Working mom to receive doctorate; aims to help Native Hawaiians with health care access

Kawailehua Paikai pushed through innumerable setbacks, started a family, shifted her career choice, and has now earned a UH Hilo doctoral degree in nursing. She plans to focus on health care access for Native Hawaiians.

By Kiaria Zoi Nakamura.

Kawailehua Paikai
Kawailehua Paikai

A working mom has persevered challenges, setbacks, and a pandemic to receive her Doctor of Nursing Practice (DNP) degree this Saturday at the University of Hawaiʻi at Hilo.

Kawailehua Paikai, who delivered her practice inquiry defense last month on access to health care for Native Hawaiians, says what she has enjoyed most about the UH Hilo DNP program is the small cohort, the online courses, and having clinicals on Oʻahu. She says the biggest way the pandemic affected her studies was in keeping students from traveling and shifting health care delivery.

“Initially, with the uncertainty, in-person clinicals were cancelled,” Paikai explains. “I was lucky enough to have finished spring clinicals before COVID started. The clinicals for summer were pushed to fall and by then most places had shifted to adding telehealth to their practices. Without the pandemic we probably would not have had as much experience doing telehealth visits.”

As a Kānaka Maoli, Paikai is passionate about Native Hawaiians having access to healthcare. “In my current job as a case manager at Queens Medical Center, I know that access to care is an issue for the Pacific Islander community,” she says.

For her practice inquiry, Paikai investigated the perception and experience of Native Hawaiians accessing health care during COVID-19. Noting that Native Hawaiians are usually underrepresented in health care data collection, and that the data that is collected is often inaccurate, Paikai posits that while there is progress in how the government collects data on Native Hawaiian and Pacific Islander populations, there is not sufficient, reliable data to properly assess health care access in the Native Hawaiian community. Paikai believes the pandemic has added to the problem.

“Native Hawaiian health outcomes have been highly affected by the pandemic, and there is limited data to address access to care and health inequities,” she states in her defense.

In her inquiry, Paikai determines that most of those who participated in the project’s survey had the perception of not experiencing barriers to accessing healthcare services during the COVID-19 pandemic. “However, the data identified participants who faced social determinants of health barriers such as fear of losing housing, inability to pay rent or mortgage, unemployment, lack of transportation, and access to a primary care provider.”

She concludes with noting the necessity of additional research to determine the true health care needs for Native Hawaiians throughout the state of Hawaiʻi.

Perseverance pays off

Paikai grew up in Kaneʻohe on the island of Oʻahu. She graduated from Castle High School in 2001 and then attended Hawaiʻi Pacific University on two scholarships. She chose to pursue a career in nursing at the advice of her father and stuck to it despite many obstacles that befell her.

“I had many challenges while studying nursing,” she says. “ I barely passed my (bachelor of science in nursing) program and almost didn’t become a nurse because I was on my last chance of not being able to continue as a nursing student.” But she fought to stay in the program, graduating in 2008.

Kawailehua and a child with a toy stethoscope.
Kawailehua Paikai enjoying one of her most favorite activities, child care. Courtesy photo.

Paikai says that as a child, she would always take care of others but found particular joy in caring for babies. So, with unwavering determination and her steadfast commitment to healthcare, after graduation she turned her sights to her “dream job,” working as a nurse in a neonatal intensive care unit. The only thing standing in her way was the National Council Licensure Examination (NCLEX). “I was pending passing the board exam to start working on January 5, 2009, I remember the date so vividly. When I didn’t pass the NCLEX for the second time I had to give up that new grad RN job and they brought me on as a clinical assistant.”

Determined, she passed the exam on her third try, but even with that triumph, a shift in the economy made it difficult to secure the job she wanted in neonatal care.

In 2009, another door opened as she was accepted as a registered nurse at a substance abuse treatment program. “My career took an entire 360 from then on,” she says. Despite the swift change, she considers her alternate pathway a “blessing in disguise.” She says, “I was devastated I didn’t get my dream job but obviously the universe had bigger plans for me.”

A few years later, Paikai decided to go back to school. In 2011, she was admitted into UH Mānoa’s master of science in nursing program. Not soon after, she found out that she was pregnant with her first child. Prioritizing motherhood, Paikai decided to leave the program after completing her first semester.

Soon enough she was raising two children, but Paikai held on to her goal of going to graduate school. When she felt ready, she looked into the different possibilities available to her in Hawaiʻi and was intrigued by UH Hilo’s Doctor of Nursing option. She applied, was accepted, and prepared to return to school in the fall of 2018 when another surprise came into the picture. That summer, Paikai found out that she was pregnant with her third child.

“History was repeating itself again with another pregnancy during school,” says Paikai. “But this time I decided to stick it out and see it through.” She continued with school and full-time work while caring for three young children, each under seven years old.

“I also have a husband who works as a longshoreman with an unpredictable schedule and two stepchildren,” she says.

Even with such a busy schedule, Paikai continues to demonstrate the utmost diligence in her work and studies. Some of her many accomplishments during her time at UH Hilo include her selection as a recipient of the Native Hawaiian Health scholarship and her project on health care access for Native Hawaiians during COVID-19.

Paikai also has shown an interest in behavioral health. Earlier this year, in accordance with a class on health policy, she provided testimony for a state bill in support of the Hawaiʻi State Center for Nursing.

“As a nurse who has seen both sides of how behavioral health care is delivered in Hawaiʻi, I felt this was an important step to increasing access to care for those affected by severe mental illness.” She adds that individuals and families face barriers to receive behavioral health support and services due to the limited amount of behavioral health providers available, limited options for treatment if the individual is not actively suicidal or homicidal, and a lack of willingness of the individual to accept care.

She’s able to do this good work through perseverance and determination. “I didn’t quit and now I’m graduating with my DNP in May 2021,” she says.

Above photos at UH Hilo White Coat Ceremony on May 2, 2021: (left) Kawailehua Paikai with fellow Doctor of Nursing Practice graduates, (center) with graduates and faculty, and (right) with her ʻohana. Courtesy photos.

A future in nursing

One of Paikai’s immediate aspirations after receiving her doctoral degree this week is to continue her devotion to the Native Hawaiian community.

“My future goals include completing my commitment to give back two years of service as (an advanced practice registered nurse) providing care to a primarily Native Hawaiian community, most likely in a community health clinic.”

She also plans to simultaneously run her independently owned medical aesthetic practice, Demure Hawaiʻi, and newly opened Licensed Child Care in Kapolei.

Looking back on the experiences that led up to completing her DNP degree, Paikai says, “I have had many meaningful experiences that have helped me on my path to becoming a nurse, but the most important take away I learned is that when one door closes another always opens.”

“I thought my dream job was to work in the (neonatal intensive care unit) but now I realize that with my family being my number one priority, it really comes down to having flexibility in your job. Nursing is probably one of the few jobs where you have that ability to do so many different things within both traditional and non-traditional careers as a nurse.”

Story by Kiaria Zoi Nakamura, who is earning a bachelor of arts in English with a minor in performing arts and a certificate in educational studies at UH Hilo.

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