North Haven Hospice quality and safety manager Elizabeth Lee at her farewell. Photo / Michael Cunningham
She's come a long way from the days of perfectly-aligned starched hospital bedsheets but for Elizabeth Lee, and many nurses, old habits die hard.
After a 55-year career, the 72-year-old has retired and, on the first week of her retirement, is finding it a little strange.
"It's strange. It's only day two of not having to go to work... I think that one needs to be planned and not waste time, otherwise the days just disappear," she muses.
Elizabeth's nursing days started aged 18 at Tauranga Hospital School of Nursing in 1966. Back then, it was compulsory to live in the nurses' home where retired nurses, known as home sisters, became surrogate parents.
"Remember, this was the mid-60s, the hippie movement might have been under way, but not in nursing school," Elizabeth recalls.
"We were straight out of high school and in the wards, caring for patients after three months' nursing introductory school where we learned, on each other and the mannequin patient, how to provide personal care. That was a lot of responsibility and we knew it.
"Student nurses were the workforce, doing most of the work with patients, supervised by the registered nurses, the staff nurse and the ward sister."
Elizabeth (née Grogan) remembers ward sisters ruling the roost.
"They set very high standards and each had their quirks. One, I recall, had a habit of moving patients further away from the office as they got better; you'd be in the middle of doing something with them and she would whip their bed away - with them in it. If you were away getting something, you'd find them gone when you got back. You'd have to go looking behind all the curtains calling out, 'Where are you?'"
She also remembers inward-turned wheels on beds being important to early health and safety so you didn't trip over the wheel – hence the reason for filled-in shoes.
"Bedpans and urinals were made of stainless steel - we spent a lot of time in the sluice room cleaning them with Chemico and a scrubbing brush before putting them in the hot water boiler to sterilise - the steam coming off them was the reason for my early change from glasses to contact lenses."
And: "Sharply-mitred corners on the starched sheets, perfectly-aligned on the bed were a requirement - I still do it to this day - without the starch!"
Over the following 14 years, Elizabeth worked her way up through medical wards, infectious disease, EENT, surgical, staff nurse and ward sister, afternoon and night supervisor, in-service education to assistant principal nurse. After post-graduate study in Wellington, she came to Whangārei in 1980 to take on the job of principal nurse at Whangārei Hospital. It was here she met her husband John, who had been recruited from Australia to work on the expansion of the oil refinery.
Only five years later, she was appointed to the new role of chief nurse of the Northland Area Health Service (one of many predecessors of the Northland DHB) in 1985.
She remained in that leadership role through many system changes until the late 90s, leaving the then Northland Crown Health Enterprise (NCHE) to work independently.
"I travelled all over New Zealand as a surveyor in the health services accreditation programme and as an advisor on quality management systems. I'd been involved from the time North Haven Hospice was founded, so when the opportunity came to work there in quality and risk management, I was very happy to do that."
Elizabeth stayed at North Haven Hospice for 15 years, well beyond retirement age because, "I was doing work I loved for a really good cause with a bunch of dedicated people."
This involved working with the staff and volunteers on the environment, conditions, systems and processes necessary for a service of excellence – essentially still helping patients and their families.
"My nursing background has been valuable and important towards that. You have to have a really good understanding of the health sector and how it works in order to be able to be a manager."
North Haven Hospice has around 150 patients in their care at any time.
"One of the things that is different about Hospice from a lot of other services is most of the care is given to people in their own home. Our staff are out on the road visiting and being with those patients and helping them with what they are facing. So, from the perspective as quality and safety manager, it was how to do that safely, how to ensure that the staff had the kind of support that they needed to do that work while continuing to get feedback from patients and families."
Looking back over how the health sector has evolved over the years, Elizabeth reflects: "It's hugely different from when I began but the essence of nursing is the same - being with people, helping them in whatever way they need. The pace of the health service and the demand for care is so great, that spending that time is a challenge in many situations now. Turnover is much greater; people don't stay in hospital as long as they used to. Patients stayed on bed rest for longer. There's less time to get to know them. The whole relationship building up is quite different.
"The biggest change is the knowledge explosion and the way this changes practice; nursing registration is just the beginning of life-long learning."
Stand-out memories include the development of the Northland Area Health Service, one of three pilots in the country in the mid-80s that amalgamated services of the hospitals with district nursing and public health services. "It was a very exciting and ground-breaking time where the elected board had the mandate to work with the people of Northland on the design and delivery of services to meet local needs."
Elizabeth cites her favourite part of her career as, "Working with people, giving comfort and support, helping staff realise their potential and do their best for the people they were caring for.
"It's been an absolute privilege to do work I have loved with many fabulous, dedicated people over such a period. It's true; do something you love and it won't feel like work at all."
Her retirement plans include, transtasman bubble-permitting, spending time between New Zealand and Australia with family. And there's also more time to iron the tops of the sheets – something Elizabeth laughingly admits to occasionally doing.
Three of the whales succumbed on the shore.