‘Hi,’ she says to the man behind the desk, using her most confident voice. ‘I’m the nurse from Great Barrier Island. I have just escorted a patient over and I need a taxi voucher to go to the airport.’
To her delight, bordering on disbelief, he nods and hands over a voucher, just like that, no questions asked. It is a simple matter to get a taxi, then, and once she is at the airport she is on familiar ground. She is confident Great Barrier Airlines will fly her back to the island on promise of payment, and, typically, they go one better: there is no charge at all. By the time the plane lands at the Okiwi aerodrome, Adele is feeling almost cruisy.
Shannon is there to meet her. ‘There’s good news and bad news,’ he says.
‘What’s the bad news?’ she hardly dares to ask.
‘The family with the baby left their antibiotics behind.’
Adele groans. It seems this long, long day will never end.
‘Don’t worry,’ Shannon says. ‘I’ve got the boat in the water and we can run them out to the island as soon as we get home.’
‘You said something about good news?’ Adele asks.
‘The good news is that Judith says dinner is cooked at her place. She’s not expecting conversation. All you have to do is eat and go home to sleep.’
That is almost how the evening pans out. But at midnight there is a knock at the door.
‘This is ridiculous!’ mutters Shannon. ‘I’ll go. They better be dying, otherwise I’m going to tell them they can come back tomorrow!’
Adele listens to the murmured conversation at the door. Shannon reappears.
‘You’d better get up,’ he says. ‘There’s blood!’
It is not always fraught. There are magical times, too. One hot, sunny autumn day—the sea is like a deep blue mirror—Adele puts on the backpack in which she carries her gear and retrieves the baby bag from the back of her four-wheel-drive. In these early days, most of what she does is home visits. Often the weather is awful and the walking from place to place is arduous, but on days like this . . .
This, she thinks, is going to be a good day at the office.
She walks along the sand at the head of Blind Bay to the start of the track, through the bush and over the hill to the next bay, and is spellbound every step of the way by the stillness, the quiet, and the sheer beauty of her surroundings.
Her first call, for a cup of tea and a chat, is to an elderly man with medical problems. He lives in one of two small baches that his family have built and which they occupy during the holidays. Adele admires how well set up he is: outside the little building he has a pile of mānuka logs beside a trestle that he has cunningly designed and constructed to make the job of cutting firewood easier.
‘You’re pretty isolated here,’ Adele says over their cup of tea. ‘How do you cope with that?’
‘Oh, it’s not bad at all. The neighbours are always dropping over. I’m never on my own for long.’
He talks about his wife, now deceased, and about his family on the mainland. He describes his beloved daughter, Jill, who loves the Barrier and comes across whenever she can. He hopes she will join him here soon on holiday.
Adele sets off again along the clay track, up and over a hill to the next bay. As she descends the hill through the bush, she can hear a chainsaw revving. When it falls silent, she hears the sound of chopping instead. Soon the track opens to a fresh clearing. It is the middle of nowhere, but there is a man standing in a drift of reddish sawdust and surrounded by fallen mānuka. He has obviously been working hard for some time. Adele stops for a chat.
‘I’m going to build a house here,’ he says. He tells her a bit about himself. He has been working for the last little while on prawn trawlers in Australia. He has long had a dream of settling on Great Barrier Island and building his own home.
The track takes Adele away from the coast and into the bush, and she finally reaches a sun-filled house nestled beside a stream surrounded by native bush. The family who live there, far, far from anywhere, welcome her. She has come to see the latest addition—a plump, healthy newborn whom they have only just brought home from the mainland. Adele performs the checks she has come to do. Everything is well, and she walks back to her vehicle for the hour-long drive home.
Over the next few years, she makes this journey—and lots like it—several times. Other babies are born in the meantime, and partly out of consideration for Adele, and partly to turn the well-child checks into a social occasion, mothers and babies gather in a single home for her visit. When she walks this route, she drops in on the elderly man. Eventually his health deteriorates to the point where he has to relocate to be with his family on the mainland. Soon after that, Jill moves into his bach. She will become a firm friend of ours.
The rural nursing experience is tough on Adele and Shannon’s relationship in some ways, but there is a silver lining. It is an eyeopener for Shannon. In their previous lives—rural nursing in Australia, working as a midwife in Auckland—Adele has gone off to work in the same way as Shannon has gone off to work. He worked as a workshop supervisor for a Western Australian iron-ore mining company, and in New Zealand he plied his trade as a motor mechanic. His professional life probably had its ups and downs, its dramas and its frustrations, but he did not really feel the need to share them with Adele. Nor did he stop to think that nursing might be different. Consequently, he used to have little idea of how complex and emotionally demanding Adele’s job could be. She became used to internalising a lot of the stress and anguish of her nursing.
Great Barrier Island has changed that. He has been in the thick of it, right from the start. One night, Adele sets off to pick Shannon up from the Port FitzRoy Boat Club, the only place resembling a pub in the north of the island. As she drives past the wharf, the beam of her headlights picks out a body lying motionless in the middle of the road. A little further on, she can see a motorbike on its side, its headlamp still illuminated. She stops and climbs out.
‘It’s Adele, the nurse,’ she says to the man. ‘Can you hear me?’
‘Yes,’ he mumbles.
‘Are you hurt?’ she asks.
‘No,’ he replies. ‘Just want to sleep.’
‘Well, you can’t stay here,’ she says. ‘You’d best come to the clinic so I can check you out.’
‘No, I’m right, thanks,’ he says.
It takes a while, but she finally manages to persuade him that there are better places to lie down than in the middle of the unlit road on a moonless night—especially when everyone else at the Boat Club will be making their own, not necessarily cautious, way home very shortly. Adele helps him up and he limps to the car. By the time they reach the clinic, he is starting to feel pretty sore, and Adele is wondering how she is going to get him inside. But at that moment, Shannon turns up. He had given up on the ride Adele had promised him and decided to walk home. Together, they help the rider into the clinic, where Adele examines him and dresses his cuts and grazes. While there does not appear to be anything seriously wrong, she wants to monitor him for concussion, so she and Shannon help him to settle on a mattress in their lounge. During the night, Adele gets up every hour to check on him.
‘Thanks for helping out last night,’ Adele says when Shannon emerges the next morning.
‘No worries,’ Shannon says.
You will hear people in Emergency refer to ‘car versus bike’ situations, signifying a collision between a car and a motorcycle. Well, one night Adele has a ‘cow versus bike’ scenario to deal with: she receives an early-evening phone call to say that a cow has stepped into the path of a local man riding home from work. A workmate travelling behind him saw his motorcycle on the road. When he stopped, he found his friend, who had been thrown into a drainage ditch. The cow appeared to be unharmed.
When Adele arrives at the scene, it is obvious that the man has fractured his femur and will need to be evacuated to hospital. She writes instructions on a piece of paper and sends a bystander to the closest telephone exchange t
o ring for a helicopter. He returns to say it is all organised. Adele now needs to get an intravenous line in, so that she can administer drugs to manage the pain and keep his blood volume up, but it is dark and cold and the man’s veins are such that it would be a challenge to get the needle in if she were in the clinic, let alone beside an unlit road. She decides it is best if they take him straight to the airstrip, so that there is no delay for the helicopter transportation.
At the airstrip, they wait what seems an age, but only fifteen minutes have elapsed when someone arrives from the telephone exchange to say that, for some operational reason or another, there will be a considerable delay in the helicopter’s arrival time. Adele decides she will transfer to a nearby house that has a generator and good lighting. The patient is taken inside on a stretcher and placed on the floor, where Adele kneels and prepares to insert the intravenous line. At that moment, the door bangs open and a drunk visitor lurches over.
‘Outta the way,’ he says, trying to push Adele aside. ‘I can sort this. I gotta first aid certificate.’
Adele is afraid he will blunder over the broken leg. The patient doesn’t look too happy about the proposed change of caregiver, either.
‘I’ve got a first aid certificate, too, as it happens,’ Adele says curtly. ‘Now go away!’
The other locals who are helping hustle the drunk man out of the room. With the line in, Adele is able to get the pain under control, and soon they hear the throb of the helicopter’s rotors. With the man safely installed and the chopper beating its way back to the mainland and Auckland Hospital, she can get to bed.
Adele puts down her book. She could have sworn she heard someone calling out. It is a hot, still night, and she has all the windows of her bedroom in the nurse’s cottage open.
There it is again. It definitely sounds like someone calling for help.
Adele dresses and goes outside on to the lawn.
‘Help!’ a faint voice calls. She cannot see anyone.
‘Is someone calling for help?’ she shouts.
‘Yes! Me! Help!’
‘Where are you?’ she calls.
‘At the wharf,’ comes the reply. Adele walks the 50 metres down the road to the wharf where there is a cargo barge tied up. She still can’t see a soul.
‘Where are you?’ she calls.
‘Down here.’
She looks over the edge of the wharf and sees the skipper in the tide with his back pressing against the hull of the barge and his feet propped against the wharf.
‘Why don’t you swim to the ladder?’ she asks.
‘I can’t swim,’ he replies.
Adele looks around for something to toss to him, and sees the water hose coiled on its reel. She is just unwinding it when she hears voices up the hill. It seems the crew of the vessel are on their way down from the Boat Club. She drops the end of the hose to the man in the water and tows him to the ladder. He is just gratefully climbing the ladder when his crew arrive along with one of the local women.
‘Are you injured?’ Adele asks the dripping man.
‘Tore my back up a bit on the wharf barnacles,’ he replies.
‘Let’s get you aboard and I’ll have a look.’
Just as they are about to step over on to the deck of the boat, one of the crew members, who seems to have surveyed the scene in front of him and jumped to the wrong conclusion, steps forward and begins to abuse Adele.
The local woman leaps to her defence. ‘How dare you talk to our nurse like that?’
Adele and the skipper board the boat and go into the galley, where he strips his wet shirt off so that Adele can examine the abrasions on his back. Overhead, the arguing continues between the angry crewman and the staunch local woman. They abruptly cease, and there is a loud splash. She has evidently shoved him off the wharf.
Adele looks from the skipper to another of the crew members who has come down to the galley.
‘Should I be worried that there’s someone else in the tide?’ she asks.
‘No,’ the skipper says. ‘He’ll sort himself out.’
The crewman nods. And sure enough, as Adele leaves the boat, the chastened crewman is standing dripping on the wharf.
That was not the first time someone had landed in the tide after a night at the club, either. One time, Adele and Shannon listened as a wife abused her husband, seemingly without drawing breath, for the five minutes it took them to walk to the wharf. They could even hear her voice over the sound of the boat motor once it started, and her husband didn’t utter a word the entire time. Suddenly there was a splash, then silence.
Shannon and Adele looked at one other.
‘Keep well out of that one,’ Shannon said.
A short while later, they heard the boat set off and the woman’s voice start up again. It was a relief when they had faded into the night.
It wasn’t only people who went into the water. One evening, one of the locals returned from Auckland with a new set of false teeth and promptly lost them overboard. Replacing them was going to be prohibitively expensive. He was devastated.
On a long shot, Adele and Shannon went down to the wharf at about midnight at dead low tide, and walked around in the mud with a torch.
‘Look,’ said Shannon.
There, in all their glory, were the teeth, grinning at them.
The work, especially in summer, is relentless. The sheer range of emergency situations to which she is called is challenging and stressful. One day, Adele phones her supervisor in Auckland and tells her that she does not think she will be able to stand another summer like it without extra assistance. So for several years, Fay, her predecessor in the job, returns to the island for three weeks each summer. It is never again as busy as that first year.
Chapter 3
PART OF THE FABRIC
Since early European colonisation, Aotea has been subject to discrete ‘waves’ of settlement, usually determined by the economics of the day. Māori were long established here, of course. They settled mainly around the coastal edges in a number of kāinga (villages), and lived in a kind of symbiosis with the land and its resources. Evidence of these and of pā sites—fortified villages, of which at least 32 have been recorded—can be found. These pā were seasonally occupied from the 1600s by Ngāti Rehua—Ngāti Wai ki Aotea, the present-day tangata whenua of Aotea.
The first Europeans were engaged in ‘extraction’ industries—whaling, mining for gold, silver and copper, kauri timber and gum-digging. Once these industries had each run their boom and bust course, a new phase in the island’s history would begin. Farming eventually became a large industry—twenty settler farms sent a weekly load of cream off to the mainland.
Tangata whenua and the pioneer families remain at the core of the community to this day, as the largest private landowners. They have persisted through many generations and are understandably resourceful and self-reliant, having adapted to the hardships of the Aotea way of life over time.
The next wave of settlement was, for want of a better word, the ‘hippies’, who were seeking an alternative lifestyle to the mainstream. They set up cooperative communities and sought to be self-sufficient, and had in common with the settler families the same pioneering spirit and self-reliance. They were interested in preserving the environment with which they were interacting. Many of these people and their children still remain.
More recently, there have been those who have deliberately sought out the kind of lifestyle for themselves and their families that only places like Aotea can still provide. Often these are tradespeople and those who work in the service industries, and they have contributed a great deal to the island’s infrastructure, bringing skills and a strong work ethic. And, as a constant for very many years, there have been families who own baches on the island. While they do not live on the island year round, they have a long-standing link to and passion for it.
The islanders are largely accepting of difference and diversity. There can, of course, be a range of opinions on an
y given topic that can erode even the best of relationships. But in times of need the community comes together, and while it is a patchwork rather than a smooth, seamless whole the Barrier community is still a rich piece, stitched together by the shared fact of isolation. In the end, everyone is (almost literally) in the same boat. Above all else, the Great Barrier Island community is an outstanding example of the way people in isolated communities are resilient and self-reliant and will find a way to make things work. One of the rewards of rural nursing here is that you see first-hand the basic human talent for caring, building and maintaining a strong community network.
And, luckily for us, one of the things that the islanders universally agree upon is the necessity of good healthcare. They care for each other as well as supporting us in our efforts to care for them.
‘What’s your ETA at the wharf likely to be? Over,’ Adele says. She releases the transmit button on the hand-piece of the CB radio. There is a burst of static, and after a short silence the speaker crackles into life.
‘Ooh, give us forty-five minutes, I reckon. Over,’ the voice replies.
‘Roger,’ Adele replies. ‘Bring him up to the clinic when you arrive. See you then. Nurse’s cottage over and out.’
Adele hangs up the hand-piece and walks into the lounge. She sits back down in front of the television, pleased that there will be time to watch the end of the programme she has been enjoying before she needs to deal with the emergency.
Well, look at me, she thinks, amazed. I am not rushing around checking my emergency gear. I am not all worked up fretting about the procedures I might need to perform. I am not anxious at all!
It has taken six months of living on adrenaline to reach this point. Six months of feeling the catch in her breath and the race of her pulse with the news of each new drama. But now she has come to realise that the situations are never quite as bad as people report, unless they are actually performing CPR.
Island Nurses Page 4