First contact - building a rapport

And so, I made it my, my job to go up there [to place]. And then, slowly, the nurses that I worked with over the years have found it actually a valuable asset. And you know the two most recent [nurses] that I’ve worked with over years, I’ve heard them talking to other people, ‘We let her go in first. We let her do what she needs to do and then she hands it back to us.’ And I’ve seen people respond in a way, ‘But… you’re the Nurse Practitioner,’ or, ‘you’re the Clinical Nurse. You should be the lead.’ ‘No, no, no. We don’t go into that area and tell her how to do it or tell those people how to do it. We’ve had the message, ‘don’t do it.’ She [Hospice Kaitakawaenga] takes us in… introduces herself to the whānau and then she introduces us as a colleague, and we just let her do all the talking and the connecting. And then she’ll say, ‘so the reason why we’re here today’ you know,’ have you been spoken to by oncology or your GP or-?’ And then away we can go. We’ve just learned to wait.’

And some of the staff have told me that they have found it quite useful that I can just walk in, and they can feel the tension in the air, they can feel that, ‘Oh, it’s those scary people coming from hospice. Oh, who’s her … she doesn’t look white.’ In fact, one of our patients one day said to my colleague… (We’d done some work, introduced some medication). Went back, we heard that it worked well. We achieved what we needed to achieve. Went back the next time, we walked through the door, ‘Kia ora matua!’ And he says, ‘Kia ora. I’m good.’ And then he said to my colleague, ‘You’re not bad for a white girl.’ You know what… she took it as an amazing compliment.

And I said, ‘You actually addressed an issue that the GP was pointing out. We need to decrease the number of times that this patient’s coming into hospital.’ ‘How can we actually do it?’ We actually looked at the issue, ‘But do you know the other thing that you found out that neither you or I picked up on the first two visits?’ She said, ‘What was that?’ ‘He’s illiterate. He can’t read.’ A family member arrived when we were there… we just looked at this box of mish mash [medication]. Some weren’t even his medications; they were his mother’s that had died a few years earlier and they were just like old stuff and they were relevant. Couldn’t get our heads around it. Slowly [it dawned on her] … he’s actually illiterate. He couldn’t read.

… All communication is respectful. I’ve listened to specialists and they just have this thing about them that is just kind [of], it’s very straight up. It’s just really, really good yeah.

I think they [ill person/whānau] need to be good mates with their palliative team. I think the GPs and from hospital to palliative, I think they all need to be with the families but to, but to express it in a way that we can call ‘simple English’; simple, simple yeah. Um and so far, I’ve seen some really, really good interaction between the whānau and GPs, hospital staff, palliative [staff].

[F]or staff, the way staff communicate with them [whānau manaaki] is really, really important to be kind, to listen. And just to have that that trust for them to gain that trust in that person. Yeah. [Kindness means], I think it’s the way you talk to people and, you know, it has to be genuine. And you have to be consistent and follow up with anything that you say to them that you’re going to do. You've got to be really, really, you’ve got to be on the ball to be honest and be kind and yeah just to be honest in the way that you deal with people.