Jenny Bell NP Primary Care
My name is Jennie Bell and I am a Nurse Practitioner on the West Coast.
I initially trained as a Registered Nurse in UCOL, graduating in 2006 and starting work in Hastings Hospital in surgical specialities in 2007. I then spent a year working in ED in Palmerston North before spending some time doing rural work in Australia. In 2009 I moved to Greymouth and started working in a medical ward. The rural setting of the West Coast provided opportunity for extra development and study which I was grateful to use.
When a RN role became available in ED in Greymouth I transferred in 2011 while continuing my study. While working in ED I completed a clinical masters through the Eastern Institute of Technology (EIT). My thesis has a rural focus “What are the core components of the Rural Nurse Specialist Role in New Zealand?” and was especially relevant to the area I worked in. As I studied the volume and acuity of patients in ED continued to increase, creating the opportunity to develop a Nurse Practitioner role in ED on the West Coast.
In 2016 I completed a Certificate of Interest through EIT (prescribing practicum). During this time I worked alongside the senior nursing team developing the Acute NP role. Initially the NP role was developed in the context of creating an acute demand service. This buisness case is still going through approval process. However, once qualified I was offered the role of Nurse Practitioner, Acute.
This role is split between the Emergency Department and an acute walk in clinic in a GP practice. Other components of the role include teaching and support of new initiatives in both areas.
ABSTRACT
Title: Baiting, biking and bush-bashing. The story of two intrepid newbie Nurse Practitioners on the West Coast
This will be co-presented by two NPs. It will consist of a photo essay augmented with an authentic discussion about our practice on the West Coast.
The West Coast of the South Island is a unique part of New Zealand. Geographically diverse with a population of 32, 600 (WCDHB, 2015) spread out over 600km. Changeable weather conditions and isolated geography can make healthcare provision a challenge. There are two hospitals on the West Coast. Westport has a GP run hospital which provides care within the Buller area. Greymouth has a secondary level hospital providing services with an on-call component e.g. on-call laboratory, imaging and specialists care. Healthcare throughout the Coast is mainly provided by the DHB which also own three of the six GP practices (Healthpoint, 2018). Other areas such as Hokitika and Reefton have DHB owned Health centres. In remote areas there are eight Rural Nurse Specialists run clinics which provide both emergency and primary care to populations across the lifespan. Staff recruitment, particularly of GP’s, and retention remains one of the more challenging problems for the DHB.
To add further complexity to healthcare provision the DHB is undergoing a hospital rebuild process. As part of the rebuild process new models of care are being created, including increasing service provision in the community service. Advanced nursing roles are an important part of this new model of care.
The challenges faced in rural areas like the Coast provides an ideal environment to utilise the skills of advanced nursing roles. NP’s have the capacity to provide dependable, long-term health services in hard-to-staff areas. However, the same isolation and geography which can create challenges for clients seeking healthcare can also play a part in accessing mentoring and supervision and the support require in these roles.
We are the first “home-grown” Nurse Practitioners on the West Coast. While there have been NPs working on the West Coast before they have been experienced clinicians who have come to the area for various lengths of time. Some of the challenges we have faced include inter-professional relationships, educating our colleagues, designing our roles and building up a support network for other nurses and with other clinicians around the country.
We aim to discuss some of the high points of this year alongside some of the challenges we have faced and how we have overcome these.
References:
West Coast District Health Board (2015), West Coast DHB Annual Plan 2016/2017. West Coast District Health Board
https://www.healthpoint.co.nz/gps-accident-urgent-medical-care/west-coast/ 10/10/2018
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