How I became a mental health and addiction nurse - Moe's story

Moefilifilia Aoelua (Moe), Nurse Lead Pacific Mental Health and Addiction at CMDHB, spoke with Skills Matter project lead, Jacqui Hampton about her journey into mental health and addiction nursing and her experience with the Skills Matter-funded New Entry to Specialist Practice (NESP) programme. Here is Moe's story.

Ko wai au?

Talofa lava, my name is Moefilifilia Aoelua. I was born and raised in Samoa and moved to Aotearoa as a young adult in 2010. I am a Christian woman, a wife and a mother to three beautiful blessings. I completed the New Entry to Specialist Practice (NESP) in 2016 and have very recently started the role of Nurse Lead Pacific Mental Health and Addiction for Counties Manukau DHB.

My journey did have some challenges. I became pregnant in Year 12 with my now husband and the thought or dream of going to university seemed impossible at the time. I was so determined to go to uni, but it just wasn’t an option for me to go back and complete high school. There weren’t pathways for young people like me to return to complete education and pursue further studies. From a young age, I felt drawn to becoming a doctor because of my experience seeing my late father undergo health treatments. This dream led to us making the big move to leave our country Samoa where we grew up and where our families and what we knew was and move to Aotearoa to pursue education and seek better opportunities for us and our small family.

My journey into mental health & addiction nursing

Once in Tāmaki Makaurau, I stayed home but the dream to pursue university remained so I explored options of how to get into health. I realised that I had no qualifications nor NCEA credits to enter into medicine. I thought nursing may actually be a pathway. I went to Manukau Institute of Technology (MIT) and completed the required foundation studies then completed the MIT Bachelor of Nursing Pacific degree. I had no intention of getting into mental health nursing. Growing up in Samoa, the concept of mental health and mental illness didn't really exist and the media certainly painted mental illness in the wrong way, so by the time I got to do my placement, I was actually quite scared.

I realised the people seeking support looked like me and at any point in our lives, anybody could be in their situation. I remember sitting in the Clinical Nurse Liaison’s office crying on my first day and this was just orientation of the ward – I was so full of compassion and wanted to know why people became unwell.

I found a new passion in mental health and addiction nursing and this was going to be my calling.

It’s the foundation of hauora, and I really believe there is no health without mental health.

I loved looking at the causative factors and reasons that contributed to why people became unwell and what the best practice was to support and reduce this. I loved working with tāngata whai ora to plan the support and what they needed for their recovery. I realised that spending time with people and hearing their stories was what I wanted to do. It made me more grateful for what I had and my interest and curiosity in mental health and addiction nursing just grew and grew.

New Entry to Specialist Practice (NESP), 2015 - University of Auckland

I applied through ACE and got a place in CMDHB. I had six months in a community placement in the child team and six months inpatient adult acute ward. The focus of the programme was on assessment and formulation skills, which I felt were good foundational papers for a brand-new nurse in the field like myself. There was such a strong focus on comprehensive clinical skills that was limited in our undergraduate degree. On reflection, I am so glad NESP was mandatory as it helped build further on my foundational skills as a mental health nurse. I came away feeling confident in assessments, co-existing mental health concerns and evidence-based interventions.

The preceptors who supported us played a huge role in our development. At the time, It was difficult to understand the reason why I did both adult and child mental health in my placement, but my passionate preceptors guided and helped me see the value in understanding mental health across a person’s lifespan. This helped me see the broader context for people experiencing distress. There’s no denying it’s a big year, so definitely access all the support that you think you need to get through.

My journey after NESP

After a period of working in the inpatient environment, I moved into early intervention for psychosis. This is where I learned further the different kinds of assessments – initial comprehensive assessments, crisis, acute, recovery and then assessing readiness for returning back to work/studies/life. I learnt about the impact of trauma, trauma-informed care, supporting people with emotional dysregulation, setting boundaries and attachment issues, and harm reduction strategies for substance use. I became interested in dialectical behavioural therapy and really honed my therapeutic skills, both kanohi ki te kanohi, but also in a group setting. We ran educational groups, hearing voices groups, managing anxiety. We ran social and sports groups. It showed me that there is so much more we can do in mental health and addiction nursing. My way of nursing expanded and refined, and I became therapeutic and recovery-focused in my nursing – how to support people getting back into work or school, how we support people to get back into the river of life. I understood and valued the multidisciplinary approach to care, person-centred and whānau-centred care.

After working in Early Intervention for Psychosis, I moved and worked in Adult as a Clinical Nurse Specialist working alongside the adult team and also within this role did primary liaison work. While doing these as a nurse, I found teaching a passion and would take up opportunities to speak as a guest lecturer in the undergrad Bachelor of Nursing Pacific programme at MIT. I also worked in the community acute team. This gave me a variety of exposure across mental health.

The importance of culture

If we are nursing Pacific, Māori, Asian, other ethnic minorities or marginalised peoples and groups, we must view them through who they are, where they come from and what’s important to them. The way I practice now is to listen to their story first and understand their experience through their culture. People’s culture needs to be heard, understood and validated, otherwise recovery cannot begin.

Your main skill in mental health nursing is connecting, actively listening, identifying things that interest them and weaving your clinical skills through this talanoa, this kōrero by asking, tell me more about that, what led you to do this? If you were to do that, how would things change? How do you want things to be? How did that help you? That sounds like it’s really important to you. Remember, you’re not just there to hang out with the person. You are there because there is a reason why they ended up in your care and you use your culture to understand, connect and build compassion.

My new role, Pacific Lead Mental health and Addiction, Counties Manukau DHB

My kaupapa for my new role is to ensure we best support our Pacific communities. We want to awhi and grow our Pacific nurse workforce in mental health and addiction nursing, and to ensure the Pacific lens sits firmly in mental health and addiction nursing. We will do this by connecting and mentoring our Pacific nurses coming through, identifying the things they are passionate about and trying to align them with projects and areas that may match these values.

I want to further support education providers to help them understand what Māori and Pacific nurses need and how nurturing culture is key to supporting our nursing workforce and the communities we serve.

It’s also very important to me that we recognise that graduate Pacific nurses bring new experiences and there is diversity within this group. The new graduate nurses are even different to when I started 10 years ago. We need to be open to the fact that the Pacific worldview continues to grow. We need to listen and understand and work together in order to grow.

Find out more Skills Matter and the New Entry to Specialist Practice programme here.