Primrose Mharapara, a nurse practitioner in the hemodialysis unit at Toronto General Hospital, has used her experiences as a refugee, a patient and a caregiver to inform how she treats patients. “There is so much more to our patients than meets the eye,” she says. (Video: UHN)

​​The first thing Primrose noticed when she arrived in Canada as a refugee was the size of the buildings in Toronto.

"They were so tall. I remember saying to myself one day when I get a job, I'm going to live in one of these buildings," she says.

Now a nurse practitioner in the hemodialysis unit at Toronto General Hospital (TGH), she has come a long way from being awe-struck by the city's skyline. On her journey from arriving in Canada as a refugee to becoming an integral member of the TGH team, she experienced some hardship, but throughout was mostly full of hope.

Her experiences along the way have had a profound influence on both her decision to get into healthcare and her desire to go above and beyond for her patients. Her accomplishments have even led one TGH patient to describe her as "the ultimate new Canadian."

Growing up in Zimbabwe

Primrose Mharapara was born and raised in Harare, Zimbabwe, the third of four children. Growing up, her life was stable. She graduated from high school and went on to university, finishing with a Bachelor's degree in statistics and geology.

Shortly after she finished school, however, life in Zimbabwe started to change.

"There were a lot of political and economic issues going on, it became unsafe to a point where peoples' lives were in danger," she says.

"Anything could happen at any time. They could pick you up from the streets for no reason and hold you hostage.  So you never knew what tomorrow had in store for you."

Primrose, fearing for her life, decided it was too unsafe to stay. She left for Canada, seeking safety and protection.

A new beginning

Primrose arrived in Canada with nothing but the phone number of a friend of a friend. She wanted to go back to school, but was on social assistance and couldn't afford the international student fees she would have to pay as a refugee.

She recalls living with uncertainty for two years while she waited for permanent residence status, not knowing what to expect throughout the process.

"I felt like I was in limbo, I didn't know whether to go to school, or not, look for a job, or not. I feared they might just come back to me and say, 'we're sending you back.'"

While she waited, she got a job at McDonald's and volunteered at a second-hand clothing store.

Two years later, in 2003, she got her permanent resident status and finally began the life she had waited patiently for. She began her next journey: becoming a nurse practitioner.

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The journey to TGH

Before receiving her permanent resident status, Primrose was hospitalized to treat ovarian cysts while pregnant with her first child. Her hospital stay coincided with the SARS epidemic, leaving her isolated and without visitors.

What could have been one of the worst experiences of someone's life became the inspiration for Primrose's new career.

"During this time, the nurses became my family. That's what actually made me decide to go into nursing. The care I received made me want to do the same and provide great care for those who are in need," she says.

After working as a nurse for a few years, she went back to school to get a Master's in nursing, and ultimately decided to become a Nurse Practitioner because it would allow her to stay at the bedside of her patients.

"I felt this Master's was taking me away from my calling. That's why I became a nurse practitioner," she says.

She was reassured of her calling again when her brother got sick with a chronic condition in 2014, requiring Primrose to return to Zimbabwe.

She was inspired by the medical care she witnessed, and what a difference it made for herself, her brother and her family.

"The nurses and doctors that saw my brother were very kind, and so concerned. It just blew my mind," she says.

"Taking my brother to different appointments just made me realize that I have a duty to make a difference in someone's life." ​

Shortly after she returned from Zimbabwe, she took her current job in TGH's hemodialysis unit, where patients attest she is practicing what she learned as a patient and as a caregiver every day.

"I'm just grateful for what has been done for my family. I felt this was an opportunity where I could also give back to the hemodialysis patients," she says.

Going beyond the physical

Deidre Barrett is one of Primrose's hemodialysis patients. She says that Primrose's presence can be felt in the unit.

"She has intelligent eyes, and she has this great smile, she comes across as being really interested in you. You look at her smile and you feel, 'I'm in good hands,'" she says.

Deirdre also says having a nurse practitioner on the floor has also made a huge difference in the patients' lives. Hemodialysis patients spend four hours per day, three times per week in the unit, and a nurse practitioner like Primrose can resolve health issues, eliminating the need to visit a family doctor.

"She handles questions which eases our lives. That's a great thing for us," Deidre says.

Annellie Cristobal, the Patient Care Coordinator in the hemodialysis unit, notices the difference Primrose makes in patients' lives, and says she is a role model for the rest of the staff.

"Watching Primrose caring for these patients is awe-inspiring. Primrose is one of the pillars in our cohesive team," she says.

Though she says working with patients in this way is her calling, Primrose adds that the most satisfying part of job is getting to know her patients beyond their diagnosis and medical needs.

"When you go to see a healthcare professional you're concerned about the physical," she says.

"But when someone makes an effort to go outside the physical and tries to know who you are and what you were before you came into hemodialysis, that makes a huge difference."

Deirdre believes that her experience as a refugee also shapes how she treats her patients.

"She knows the hardships. Everybody is very different in this ward. There are people who come from very hard backgrounds, some of them don't speak English, and it's heartwarming to see how she approaches everybody equally," she says.

Primrose says her experiences as a refugee, as a patient and as a caretaker have all influenced her main goal as a nurse practitioner: taking the time to get to know her patients to give them the best treatment possible.

"There is so much more to our patients than meets the eye," she says.​

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