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Warm Pacific Greetings!!

Warm Pacific Greetings!!. Kia Ora Ni Sa Bula Vinaka Talofa lava Kia Orana Malo E Lelei Fakalofa Lahi Atu Taloha Ni Talofa. 2. Introduction [ Atatose Canty ]. Introduction. Levuka, Fiji. Fiji School of Nursing. Levuka Hospital. Lakeba Hospital. LEVUKA. Oneata Nursing Station.

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Warm Pacific Greetings!!

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  1. Warm Pacific Greetings!! • Kia Ora • Ni Sa BulaVinaka • Talofa lava • Kia Orana • Malo E Lelei • FakalofaLahiAtu • Taloha Ni • Talofa 2

  2. Introduction [AtatoseCanty]

  3. Introduction Levuka, Fiji Fiji School of Nursing Levuka Hospital Lakeba Hospital LEVUKA Oneata Nursing Station

  4. Pacific Return-to-Nursing Programme

  5. Workforce Issues Faced By Pacific Nurses Within The Oncology Department Auckland Hospital Whilst Striving Towards Leadership!!

  6. Acknowledgement!

  7. PLAN OF PRESENTATION • Background of Pacific population in New Zealand • Where they are from • Population statistics • Geographical distribution • Characteristics • Nursing workforce • Number of nurses • Work type and settings • Specialty (Oncology) • Workforce issues • Strategies and recommendations • Leadership

  8. Objectives • To highlight the low number of Pacific Nurses choosing Oncology as a specialty • To highlight the increasing number of Pacific people utilising Oncology services (within NZ and from Pacific Islands, Countries and Territories) • To describe workforce issues facing Pacific Oncology Nurses • To discuss Leadership in the context of Nursing Care and Service

  9. Pacific Peoples are from where?

  10. Pacific People In New Zealand • People from the Pacific Islands have been in NZ for over a hundred years. • In 1991 there were 167,000(4.9%) Pacific people in NZ & in 2001 more than 231,802(6.5%) were living in the country. • In 2006,it had risen to just under 266,000 people and increase of 15% since 2001. • In comparison to the total NZ population, Pacific peoples constitute a predominantly youthful population. • Adverse socioeconomic circumstances & poor access to health care services put Pacific peoples among groups in NZ with the highest health needs.

  11. Like Maori, Pacific peoples regard health in aholisticsocio-ecological framework (is a comprehensive public health approach that not only addresses an individual’s risk factors, but also the norms, beliefs, and social and economic systems ). • Ill health is thought to be the result of disharmony between humans & their environment. • The patient may be seen as the victim of family wrongdoing • Mental illness is often thought of as possession by evil spirits • Pacific peoples arevery religious & some observershave attributed their apparentapathy to fatalism, which is part of these beliefs. • Christian doctrine dominates many customs and traditions, including those surrounding death & dying. (Tukuitonga C & Finau S. (Eds) Pacific Peoples in NZ, Pacific Health Dialog 1997: Vol 4 No. 2 )

  12. Pacific Population in NZ: 2001, 2006 2006 Census Total = 4,027,944 Pacific people=226,302 2001 Census Total = 3,737,322 Pacific people=200,262

  13. DISTRIBUTION OF Pacific Peoples in NZ - Regional

  14. Pacific Health –ADHBs Population 2010(from census 2006) 2006 2010

  15. Pacific People by Culture Group at ADHB

  16. A young population with unique challenges

  17. Over half born in New Zealand

  18. About half can speak their own language

  19. Potential Avoidable Mortality – ADHB 2003-2007

  20. Day Stay Unit Financial Year (Jun-Jul) IV+Oral Chemo+ Nurse+Blood Transfusion Appointments Breakdown by Ethncity Groups

  21. New Zealand Nursing Council Total Nursing workforce: 48,563 Total Pacific Nursing workforce: 4,951 (10%)

  22. Pacific Nurses Employment Setting Majority of Pacific Nurses work in District Health Boards (Acute) 1906/4951 (38%)

  23. Pacific Nurses by Geographic Region Majority of Pacific Nurses work in Auckland 1634/4951 (33%)

  24. Nursing Workforce IN ONCOLOGY OUTPATIENT, AUCKLAND HOSPITAL 2012

  25. Nursing Workforce IN ONCOLOGY INPATIENT, AUCKLAND HOSPITAL 2012

  26. Workforce Issues • Shortage of Pacific Nurses • Informal survey was done in which nurses were randomly picked from the 3 different areas i.e. Day Stay Outpatient, Radiotherapy and the Oncology Ward). • Lack of knowledge and awareness among non-Pacific Health workforce • regarding the Pacific Cultural Competencies and the Pacific Concept of Service • regarding the role of Pacific providers available resulting in under-utilization of these important stakeholders in time of needs.

  27. Workforce Issues • Late presentation • Data shows ( MOH NZ Suspected Cancer in Primary Care 2009) that Pacific people often present with cancer at a later disease stage. WHY? Shyness, fear, denial, anger, lack of trust and most importantly culture & language • Insufficient Information • Evidence suggests that in many areas of health, Pacific peoples do not have good information (MOH 2008b). This means that our Pacific patients cannot make fully informed decisions about their health or that of family members

  28. Workforce Issues • Financial barriers to accessing health care • Spending on health care is a lower priorityfor Pacific peoples resulting in Pacific patients not attending (DNA) Doctor’s Clinic and not having or delayed treatment (H Lewis, personal communication, Oct 2010)

  29. STRATEGIES • Daily nursing intervention with Pacific Patients who utilizes the service by assessing the problem and referral for further management. • Pasifika Week2012. • Inclusion ofPacific Family Support • Involvement ofCommunity Cancer Navigators (Health West) • Cancer Society referral if Pacific patients preferred the service provided. • Other Health Specialistreferral within the Hospital and Community based. • Pastoral Care

  30. Recommendations • Raising the profile of Nursing as a profession in which Pacific Nurses are used for recruitment into Secondary schools and Universities to showcase Oncology Nursing. • Oncology focus during Nursing degree and nurse transition from final year to new grad. • Education about Oncologyand offerwork experiencesin the department to see what a wonderful area Oncology is to work in.

  31. Recommendations • MakingOncology “Pacific Friendly”- Have aPacific Day more than once a year! • Pacific Nursessharing information with other nurses regarding Culture and health perspectives. • Encouraging own staffs to attendPacific Best Practice In Servicecoordinated by Pacific Team ADHB. • Pacific Cultural Competencies are crucial to better health outcomes for Pacific peoples, it reminds us that health is more than simply the provision of health services, it recognises, healthy cultures, healthy environments, healthy lifestyles and healthy participation in the wider society. (MOH NZ 2009c)

  32. Recommendations • Increasing the Pacific Workforce • The Health Workforce Advisory Committee recommended that increasing the proportion of Pacific peoples in the health workforce to more closely match the population should be a priority , (MOH NZ, 2006a). • Developing the Pacific health workforce will make a significant contribution to improving health outcomes. • We bring connections with Pacific communities, personal understanding of Pacific issues and Pacific cultural and language skills (MOH NZ & Minister of Pacific Island Affairs, 2010).

  33. Leadership in Pacific Nursing Context! “Anyone who is looked to as an authority (e.g., a nurse taking care of a patient ) or who is responsible for giving assistance to others is considered a leader”(Mahoney, 2001) • “Leadership is not merely a series of skills or tasks, rather, it is an attitude that informs behavior” ( Cook 2001) • Good Leadership is consistent superior performance with long term benefit to all involved. • “Leaders are not merely those who control others, but they act as visionaries who help employees to plan, lead, control and organize activities”( Jooste, 2004)

  34. Conclusion "Whatever work you do, do your best, because you are going to the grave, where there is no working, no planning, no knowledge, and no wisdom” [Ecclesiastes 9:10]

  35. Thanks Very Much/Vinaka Vakalevu!! ANY QUESTIONS?

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