Did you know the Outreach Nurses at Southland Hospital’s paediatric department have more than 60 years of combined experience helping children?
Mid-conversation the cookie earrings catch your attention and then you notice they match the Cookie Monster scrubs; and you realise Outreach nurse Debra Maheno is right at home in the paediatric department.
The Outreach and Outpatient service connected to the department has been running since 1996, and Robyn Kelly is one of the original nurses who started in November of that year.
Debra joined in 2000 and Sharleen Frewen in 2012. The trio work part-time to make up the 2FTE for the service.
Having that longevity has given the service continuity and a significant depth of experience.
As senior and experienced paediatric nurses Robyn, Debra and Sharleen do blood tests, IV lines and sedation young patients going to other areas of the hospital for tests.
The Outreach service started after a colleague of Robyn’s (who had won the Margaret May Blackwell Scholarship) travelled to Canada and the UK and came home and put together a case for the service.
Robyn says she expressed an interest in Outreach care as she had an oncology patient dying at home and wanted to be able to visit during work, but she was not able to, as it was not part of her job at the time.
That patient became part of a big push to create a service to incorporate home visits into her job in the future, she says.
Paediatric Department Clinical Director Dr Ian Shaw likens the trio to the power of the All Black forwards, and that he could not do without them.
“... without them I could not do my job. It’d be like the All Blacks going out to try and win with no forwards in the pack,” Dr Shaw says.
Dr Shaw, who has worked alongside the outreach nurses for many years, says they free him up enormously to do acute outpatient work.
Patients who have inflammatory bowel disease can have biologic infusions because the nurses are running it.
And patients with immune disorders and juvenile arthritis who also need infusions can get it done in Southland because of the service.
The nurses also work with complex neurology, surgical, immune and oncology patients
One of the areas Dr Shaw is most proud of is how the Outreach Service works with children who need oncology care.
There are two treatment centres in the country. One is in Auckland and the other is in Christchurch.
The work that Robyn, Debra and Sharleen do for oncology comes under the direction of the Christchurch centre, and their work is audited regularly by The Children’s Oncology Group (COG), a national cancer institute.
The nurses' treatments include chemotherapy, and co-ordinate all the cancer care for the department, he says.
“New Zealand’s outcomes for child cancer are in line with Australia, Switzerland, France and the Netherlands.”
More importantly, Dr Shaw says a child in Otautau will get the same treatment as a child in Auckland or a child in Zurich.
“That’s a pretty fantastic result.”
When the nurses hear Dr Shaw’s All Black analogy, they laugh but understand how appreciative he is of them and the work they do.
The first Outreach Nurse Service was started in Hawke’s Bay and Southland became the second region to operate one. Today, there are outreach services in most parts of New Zealand.
Home visiting for the team has become less as patients come to the hospital for multi-disciplinary contacts with doctors, dietitian, speech and language therapist, pharmacist, physio and occupational therapists.
“We try to get everyone all together so the patient can see them once rather than having to come in for lots of different appointments,” Robyn says.
Home visits help to provide families with continuity of care between home and hospital. Once a month they also go to Queenstown to work with patients and their families.
Another important part of their work is palliative care. In this scenario the trio go on call for 24 hours, seven days a week to provide support.
Having variety in their day and covering a broad range of health conditions is a reason “they love their job.”
“We have a lot of contact with specialists and consultants throughout New Zealand, there’s a lot of problem solving going on and we are liaising between home, hospital and specialist centres for patients,” they say.
It is not surprising the nurses build relationships with patients and their families, as in some cases they have looked after a child all their lives (up to the age of 16), especially if they have a chronic illness.
As senior nurses experienced in a lot of paediatric procedures they’re often called on by others for advice or assistance such as placing IV’s.
While delivering the outreach service, they say where they are based in the paediatric department is important as they are central to the whole team around them from consultants to the Children’s Ward staff.
“Children are great to work with. They usually get over things really fast and they deal with chronic illnesses amazingly,” Debra says.
If Robyn had a magic wand, she would love it if the service could increase the home visiting side to support more families.
Paediatric Outreach Nurses, from left, Sharleen Frewen, Robyn Kelly and Debra Maheno.
Paediatric Outreach Nurses, from left, Sharleen Frewen, Robyn Kelly and Debra Maheno.
