We are living in difficult times. COVID-19 has forced children out of schools, elderly into further isolation and most significantly, it has exposed the crippling social inequalities that the most vulnerable in our communities have endured for far too long. While the rest of New Zealand are on lockdown, essential workers are sacrificing time away from their loved ones to ensure that the country runs smoothly and safely. This mini series aims to raise awareness, encourage hope and honour our people working on the frontline during COVID-19.
Angela Moananu is a Registered Nurse at Health Connections and Elstree Ave Family Doctors. With five years of nursing under her belt, she has held a variety of different roles in the healthcare profession. At Elstree Ave Family Doctors, Angela takes care of different patients with a range of health needs. Comparatively, Health Connections is an organisation which oversees the care of the biggest Youth Justice Residence in New Zealand and Care and Protection Residences around Auckland. Under Health Connections, Angela is providing care for a recently established Youth Health Service which is a GP clinic catered to the needs of rangatahi aged 10-25. As an essential worker during this period, Angela shares about her role in protecting vulnerable people.
We've never experienced anything like this before in our lifetime so as a nurse, working out in the community, how has it been for you?
It feels really weird. Its unchartered waters currently. We have never worked in this space before. It’s interesting being in the community because you catch the well people who are full of anxieties because of the uncertainty of things during COVID, but then you are also looking after your regular patients who also have health needs and may be unwell without it being a COVID crisis. Recently, we (as most primary health care clinics have), moved to more over the phone/virtual (video) consultations as much as possible. There is an immense pressure to give the best possible quality of healthcare in this new form whilst trying to keep yourself and your colleagues as safe as possible.
At Elstree Ave Family Drs, I was in contact either via phone or in person with over 50 people in one day; that is over half the contact I usually have. And this was only myself, there were other nurses and doctors working the SAME workload for the SAME clinic on the SAME day! We are probably doing the same work we do in a week in a day. But then you think about the 50 people I have seen (plus the others seen by Drs and other nurses) and you think if even half of them have prescriptions, how much pressure is that putting on to pharmacists? But for every patient we see in the community, and every unwell patient or potential case of COVID case we see in the community, there is pressure off of the public health system (hopefully!) as they are already overloaded!
At at Health Connections, we are looking after 46 rangatahi living in an enclosed space, with very minimal likelihood of “social distancing”. Additionally, there's also not only the 46 rangatahi but the 50+ staff that are working alongside them, who are in the community and going back to the young people, not knowing what kind of contact they had while living their daily life. There's also the new rangatahi being admitted, coming in from the wider community too. It’s been a massive learning curve for Health Connections and I think we’ve done extremely well to not only learn for ourselves but to try and educate those working alongside young people.
Over the 48 hours prior to lockdown we knuckled down and reviewed each and every young person and did a prioritisation of their health needs. This was looking at 46 people in Youth Justice, 3 people in Care and Protection Residence, 30+ in Alternative Education Schools and 20 enrolled young people in the Youth Health Service. We are still available for one targeted clinic for acute needs onsite and then available over the phone/virtually for the time we’re offsite. The young people at the residential sites have always had access to us, and I think it’ll be an adjustment for them too because we hold a lot of complex young people in terms of their physical, sexual, mental and emotional health needs. A lot of young people find comfort in talking therapy with us face to face, and this will transition to being over the phone/video.
Over the last two weeks, Elstree Family Drs and Health Connections have been working overtime and tirelessly in trying to provide as many flu vaccines to high risk populations.
It's an interesting time to be a nurse during the pandemic. It’s trying to maintain the best quality of care that every human being living in New Zealand deserves but in a different format that is new to clinicians and patients. MOST people have been super understanding.
Wow, what an intense couple of weeks you've had so far, even before the lockdown! Given your role and the risk you may be exposed to, how have your loved ones reacted to you working during the lockdown?
They’ve been absolutely fine! Is that bad? They’re all understandably a little bit worried because of the infectious nature of COVID-19, but overall they’ve been supportive of the stable money I will make during this time NOT being off work (joking off course – kind of). I think they also understand that all nurses have a duty of care to work during this time in an overloaded health system.
That's not bad at all. Having a good support network is really important, especially at this time. Why did you make the decision to work during this crisis? Did you think about maybe stepping back and remaining on lockdown with the rest of the country?
I think it was never an option for me not to work. I never gave it a second thought that maybe I too should stay home for safety reasons. I am so grateful (though exhausted!) for being a nurse during this time and being able to do anything that might help others.
At Health Connections we hold very vulnerable young people who have never had access to the level of healthcare that we have provided for them (100% a brag!). We have taken care of long term and historic health needs that have never been addressed. Even things as simple as giving them their immunisations that they missed out on as a child but also addressing complex issues such as getting them to open up about their mental health because in most cases, they have never been seen by a health professional or they have never been asked about it.
At Elstree, we sit in a place where we cater for a lot of low socioeconomic, as well as a good number being Maori and Pacific patients, and whether it be health literacy, or access issues , we want to give them the opportunity to still have access and good healthcare.
Every human being in New Zealand deserves to have amazing quality and access to healthcare, whether in a pandemic or not (preferably not!).
Amen to that. From your position, what do you think the wider public can do to prevent the spread of COVID-19?
Stay the heck home!!! We live in a community mostly of strangers, you never know where the person next to you has been. Wash your hands, sneeze/cough into your elbow and if you’re sick stay home. But again, if it’s not essential – STAY HOME! If you are out, stay 2 metres away from your neighbour.
For those that are feeling a bit anxious or overwhelmed, what would you say to them?
This won’t be forever!!! Be kind to one another, check in with your friends and family where you can. If you know of someone who is high risk – older adults, people with long term conditions, pregnant women etc – then offer a helping hand, and make sure they stay home so they can be safe. Health Services are working really hard to keep you safe and sane, be patient and kind to us – your health is important to us, but your health is among the thousands we cater for too, so understand things take time. If you are feeling anxious, nervous or low during this time – your feelings are valid, we will listen to them and provide you answers where we can. Look after yourself and others!!
Thank you for that positive push! Lastly, how about yourself? Do you feel the tiniest bit nervous or afraid?
I am not afraid or nervous for myself. I am nervous for those who might not have the same privileges that I have, in having a safe warm home, a job that’s stable enough to last through this crisis, being fit and well and having food (and toilet paper) at home. I think most people won’t identify those as privileges but they totally are. When I went to the supermarket and there were empty shelves, I felt most bad for the people who shop paycheque to paycheque and while I’m still working, I know there are a lot of people who are unsure of what their job status or even paycheque might look like over the next four weeks.
I am also nervous and afraid for the patients we hold, for the older adults, for the people with complex long term conditions and the rangatahi who rely on the adults who look after them to take responsibility while they are in the community because it’ll ultimately keep them well. The health of the communities we look after relies on everyone listening to the rules in place to keep everyone safe.
What also makes me nervous in working with young people are those in homes where they don’t feel safe and may not be accessing education because of their resources. Working in youth justice, I do worry about the idle hands of rangatahi, and hope they keep themselves safe, but also out of trouble.
I am nervous about the mental health of everyone during this time period. There is a lot of anxiety and stress around New Zealand but there is also a lot of strain on mental health services and I do hope that we in the community health services can hold New Zealand close and provide really great and informed care so that our communities can rest easy.
STAY HOME. SAVE LIVES.
0508FAMILY- Oranga Tamariki (Reports of concern for children’s safety)
0508 744 633- SHINE
0800 787 797- Alcohol and drug helpline
0800 543 354 or free text 4357- Lifeline
0800 376 633 - Youthline
0800 111 757 Depression Helpline
0508 828 865 Suicide Prevention Helpline