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Remote Area Nursing

Remote Area Nursing
Photo: Remote Area Nursing
Remote area nurses work in a range of settings across Australia and the region, with an emphasis on remote Indigenous communities. They also cover mining, agricultural, tourism, refugee and international communities, and more.

People living in rural and remote areas who suffer from health issues face many challenges like limited access to services and transport. Time away from home for investigations and treatment can be a problem for some, as can feelings of isolation and loneliness. The staff caring for these people also have to cope with fewer resources than in large centres.
Remote area nurses may work as part of a small team, even if team members are separated from one another geographically, or work independently, referring patients when further intervention is required. Often remaining available for 24 hours a day, seven days a week, the position requires a broad scope of skills, providing emergency care and health care in the context of family and community.
While they can experience personal and professional isolation, these nurses describe the collaborative advanced practice and the broad set of professional skills required as unique in nursing and the most rewarding part of the job. A remote area nurse or midwife is generally regarded highly within remote communities.

We spoke to one registered nurse who worked through a Northern Territory agency in two remote locations and is considering doing it again, this time in Victoria. Her first placement was at Maningrida, on the coast of Northern Territory, one hour’s flight from Darwin for five weeks. She explained that it is a clinic with a GP and four or five nurses servicing the town and includes a mobile clinic servicing smaller outlying settlements. It copes with emergencies that need to be flown to Darwin, as well as dealing with day-to-day health issues and managing and following up treatment of chronic diseases like diabetes and asthma.

Her second remote placement was for four weeks at Yulara, a township near Uluru that has a small clinic with a GP two days a week and a rotating staff of three nurses. She told us that it deals mostly with the health of tourists and staff from the resort and any emergencies that are flown to Alice Springs.

When asked what the best and worst parts of the placement were, she said, ‘The best part was meeting the local 'personalities', experiencing the 'outback' lifestyle, driving a 4WD ambulance with the entire family of the sick person in the back, which was very funny, using car headlights to direct a plane on the tarmac at some ungodly hour, and many more. The worst was a plane not being able to land, or pilots not available, a lack of equipment, and missing family and friends.’

In response to the question about what she would change, she replied, ‘I don't think you can change much. They need more experienced people and facilities out 'there', with more planes and pilots. You need to wait for the transfer of sick patients until a pilot has had the required hours of rest between flights, so there is often a delay, but most of the people living remotely want to live there and they understand that there have to be compromises.’

It is also worth noting that all nurses working in remote areas will have their travel expenses, accommodation, meals and incidental expenses paid. There are other financial incentives available, like better hourly rates, tax breaks and good on-call rates due to the nature of the job.

To work in remote parts of the country, most services require that you have worked for at least three years beforehand, although this is not always the case. Some employers provide preparatory courses, orientation programs and other supports.

If you know that you want to experience remote area nursing when you are completing your Bachelor of Nursing, Bachelor of Midwifery or postgraduate degree in nursing or midwifery, it is a good idea to select topics that prepare you to work in a remote practice, such as cultural safety, self care and indigenous health. You can also look for student placements in rural or remote settings. While midwifery is not compulsory for work in a remote setting, it is certainly useful.

There is a range of educational programs for remote health workers, from undergraduate and postgraduate student placements to short courses, which have been accredited for continuing professional development points. The Centre for Remote Health, a joint centre for Flinders University and Charles Darwin University, and the RHP program, developed by the Council of Remote Area Nurses of Australia in consultation with other organisations, are just two organisations that offer remote area health education.

If you are looking to experience life in the outback, there are several career pathways open to you, no matter what part of the country you are living in. Programs are run by the various state and territory governments, which recognise the need to improve and extend rural and remote health care.

For instance, the Queensland Health Rural and Remote Nursing Relief Program provides a pool of registered and enrolled nurses for Queensland Health’s rural and remote facilities as planned relief for periods from four weeks up to three-months duration.

This means that if you are currently working within Queensland Health and want a temporary change, you can apply for leave without pay or keep your casual status, while you explore outback Queensland from the bush to the beach. Providing leave without pay is approved, you keep your position with Queensland Health, as well as any entitlements, such as accumulation of holidays, long-service leave and superannuation. Nurses from interstate or overseas are also welcome to apply.

Around the country, there are numerous programs similar to this one, as well as private agencies, that provide a pool of registered and enrolled nurses for the many rural and remote health facilities. There is plenty of work available, loads of amazing destinations and a choice of how long the contract is for.

Remote area nursing is a rewarding and fulfilling experience for any nurse wanting to further their career and explore this extraordinary country at the same time.

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