Te Mana Hauora O Te Tairawhiti
21 November 2017
After a decade of balancing work, family and study, Three Rivers Medical nurse Kylie Morresey has joined the highest echelon of nurses in the country. The achievement means Ms Morresey, who works in aged care, can now prescribe drugs.
“I’ve spent the past six months ahead of the final test reminding myself why I was doing it, and who I was doing it for. It’s for the people of Tairawhiti and I’m so relieved it’s over now!” says Ms Morresey of the gruelling qualification process.
Intern nurse practitioner in rest homes
Ms Morresey has been employed by Three Rivers Medical as an intern or trainee nurse practitioner, primary health across lifespan, for the past three years. The unique job sees Kylie treating rest home residents who remain registered patients at Three Rivers Medical, Puhi Kaiti Community Health Centre and The Doctors Te Whare Hapara.
The visiting service, which used to be provided by GPs, was created in collaboration four years ago by Hauora Tairawhiti nurse leader, primary and community, Dr Heather Robertson, and Three Rivers Medical co-owner and GP, Dr Fergus Aitcheson. ACC also played a role.
Previously, GPs were finding it hard to get away from their own practices to provide the care and clinics needed in rest homes, says Dr Aitcheson.
“This role came about through recognition that the group of seniors in aged care facilities were not well served by the traditional reactive GP model. This is a group of people who are by definition frail and liable to develop acute illness quickly.”
Dr Robertson says they had to do something different. They needed to replace the old model with a proactive one that emphasised the continuity of care. “The new role was created for a nurse practitioner but we couldn’t attract one to Tairāwhiti so we went for an experienced local nurse who could work under direction and delegation of a GP, someone who was working towards their nurse practitioner status, and Kylie was perfect.”
“It was a totally new concept and not everyone was keen on it, but now it’s embedded into how we support aged people in this region,” Kylie adds.
Making a difference for older people
Kylie has been nursing for 10 years previously at Gisborne Hospital and Turanga Health. After only three years in the rest home role and before she became a prescribing nurse practitioner Kylie won the Innovation and Patient Safety Award at the Nurses and Midwives of Tairāwhiti Achievement Awards. The judges noted that Kylie’s work significantly decreased the number of people from aged care coming to Gisborne Hospital’s Emergency Department, or being unnecessarily admitted to hospital.
Kylie says while working towards her nurse practitioner status she could diagnose a resident’s condition and suggest a prescription, but she was then restricted by her scope of practice. There were treatment delays while she consulted with residents’ GPs and got the signatures she needed for the prescriptions – sometimes around 20-30 a day.
Beetham Health Care Clinical Manager Sandy Armstrong is at the frontline of health care for older people. She says because Kylie can now sign off prescriptions elderly rest home residents are getting treatment faster.
“We’re ecstatic that Kylie can now provide this extra part of the service. She gives so much of herself to caring for our residents and now she can do it in a more efficient way. She’s thorough with her assessments, she communicates well with the residents, and to be honest we’d be lost without her.”
Earning nurse practitioner status
Earning nurse prescribing rights isn’t easy, and deservedly so, says Kylie. She completed a nursing degree, a post-graduate certificate, postgraduate diploma, and then a masters degree.
To finally become a nurse practitioner Kylie had to put together an extensive portfolio of research and experience for submission to the Nursing Council of New Zealand.
She then had to face a panel of three senior health practitioners whose job it was to grill her on case studies she’d only just seen. It took her more than one attempt to pass the demanding three to four-hour verbal exam. “
“It was the most gruelling and intense thing I have ever done. The stress of that panel situation is unbelievable and I needed to find my voice.”
Study finally over
Kylie credits her partner Murray Fleming, their three children, and her mum, stepfather, and sisters, for their unwavering support while she earned the qualification. She says her determination was also fuelled by her supportive colleagues and a passion for helping locals. “For me, it’s always been about improving the healthcare for people in this region.”