By the time he walked out her office door, nurse practitioners made a lot more sense to him.
Childs and fellow NZNO member and nurse practitioner (NP) Jayme Kitiona spoke to Kaitiaki ahead of launching their new low-fees Rotorua practice — part of an evolution away from doctor-led healthcare.
Tau Oranga Health Care opens on January 19, capping off a busy four months of preparation for the pair.
Read this story in te reo Māori here.
The NP-led, kaupapa Māori clinic planned to bring in a general practice doctor as well, as part of an eventual multidisciplinary team, said Kitiona. This was “what was great” about an evolving primary healthcare sector: no longer just the traditional model of a GP-led clinic and a nurse.
The pair met about five years ago in their NP internship, Kitiona said. “There was a group of us Māori NPs that were put together in that year so we’ve stayed close over that time and done our monthly peer review together.”
Childs said the feedback had been “amazingly positive” to NPs as people discovered their potential. “I’ve had so many patients say ‘wow, I didn’t even know you could do all this’, or ‘now that I’ve come to you I only want to come back to you’.”
One told her he’d sat in the waiting room with no idea what she could do for him — when he left he was a convert, and now a regular patient.
Changes underway for NPs
A law change last year opened the way for NPs to finally prescribe the same medications as doctors. This allowed NPs to prescribe medicines funded by Pharmac but yet to be approved by MedSafe — often brand substitutes when there were global shortages.
Meanwhile from February 1 NPs can diagnose and prescribe for ADHD — with the goal of timely and equitable access to care.
Kitiona said there were about 60 to 80 Māori nurse practitioners in Aotearoa. “We were fortunate enough to have our first hui-ā-tau as all the Māori nurse practitioners in 2023, and that was led by Rhoena Davis.”
“For us, I guess it’s about bringing in te ao Māori into the clinical skills and all the clinical experience we have.”
Childs had worked in primary care in Rotorua for more than a decade, she said. “This is where I really love to be. I have worked at Rotorua hospital, I’ve worked as a clinical respiratory nurse specialist prescriber but I’ve always found my way back to primary care.”
Kitiona loved the sector too — before returning home to Rotorua, she worked in rural primary care for about 14 years on Waiheke Island.
They trained to become NPs, Kitiona said, because they wanted to do more for patients. Registered nurses working at the top of their scope still faced the challenge of having to refer patients to GPs or NPs.
The kaupapa-Māori approach was especially important in a city with an about 43 per cent Māori population — more than double the national proportion.
“For us, I guess it’s about bringing in te ao Māori into the clinical skills and all the clinical experience we have, and working with whānau in a way that brings in ao-Māori views so that we are culturally safe and culturally appropriate.”
Meanwhile the clinic has found a home in the Janet Fraser building, owned by Te Rōpū o te Ora Women’s Health League, with historical links to regional iwi Te Arawa, and nursing.
In the 1930s, nurse Ruby Cameron rallied the rōpū to fundraise for a guest house for Māori often refused rooms at hotels while visiting whānau in hospital. The building eventually opened in 1948.
Kitiona said people often had a long wait to enroll in clinics in the city — then with high demand there was a long wait to get into appointments, she said.
“Before we have to add more team members on, our capacity’s probably somewhere between 1300 to 3000. And then we’ll grow our team, we’ve got lots of plans to grow and expand.”