Te Arawa responds.
Subject: Nurses (Social aspects)
Emergency medical services (Management)
Authors: Batt, Jean
Atherfold, Cheryl
Aroha Korowai
Grant, Ngaroma
Pub Date: 10/01/2011
Publication: Name: Kai Tiaki: Nursing New Zealand Publisher: New Zealand Nurses' Organisation Audience: Trade Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2011 New Zealand Nurses' Organisation ISSN: 1173-2032
Issue: Date: Oct, 2011 Source Volume: 17 Source Issue: 9
Topic: Event Code: 290 Public affairs; 200 Management dynamics Computer Subject: Company business management
Product: Product Code: 8043100 Nurses NAICS Code: 621399 Offices of All Other Miscellaneous Health Practitioners SIC Code: 8062 General medical & surgical hospitals
Geographic: Geographic Scope: New Zealand Geographic Code: 8NEWZ New Zealand
Accession Number: 271050309

Nurses from around New Zealand were quick to respond to the needs of Christ-church after the devastating February 22 earthquake. As part of a national iwi response, co-ordinated by Te Puni Kokiri (TPK), a team of nurses from Te Arawa was sent to help the people of Ngai Tahu for two weeks just days after the quake. This response was managed by the Te Arawa Trust/Te Pumautanga.

The Te Arawa nursing teams comprised five registered nurses (RNs) from the Rotorua primary health care service Korowai Aroha, Lakes District Health Board (DHB) associate director of nursing, Maori, Jean Batt, associate director of nursing professional development Cheryl Atherfotd, two Lakes DHB mental health nurses and one nurse volunteer from the community. The work was undertaken in partnership with Ngai Tahu, Christchurch's Emergency Response Centre, Civil Defence, the Police, Fire Service, Canterbury DHB and other iwi support groups.

The first Te Arawa response team arrived in Christchurch four days after the earthquake. A grid pattern of Christchurch suburbs was developed from information sourced from local health providers, Police, Fire Services and TPK, enabling the team to identify areas of high deprivation and high Maori populations.

The team was accommodated at Christchurch's Rehua Marae. Fortunately the wharenui sustained only minor structural damage and continued to have running water, power and sewerage. Rehua Marae also hosted TPK's central co-ordination. Each response team consisted of 23 people, so managing travel, accommodation and safety was a significant undertaking. Teams also came from Nga Hau e Wha in Christchurch, Ngati Haua, Raukawa and Tainui.

The response team was dispatched to work house-to-house in the general Aranui area in the first week, and the greater Aranui and Bexley areas in the second week. The team broke into pairs, comprising a nurse and a support/ security person. The nurses completed clinical assessments and the support person completed environmental screening for fire safety, water, sewerage, power and food supplies.

Each day began at 6am when everyone got up to prepare for the day, check and pack medical supplies, have breakfast, pack the vans, meet for karakia and a briefing, and head out to the designated area around 8am. Nurses wore navy scrubs and each nurse carried her own backpack containing standard equipment for assessment and initial treatments.

Korowai Aroha provided the initial medical equipment for the response. Further supplies were sourced from Lakes DHB and flown to Christchurch by the Te Arawa Trust. Sphygmomanometers, tympanic thermometers, blood glucose meters and other assessment equipment was eventually supplied by Canterbury DHB and returned to them at the end of the exercise.

Details of assessment, health needs and interventions were sent to each person's GP. Many cases of anxiety, stress and post traumatic symptoms emerged, and these people were referred for follow-up.

The first week was difficult, due to the lack of medical infrastructure in the community. We did find one GP clinic open for five hours each day in Aranui. This became an important referral source for medication and management. In the second week, we had some limited access to a doctor attached to Tainui.

The teams returned to Rehua Marae around 6pm each evening to unpack medical gear, complete documentation, prepare for the next day, have dinner, debrief and karakia before turning in for the night.

On some days, Work and Income provided a case worker to work with the team. This enabled the response team to immediately provide a link person to address issues around benefits, allowances, Red Cross registration and other needs.

The Tainui team prepared hot meals for people without power and provided food to cook to those with power. The Raukawa team of van drivers organised a "kai run" each day, after they had finished transporting and supporting the nursing teams.

During the two-week operation, the teams visited over 2000 homes. The Te Arawa Trust also flew home 34 Te Arawa whanau traumatised by the event. Medical checks were provided at three kohanga reo and three marae.

During the first week, the nursing teams identified people who had not seen anyone since the earthquake, in particular the elderly who were very frightened. Some of these people had significant health needs and injuries, such as fractures and chest pain. During the second week, we saw more health issues resulting from the earthquake and liquefaction, such as infections (skin, eyes and respiratory), anxiety and stress, and the impact on existing conditions such as diabetes.

Nursing highlights

There were a number of nursing highlights. Being able to access a team of skilled Maori nurses at such short notice was very encouraging. It was also great to see the two nurses who completed the nurse-entry-to-practice programme in 2009 using these skills to care for patients with complex needs in a community setting. The way the nurses worked also demonstrated the lessons learnt from the 2005 Lakes DHB cultural competency framework.

Te Pumautanga o Te Arawa Trust's initiative was a unique opportunity to respond to a national emergency with a clinical team equipped to work effectively in the community, complementing other services. In their support for the initiative, Korowai Aroha and Lakes DHB demonstrated a unique partnership. We were grateful for the opportunity to support the Christchurch community and the Ngai Tahu people through this initiative.

We thank Korowai Aroha Trust for releasing their RNs, and for the support of Lakes DHB director of nursing Gary Lees and general manager Maori Phyllis Tangatu.

Report by Jean Batt, Cheryl Atherfold and Korowai Aroha chief executive Ngaroma Grant
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