Snow Shinoy is one of eight nurses working at St Dominic’s Centre in Feilding, which is run by the Dalcam Healthcare Group. St Dominic’s is a 49-bed residential facility offering recovery, respite and crisis services for people living with mental illness. Some service users are there under the Mental Health Act. Some will stay there permanently, and some will move to less assisted care facilities or to community care when they are able.

Snow is from India where she was a hospital trained nurse and worked for five years in medical and surgical wards. She came to New Zealand with her husband and children in 2010, and has done two years’ further training so she can work in the system here. As part of this training she had a placement at St Dominic’s and she successfully applied for a vacancy there when her New Zealand training was completed in 2016. 

Her role includes caring for residential service users and working with general practitioners and specialists to complete assessments and develop individualised care plans. Mental health was reasonably new to her, but she was keen to learn, so her manager suggested she do further study via the NESP programme, which she finished in October 2017.

Challenges

Having a busy family of three children and living rurally presented challenges for Snow. She works four days a week, leaving her a full day for study, but had to travel daily by train to the Whitireia campus in Porirua for a week four times over the year. This was a two-hour trip each way and it was very tiring fitting this in around the demands of work and parenting.

Another thing Snow says was challenging was that, as a nurse working in an NGO, she didn’t have access to the same collegial support as the district health board nurses doing NESP training alongside her.

“I think a real advantage for them is that they have lots of other nurses around them they can talk to and from whom they can receive professional support. I felt I was alone in my study a lot of the time as I was the only one doing the NESP programme where I worked.”

Supervision and support

Nevertheless, Snow says she has received great support from her husband and family, and from the management team at St Dominic’s. She says they were amazing.

“I really felt like they did everything they could to help me through the training and get the most from it. They gave me extra time off when I had assignments due and were very hands on in arranging a placement for me at the Acute Inpatient Service for Mental Health (Ward 21) at Palmerston North Hospital where I learned so much.”

They also arranged a supervisor for her. NESP students are required to meet with a supervisor 10 times per semester, but Snow says she met with hers even more often.

“She was just so helpful. She has also worked at Ward 21 so was really knowledgeable when I checked in with her about the decisions I was making with service users during my placement there. As the mental health coordinator for the Mid Central region she is also the one who refers service users to St Dominic’s, so she already knew many people’s situations when I discussed their care plans with her.”

Her supervisor would also comment on Snow’s assignments before she handed them in and was always on hand to give advice when needed. 

Snow’s NESP course costs were covered by Dalcam so she is bonded to work for at least a year in St Dominic’s now that her studies are complete. 

The learning

Snow says she has learned “heaps of new things” under the NESP programme.

One thing she found particularly valuable and relevant to her work has been trauma informed care and how to work with people, taking into account the things that have happened to them in the past that are causing distress for them now. 

Another important learning has been the importance of reflective practice – using a model to think about an incident that has happened so there can be better outcomes in future if that sort of incident occurs again. 

“Things like this may not have come to mind in the same way without the study,” she says. 

“And when I was working with service users in acute settings during my placement I really gained a lot of confidence in dealing with people in crisis situations. For example, I learned how to de-escalate using sensory modulation and I think that’s really good practice.”

Another thing she found very informative and helpful was an improved understanding of the legal aspects around people who have been placed into compulsory care.

She says the practical workshops were really good for increasing her empathy for the people she cares for.

“At one of these I experienced what it is like to hear voices, and now I much better understand how this affects people and their ability to listen and concentrate.”

Encouraging other NGO nurses

Snow really encourages mental health nurses working in NGOs to consider doing further study under the NESP programme, and not just because it provides much needed interaction with colleagues and advisers. 

“To work with service users and other mental health professionals, we really do benefit from clinical knowledge, and I have gained a great deal of that through this study." 

“Everybody has been encouraging and supportive, including the Whitireia tutors, and I just feel so much more confident and capable in my work having done this.”