei.
The challenges
“I’m concerned about all our people, our patients but especially tamariki and young Māori men,” says Hand who has two sons and 10 mokopuna.
“So many of our kids are lacking the basic needs. The cost of living, cost of food and lack of housing is making them sicker.
“Our young Māori men are dying before their time from heart problems, that if were caught earlier, they’d still be here. And their kids wouldn’t be growing up without their dads.”
All these challenges are what Hand describes as the “raw realities” facing too many of the 2,500 patients enrolled at Te Hau Awhiowhio o Otangarei Trust where Hand has worked since 2018.
The solutions
“We could go on all day about the problems, but here at Te Hau we don’t have time to do that, so we continually ask ourselves ‘what can we do better?’”
And asking those questions has resulted in Margaret and her fellow nurse practitiioners, Martin and Janine Kaipo, introducing wrap around support within their health services.
“Janine is a visionary, she never dwells too much on the problem and is constantly leading us to find the solutions.
“In response to our tamariki going without the basics, we’ve introduced wrap arounds. It is never enough though, but we are slowly getting there.
“In an effort to respond to our young Māori men dying too early from heart problems, we go to them now and call them in, if we see they’ve just joined us,” says Hand, who is also on the NZNO Board.
Tai Tokerau crying out for more NPs
About six years ago, the health clinic at Te Hau Awhiowhio o Otangarei was on the brink of being closed as they had lost their GPs. But Hand, Martin and Janine didn’t let that happen.
“That year I became a nurse practitioner. And that’s when Martin, Janine and me said ‘no! – our people need this, we won’t let them down even if others have forgotten them.’”
Racism and ignorance
Today, the health service has now grown – it has seven clinics, three fulltime NPs, a locum doctor who visits once a fortnight and a zoom doctor. The service also has a new house in the biggest building in the Whangarei CBD.
“A lot of groups in this CBD don’t like us being here. About 98% of our patients are Māori and I guess the neighbours are not use to seeing so many Māori in one place.
“But we are trying to address a need, an unjust inequity to help Māori people here live better and longer lives. So too bad for them if they don’t like the view.”
Tai Tokerau crying out for more NPs
Because of the isolation of many communities in the country’s most northern region, Hand said it was critical that “turbo speed” be put on the growth of the Māori nurse practitioner workforce.
“Our people up here are crying out for doctors, that we NPs know they won’t get. That’s where we as NPs come in and the need for more Māori NPs in this region, is huge. There’s just not enough of us.
“For Māori nurses considering whether or not to becomes NPs, I tell them it’s a tohu that will help you care more for your whānau and iwi. Do it, just do it!”
Humble upbringing
Hand pays a lot of her humility to her koro and kuia (grandparents) who raised her, and her two brothers, in Auckland and then in Dargaville where she was able to be more active in her iwi – Te Roroa and Ngāti Whātua ki Kaipara.
“My mum died when I was a baby.
“Koro worked on the railways and nan worked in a number of jobs, including, as a parking metre worker just to feed us.
“They had beautiful and humble values which I’d like to think I have in me today.
“They were always proud to be from our iwi and that’s why I did my nurse practitioner exam at my marae – Waikaraka in Kaihu near Dargaville.
“I passed that exam so that’s why I give all the mana and recognition back to my marae and my relatives in this region who’ve walked the same path as me.”
Hand also wanted to acknowledge the late Rhoena Davis who passed away recently. Rhoena was a nurse in Northland since 1993 and for more than 30 years her nursing ability was unparalleled.
“Rhoena was an inspiration to me. It has been so mokemoke or lonely without her. But I can hear her saying right now – ‘get to work Margaret, never mind the moaning – find those solutions.”
From nurse to cop to nurse
Hand’s first job as a nurse was at Whangarei Hospital where she worked for 20 years specialising in ICU and surgical.
“I took a break from nursing and actually became a police officer for four years. I decided to go back to nursing, had my break,” she giggles.