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Rheumatic Heart Disease Australia

RHD Resouces

Top nurse takes home top honours

Top End nurse Greg Smith has taken home top honours at the 2018 Northern Territory Nursing and Midwifery Excellence Awards. Greg was recognised for his outstanding care in treating people with acute rheumatic fever (ARF) and rheumatic heart disease (RHD).

“My most rewarding role has been to deliver health services to homelands. Visiting each of the 30 outstations once every four weeks was invaluable in supporting people to live healthy lives on their country, delivering medications, doing health checks and attending to acute complaints. It was a privilege to spend time with people on their country, learning their ways.”

Greg Smith, a Primary Health Care Nurse working with the Top End Health Service (TEHS), took out the top gong at the 2018 Northern Territory Nursing and Midwifery Excellence Awards. He was recognised for his work and research undertaken in RHD disease patients in the community. Greg is currently in charge of the RHD portfolio at the Maningrida Health Centre in the Northern Territory. 

RHDAustralia would like to congratulate Greg on winning both the Excellence in Nursing/Midwifery Education and/or Research and the 2018 Nurse/Midwife of the Year award.

When asked what these awards meant to him, Greg said, “I am honoured to win both the Excellence in Research/Education and the Nurse of the Year awards. I like to think that this will emphasise the value of research in nursing. I hope to be able to facilitate the community having a greater voice in the design and implementation of health service delivery in Maningrida.”

He went on to say that as health professionals, awards such as these serve as a reminder that the work you do is valued by colleagues and the people supporting you in your job. 

“People generally are very appreciative of the work nurses and midwives do. The heartfelt thanks we receive is one of the perks of the job; however, it is also really important to value and reward professional excellence. These awards are an opportunity for us to come together and celebrate the great work we do,” said Greg.

He gave some important insights into his role as a remote area nurse stating, “I prefer to call myself a Primary Health Care Nurse. Apart from attending to acute presentations, which range from runny noses and sore ears, to heart attacks and strokes, I have taken on a number of different responsibilities.

“Initially I looked after the patients with mental illness, then kids with chronic conditions. In my current role, I have responsibility for 200 RHD patients, nearly 160 of who require long-term three to four- weekly injections to prevent their condition from deteriorating. A key component of this role is education about primary and secondary prevention. Community workers are integral in providing this education.

“My most rewarding role has been to deliver health services to homelands. Visiting each of the 30 outstations once every four weeks was invaluable in supporting people to live healthy lives on their country, delivering medications, doing health checks and attending to acute complaints. It was a privilege to spend time with people on their country, learning their ways.”

After working with the community for many years and seeing how important it was to provide culturally appropriate care, Greg began a research project through Charles Darwin University and Menzies School of Health Research.

His research investigated patient experiences with primary health care delivery and how implementing a form of patient-centred care could improve the outcomes and experiences for residents in Maningrida.

“As part of my Masters of Public Health through CDU andMenzies, I worked with the community of Maningrida to understand their experience of health service delivery, and to document how health service delivery could be improved,” said Greg.

“Working with the Malabam Health Board, we put together an Advisory group to oversee the project. All the eight major language groups were represented, and the advisory group members co-facilitated focus group sessions. The project was supervised by Dr Paul Burgess and Dr Renae Kirkham. In all it took about two years to complete.

“I was supported by TEHS who granted me study leave for six months, and by the Office of Aboriginal Health Policy and Engagement who provided grant funding,” said Greg.

Greg’s research revealed that the current service delivery has lacked appropriate cultural security, which reduced community access to care. He noted that the community identified improvements to how health care can be delivered by:

  • Restructuring care teams to foster culturally secure relationship-based care, based on family groups;
  • Strengthening the Aboriginal Health Practitioner role as the focal point of care continuity to deliver self-management support;
  • Care coordination and health coaching; and
  • Cultural mentorship for non-Aboriginal staff.

“These changes require changes to the way Aboriginal Health Practitioner (AHP) roles are defined as well as how training is delivered. The AHP will be the core member of the team,” he said.

“We have known for a long time that in Aboriginal health relationships are the key. It makes sense that we structure health service delivery to foster relationships.”

Reflecting upon his last eight years of work in Maningrida, Greg said, “I’ve found my time living and working in Maningrida to be immensely rewarding. The longer I’ve stayed, the more I’ve got to know the local community, the more I have fished and foraged with them, the more I have learnt their customs, the more joy and fulfilment I’ve got out of my work.

“Developing respectful two-way relationships with the community has enabled me to be more effective in my role as a primary health care nurse. After a stint of long service leave later this year, it is my dream to be able to come back and implement the findings of my research.”