Palliative care programme proves impactful

Helping patients navigate the final stages of their life journey is a responsibility Alexandrah Swann (Te Whanāu-ā-Apanui, Ngāi Tahu and Samoan villages Afiamalu, Lotopa) doesn’t take lightly – but one she feels lucky to have.

“Palliative care is a privilege. To be invited into people’s homes, welcomed into their lives, to witness not only death but life, and have stories shared of adventure, deep love, connections, past hurt, forgiveness and reconciliation can never be taken for granted,” she says.

Alexandrah has a Bachelor of Nursing from Manukau Institute of Technology and is graduating with a Postgraduate Diploma in Health Sciences specialising in advanced nursing from the University of Auckland this December. She is currently in the final year of the Donny Trust Palliative Care Nurse Specialist Training Programme, which she began in 2023 after being drawn to the area’s holistic approach.

“Having a healthcare lens that prioritised caring for the whole person and their whānau aligned with my values as an individual,” she explains, noting that her Samoan and Māori heritage helped to prepare her for this type of compassionate, people-focused work.

“I grew up in a big, blended Pacific family with Samoan, Māori and Cook Islands siblings. That really shaped how I understand people, cultures and different concepts of family, and it has given me a natural ability to build rapport with, and relate to, others. I try to approach every interaction with respect and humility, going in with a mindset of service to try to balance out the power dynamic that can sometimes exist between healthcare professionals and the people we care for.”

The Donny Trust Specialist Palliative Care Nurse Training Programme was created in 2007 to provide a clear pathway into specialist palliative care for nurses. It is funded by The Donny Fund via Momentum Waikato Community Foundation, and provides trainees with a stipend while also covering study costs as they complete postgraduate papers at the University of Auckland’s School of Nursing, along with four clinical placements.

Alexandrah completed placements at Mercy Hospice – one in the inpatient unit and another with the community team – and with the palliative care teams at Te Toka Tomai Auckland and Middlemore Hospital. The combination of theory and practice was extremely effective, she says.

“The programme is second to none. Its development ensures you are equipped academically through papers that advance your knowledge and critical thinking skills, and supported clinically with dedicated preceptors and diverse hands-on experience in complex patient care at a community, tertiary and specialist inpatient level. You’re also provided with academic mentorship, clinical supervision and professional supervision to foster your overall development.”

She believes the programme is a powerful example of how to build a high-quality specialist workforce, and could be replicated across other nursing areas to strengthen staff capabilities, grow numbers and improve retention.

“Financial support from the Donny Charitable Trust has greatly contributed to my success throughout the programme and to advancing my career into a clinical nurse specialist,” she says. “Their willingness to fund an initiative like this has created meaningful opportunities for nurses to develop and upskill.”

Her time on the programme hasn’t been without challenges, including a deeply personal one: in 2024, her father was diagnosed with gastric lymphoma at just 56 years old. While he is thankfully in remission now, grappling with constant unknowns while simultaneously navigating the healthcare system and meeting multiple specialists as the only healthcare professional in her family was incredibly difficult, she says. There was one positive outcome, however.

“This experience gave me an indescribably deeper appreciation for the resilience people show when traversing a cancer journey, and it strengthened my empathy and understanding of what patients and whānau go through beyond the clinical setting.”

When it comes to the most memorable aspect of the programme, Alexandrah is quick to answer.

“He tangata, he tangata, he tangata: it is people. A very special part of my journey has been the people I have worked with, all genuine carers, deeply compassionate and committed to providing excellent care.”

Following graduation, she plans to build on her learnings from the programme, developing her skills in both acute and palliative care. Looking further ahead, she hopes to one day progress towards becoming a nurse practitioner – “should the stars align!”

Alexandrah is grateful for the support she received during the programme: “I am indebted to the Donny Charitable Trust; Jenny Thurtson, Poi Programme Lead, Mercy Hospice Auckland; Sandra Notley, Nurse Practitioner, Mercy Hospice; and the University’s Associate Professor Jackie Robinson.”