Nurse shares mana and shines light on ‘raw realities’

October 29, 2024

Within minutes of being named the top nurse practitioner of Aotearoa for 2024, Margaret Hand was passing over that mana to her marae and other nurse practitioners in Te Tai Tokerau.

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 Āwhiowhio ō Otangarei Trust in Whangārei.

Margaret Hand with other nurse practitioners from in and around Whangārei who saved a health clinic that their community needed.
The challenges

“I’m concerned about all our people, our patients, but especially tamariki and young Māori men,” says Hand, who has two children 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.

‘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 2500 patients enrolled at Te Hau Āwhiowhio ō Otangarei Trust, where Hand has worked since 2008.

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 the trust’s chief executive officer, Martin Kaipo, and one of the founders of the trust, Janine Kaipo, along with Hand, introducing wrap-around support within their health services.

‘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?’

“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.

Margaret Hand putting in the mahi during the COVID-19 outbreak.
Tai Tokerau crying out for more NPs

About six years ago, the health clinic at Te Hau Āwhiowhio ō Otangarei was on the brink of being closed as it had lost its GPs. But Hand, and Martin and Janine Kaipo, 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 full-time 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 Whangārei CBD.

“A lot of groups in this CBD don’t like us being here. About 98 per cent of our patients are Māori and I guess the neighbours are not used 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.”

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 NP workforce.

‘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.’

“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 attributes 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 meter worker, just to feed us.

“They had beautiful and humble values which I’d like to think I have in me today.

‘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.’

“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. Davis had been a nurse in Northland since 1993 and for more than 30 years her nursing ability was unparalleled.

The late Rhoena Davis – an inspiration to Margaret Hand.

“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 Whangārei Hospital, where she worked for 20 years specialising in intensive care and surgical nursing.

“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.