New Chief Nurse and Midwifery Officer

Working at Maunu House feels so much like home that Maree often goes to stop and pick up her mail at the front doors as she did back in her days of training.

After registering Maree moved first to Middlemore Hospital and then returned to Northland to work in Kaikohe. Maree worked for several years in Hawkes Bay before deciding to fulfil a lifelong desire to join the military as a nurse in the New Zealand Army.

The Army was tough at first as Maree, and other officer candidates were required to take part in a week-long testing period for the officer selection board to see if they had leadership potential.

Candidates tackled fitness challenges followed by mental tasks to monitor how they functioned in high-stress situations and work collaboratively with others.

After passing the selection board, Maree started at Waiouru Army Camp Hospital, helping to keep the fighting force fit by providing primary health care and women's health.

"There were around 1500 people that received healthcare through the military in Waiouru at the time. But because military personnel are generally a young, fit vetted population – with no pre-existing conditions, we dealt mostly with injuries and communicable diseases. We did lots of vaccinations to maintain their health status to ensure they were all deployable."

After completing an aeromedical evacuation course, Maree was seconded to join the Royal New Zealand Air Force where she later deployed to East Timor as a flight nurse. Her brief was to care for the New Zealand contingent in Suai and also provide support to companies of Irish and Fijians soldiers.

When her team witnessed the community's desperate need for medical help, they started packing up kits and holding clinics to support the local NGO's.

Maree was surprised how quickly the locals responded to the treatment, compared to the Westerners who were so used to having antibiotics and pain relief.

She returned to Ohakea Military Base after East Timor and was promoted to Captain, and then offered a role as the Principal Nursing Officer at 2 Field Hospital in Linton Military Camp.

Her next deployment was to the Bamiyan Province in Afghanistan, joining a contingent of 104 people working on identifying engineering tasks to rebuild the area's infrastructure for the local Hazara people. The medical team provided care to the New Zealanders, a group of Afghan National Police and other locally employed civilians.

Her team attempted to support the delivery of health care in the community and at the local hospital – which Maree said was very basic, "There were nurses who had no training. They were just local people trying to meet a need. We'd go down and see what we could do to help out – mostly offering knowledge, as we didn't have a lot of kit."

When one of the New Zealand nursing officers on another tour to Bamiyan identified that the mothers in prison, had no clothing or nappies for their babies, that nurse set up the project "Babies of Bamiyan". She arranged for baby clothes, sewing machines, and material to be sent over for the women to make disposable nappies.

A local policeman came to Maree because he was having trouble seeing, she gave him her glasses to try on. Maree said his reaction was unforgettable, "He could see, and was so excited. Because there was no optometry service available, I contacted one of the nurses at Burnham Military Camp and asked if they could source old glasses at the optometrists in New Zealand.”

Hundreds of New Zealander's pairs of unused glasses were sent to Afghanistan and distributed to the local community according to their needs.

"Simple things can make a massive difference. This meant people could continue to work in a place where if you don't work, you can starve."

Soon after returning to her unit in New Zealand, she was posted to the New Zealand Command and Staff College (Defence Force University) to do the senior staff course after being recommended for promotion.

She completed a Postgraduate Diploma in Defence Studies through Massey University as well as Command and Staff College deliverables, which were very Defence specific. She studied alongside military colleagues and officers from Police, Fisheries and Customs learning about cybersecurity, terrorism and crime.

Following graduation, she went to work as staff officer (2IC) to the Director of Nursing Services at New Zealand Defence Force Headquarters in Wellington where she lived in the barracks in Trentham, venturing home to Manawatu in the weekends.

By then, Maree said she had been advised she would be the next Director of Nursing Services and had a year learning from the current Director who taught her a considerable amount about working strategically and introduced her to the nursing networks. At this time, she was also working on a Master's in Strategic Studies through Victoria University.

Her Master's research project focused on Professional Development and Recognition Programmes (PDRP), scoping to see if PDRP was suitable for Defence nurses. Then went on to do another project looking at creative thinking in government organisations and how to facilitate innovation.

She was then promoted to Lieutenant Colonel and Director of Nursing Services, where she stayed for five years.

As she got older, Maree said maintaining the fitness requirements was an increasing challenge, and she felt she needed a change, so decided it was time to finish her 22-year military career.

The Army gave her a year's secondment on full pay to work anywhere she liked. The innovation at DHBs and opportunity to work with patients again supporting nurses to facilitate good quality care drew her to Whanganui DHB. After her year's secondment, she was offered a job as associate director of nursing for Patient Safety and Service Quality.

She remained at Whanganui from 2012 until August 2019, while working on her PhD studies which looks at how military nurses navigate professional accountabilities and role expectations.

Maree was interested in how nurses in the Army meet their job description expectations while meeting the responsibilities and the clinical governance competence requirements that nurses need.

"Most of the information out there about military nurses is American. So, there was a hole there to have that question answered. Towards the end of my thesis, I needed to commit to it, so I got a job as a lecturer at Massey, where the academic environment supported my research. It was quite busy – but any job nursing is busy!"

"I thought the pressure and culture of Defence would mean that nurses would work tightly to that brief.

“However, I found that military nurses worked towards the nursing brief with a nurse's lens that prioritised patient care ahead of the Defence strategy.”

Maree said she has gathered from her research and experience with nurses that the team around nurses and the education they have had helps to optimise their potential.

"The types of people who are nurses have a philosophy in life to care – not to meet budgets or organisational strategy. I thought nurses in the military would have assimilated some of the combat ideologies. But they don't - those that want to be soldiers leave and become soldiers.

"I've seen that at Whanganui DHB and from what I've seen here in the first few weeks I've been here – the nurses put the patients first.

"If you're going into nursing - you have an orientation towards caring for people. We need to build on that because it does make nurses particularly vulnerable to burnout, and someone needs to be looking out for them. You need to know your team and to look after them."

Maree is excited about her new role and has already set a range of goals to achieve.

The issue of recruitment sits high on her list. She said she doesn't understand why anyone wouldn't want to come to Northland to work and is determined to work with other agencies to help break down barriers, to ensure nursing is encouraged as a profession.

"We need to get out into schools and show students that nursing is a viable career for Northlanders both in the towns and rural areas.

"There are some schools in Northland not currently offering subjects that enable students to get into health sciences, and I want to help with the health professions’ current focus on that. In 10 or 20 years, we want those students working for us. So, we need to concentrate on that early strategy and get nurses who go further afield to study to come home to work. We also need to be educating and hiring nurses that represent the population."

Retaining staff is another of her priorities. She believes the key to this lies in good leadership and encouraging and maintaining professional development.

"If we invigorate our nursing leadership to be the kind of leaders staff want to work for, our nurses will be satisfied, engaged and challenged."

Maree said she is encouraged and supportive of both Northland DHBs affirmative action strategy and the work going into patient safety and quality. She is excited about helping to develop strategies that lead to patients getting good quality care.

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