45 Minutes with Monina Gesmundo

Today's edition is a quick trip back to the southern hemisphere but further down under: New Zealand. This country offers unique opportunities for registered nurses to practice in a diverse range of nursing practice areas, in a variety of settings. In the early 2000, quite a number of Filipino nurses found opportunities in that beautiful country. No less than a Iskolar ng Bayan got fascinated with this place.

Monina Hernandez Gesmundo is a graduate of the University of the Philippines Manila College of Nursing (UPCN). She was recognized as the Most Outstanding Student of UPCN in 1992 and the Most Outstanding Student of UP Manila in 1991. She was a placer for both nursing and midwifery board exams. Shortly after graduation, she volunteered as a community nurse to far-flung rural areas as well as in various urban poor communities of Metro Manila from 1992 up to 1999. In 1999, she was invited to join the UPCN faculty and taught there until 2007. Monina was also a most sought-after local board examination reviewer all over the Philippines from 2005-2009.

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Apart from teaching, Monina has authored a book on community health nursing and a comprehensive reviewer for the board exams. In 2009, Monina was sponsored by Counties Manukau District Health Board to study and work in New Zealand. She is currently a clinical nurse specialist in infection prevention and control at Middlemore Hospital while actively pursuing postgraduate studies at the University of Auckland. Monina is member of the Pi Iota Chapter of the Honor Society of Nursing, Sigma Theta Tau International. Her research interest focuses on patient safety and infection control.

In this interview, Monina provides a practical viewpoint of nursing practice in New Zealand, the public attitude towards Filipino nurses and her professional work.

1. Tell us a bit about your current work.

I am Clinical Nurse Specialist for infection, prevention and control at Counties Manukau District Health Boardin Manukau City, Auckland, New Zealand. My job entails strategic management and implementation of essential quality improvement initiatives such as surveillance of:joint and caesarean section surgical site infections, multi-drug resistant organisms (MDRO), clostridium difficile, blood stream infections, central line and peripheral line infections and other significant infectious diseases.

Some people refer to me as the hand hygiene lady because I also conduct hand hygiene compliance audits and gold auditor trainings; however, I also engage in planning, implementation and evaluation of infection control processes in collaboration with other healthcare teams; development and updating of infection control policies and guidelines; provision of evidence-based advice to staff on infection prevention and control matters such as risk reduction, product evaluation and selection, disinfection, sterilisation of equipment and relevant statutory, legal, organisational and other infection prevention and control requirements.

As an infection control CNS, I am also involved in outbreak management; clinical audit and clinical risk management; research and development of evidence-based interventions; and, collaboration with all members of the health care team to ensure that staff receive quality clinical information, education input, and support.

2. What are some of the challenges in your work?

My work becomes very challenging during outbreaks because we really need to work fast and work hard to stop the cross-transmission of infections or even to arrest the increase in colonisation for certain MDROs. And because I have previously worked as a staff nurse, I can really empathize with the staff when it becomes too busy in the ward because of the outbreak. We are bound by a common goal though, that is, improved patient safety. Thus, when the outbreak is over, I really make it a point to thank and congratulate all the staff for their hard work and dedication. The nursing staff remains to be the backbone of the healthcare system. They deserve to be praised in times of success, such as during outbreak resolution.

3. What is the overall attitude of the NZ public towards Filipino nurses?

I have heard a lot of nice stories about Filipino nurses here whom patients find respectful, caring and skilful. There was this instance when I sat next to an old European lady while travelling to another city. When she learned that I am a Filipina nurse, she got so delighted that she started talking about how caring her Filipina nurse was. From her story, she said that the nurse patiently took care of her post-surgery in a public hospital, and that the nurse was all smiles each and every day. There was also another instance when I came to see a justice of the peace for the signing of a statutory declaration that I made. When she learned thatI am a Filipina nurse, she was so pleased that she talked about a male nurse who was called in by a colleague who made several attempts to insert an IV cannula on her. She said that the Filipino nurse was so skilful that he was successful in inserting the cannula on his first attempt. She was so pleased with us (Filipino nurses) that she blessed me. She even said that if she and her family would need care again, she would want a Filipino nurse to take care of them.

I myself have witnessed a lot of patients giving really good feedback about us, Filipino nurses, and the quality of our care. And without bragging, I have had several patients who said that I was one of their “favourite nurses”, together with another Filipina colleague, because we answered the call bell promptly, we answered their questions well and also because of such qualities as kindness, respectfulness, cheerfulness, caring attitude and empathy.  

4. Any recommendations for Filipino nurses who would like to work in New Zealand? 

New Zealand is a very beautiful country with a culturally diverse population. The Maori people are the indigenous people of New Zealand and English is the predominant language. Thus, for Filipino nurses who would want to work in New Zealand, I suggest that as a preparation, they should reflect on and internalize the principles of cultural safety. One very helpful document would be the Guidelines for Cultural Safety, the Treaty of Waitangi and Maori Health in Nursing Education and Practice, available online through the Nursing Council of New Zealand website.

The Nursing Council of New Zealand protects the public by setting standards for nursing in New Zealand. These standards are applied to all education programmes in New Zealand, nurses working in New Zealand and overseas trained nurses who wish to work in New Zealand. Anyone who wishes to work as a nurse in New Zealand must first meet these standards and then continue to maintain the requirements to demonstrate their competency to practise nursing. Thus, Filipino nurses should study the following documents as a preparation for practise: Competencies for registered nurses, the Code of Conduct for nurses, the Guidelines: Professional Boundaries and the Guidelines: Social Media and Electronic Communication. Similarly, all of these documents are available online through the Nursing Council of New Zealand website. Filipino nurses should also familiarise themselves with the requirements for overseas registered nurses as spelled out in the nursing council website. In this way, they will be properly guided as they apply for registration in New Zealand.

Apart from the professional requirements, Filipino nurses who would want to work in New Zealand should be prepared to live in New Zealand. This means that they should be prepared to learn how to drive (right-hand drive), adapt to the climate, adapt to the lifestyle and adapt to the big change that they are about to face. It is a good thing though that we now have a lot of Filipino nurses who work in various hospitals, clinics,rest homes and other facilities all over the country. This would hopefully minimise the homesickness that besets every Filipino who sets foot in a foreign country. To further assist Filipino nurses, the Filipino Nurses Association of New Zealand (FNANZ), is now registered as an organisation with the government and it aims to enhance the solidarity of Filipino nurses, to promote professionalism among Filipino nurses, and to protect the welfare of Filipino nurses in New Zealand. For those interested to join, please do not hesitate to contact me so we can work hand in hand in supporting fellow Filipino nurses who may need our help.

Finally, communication is very vital not only in nursing care but also in one’s day to day existence. With English as the predominant language, Filipino nurses who would want to work in New Zealand, should learn to think, speak and write in New Zealand English. Notice the spelling in this write-up? Be prepared to shed off the “Z” in some of your English words and replace that with an “S”, i.e., organization should be spelled as organisation. Be prepared to get confused in spelling such common words as diarrhea as that should be spelled as diarrhoea in New Zealand. And when someone asks you about your plans on "boxing day", they are not referring to another Manny Pacquiao bout, they are referring to the day after Christmas (December 26), a public holiday in many Commonwealth countries.