Walking beside those with cancer: supporting those who have received a cancer diagnosis negotiate their way through the treatment journey is richly rewarding work for a Rotorua-based nurse.

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Standing alongside a person throughout their cancer journey is the essence of Tirita Olsen's work. Appointed as a cancer nurse specialist, Maori health, for Lakes District Health Board late last year, she began the role in January this year after 14 years as a district nurse.

She was encouraged to apply for the newly-created position but was a little unsure about whether to do so. "I could see it was a rote I could flit but I loved the clinical side of district nursing and the new rote meant moving away from that, and more to helping people negotiate a pathway from diagnosis through treatment."

But any initial misgivings have evaporated and she loves her new position which, at present, has an active case load of 65 patients throughout Rotorua, Taupo, Turangi and Murapara. Thirty-five percent of people in the region identify as Maori.

Enrolled nursing

Olsen's nursing career began when she trained as an enrolled nurse at Rotorua Hospital in 1975. "My mother reckoned as a child I looked after everything and everybody and said I would make a wonderful nurse. She realty pushed me into going nursing. I wasn't too sure, so did the enrolled training to find out and I loved it. I'm stilt grateful to my mother for persuading me to go nursing."

Olsen subsequently did her general training and has always worked at Rotorua Hospital, including in the emergency department and theatre. White raising her three children she worked in rest-homes and did some agency nursing and returned to Rotorua Hospital 14 years ago as a district nurse.

As a district nurse, she was involved in caring for cancer patients, as the district nursing service shared the palliative care contract with the Rotorua Hospice. The district nurses did the "hands-on" care, white the hospice nurses were more involved in a social/counselling role. But with the expansion of the hospice, art palliative care is now undertaken by hospice nurses.

Olsen's journey with cancer patients begins when they receive a confirmed diagnosis of cancer. Her dose links with Lakes Radiology means all Maori women diagnosed with breast cancer are offered Olsen's services. "I see most women. It is important I am there fight at the beginning so no 'old stories' get in the way of a person's journey. Everybody has a story about someone who had a bad experience. In my first meeting with a patient, I tell them I'm a person who wit[ stand alongside them in this journey. Sometimes a person wilt need a lot of time and support through their active treatment; at other times they will need very little support."

Olsen's role includes attending appointments with patients and follow-ups with surgeons, talking through the diagnosis with people, listening to their fears, helping them understand the waiting time between surgery and the start of any chemotherapy or radiotherapy. Often she needs to explain the diagnosis. "Many patients don't understand what the doctor has said to them."

She can also offer practical help such as organising help with housework or assisting a patient get their nutritional supplements. "What I do really depends on the needs of each patient."

Some people want art the information about their diagnosis and treatment options fight at the start; others just want to take smart steps and to focus on what's immediately in front of them.

Involving whanau, supporting and guiding them, and explaining their family member's diagnosis, is an integral part of Olsen's work.

Her caseload is very varied in terms of the range of cancers people have and the age of her patients.

"I have had to learn and am still learning a great deal clinically. I work alongside the other cancer nurse specialist David Boles and he has been so supportive. Because I have lived in Rotorua all my life and worked as a district nurse for so tong, I have huge community knowledge but David has realty supported me a great deal clinically."

The two nurses happily care for one another's patients if need be and Olsen will look after Pakeha women who prefer to have a female nurse; just as Boles cares for any Maori men who prefer a male nurse.

Of her 65-strong case toad, eight patients are presently under the care of the hospice. The hospice undertakes art of their care but should they undergo any further active treatment, Olsen will come alongside them again.

She finds her work immensely satisfying. "To see the relief on a person's face as I explain something that has been troubling them or offer to support them at their next appointment is very rewarding."

Olsen believes her love of people is one of the most important skills she brings to her role. "Love is central to my practice. There is a lot of joy and happiness in my work. I have always seen my rote as a nurse as doing the very best I can to help someone, whether that involves their death or their life. Have I made them comfortable? Have I met their needs? Are they better off for my intervention than they would have been without it? These are the questions I ask myself."

Very few people have refused Olsen's help. One woman was very brisk at the initial appointment and told Olsen she didn't need her. Undeterred, Olsen just kept texting her regularly and eventually the woman called, saying "I'm in trouble".

"The fact I'd kept in touch was important and I was able to establish a good relationship with that woman and support her when she was ready."

With skills developed during her district nursing, Olsen says she is always reading people, assessing how they act towards each other, working out what might help, how she can best support them and their family. "Meeting people face-to-face is really important. I will often begin my visit with a karakia if I think that is appropriate. I can sense whether a person would want that or not."

As well as being with her patients, Olsen attends a weekly multi-disciplinary team meeting at Rotorua Hospital, one a fortnight at Taupo Hospital, when she also visits her patients in Taupo, attends oncology study days and the Midlands Cancer Network's care co-ordinators forum in Hamilton every three months. She is also completing her diploma in Maori studies at Te Wananga o Aotearoa. She works four days a week.

Of Ngati Whakaue descent, a sub tribe of Te Arawa, Olsen is the grandniece of the first Anglican Bishop of Aotearoa, Fred Bennett. She is very grateful for the support of her husband and family, her parents and her church family, the Christian Life Centre in Rotorua, "as the demands and sadness of this role could be overwhelming"

Acknowledging these words as those of the ancestors, Olsen says this whakatauki about the importance of Love, expresses how she sees her nursing role and care.

Tuhia kite rangi

Tuhia ki te whenua

Tuhia ki te ngakau o nga tangata

Ko te mea nui ko te aroha 

Tihei mauri ora.