Writing

Taking on the remote challenge

Suzanne Phillips has been nursing for 30 years, and remote area nursing for five. She spent most of her carer working in correctional facilities (prisons) in Australia and New Zealand, including a stint in 1999-2000 as health manager at Melbourne’s Metropolitan Women’s Correctional Centre, the first private women’s prison outside the USA.

Following that, she joined the Federal Immigration Detention Service, first in Melbourne, and then at Woomera in South Australia. Taken by the beauty of the outback, she joined a nursing agency and took a positing to Darwin. She has been working in remote and rural areas for the past five years. She works for periods of about six weeks at a time, as a locum for nurse unit managers at Sunrise Health Services at Katherine in the Northern Territory, and in the Tri-State area on the borders of Western Australia, South Australia and Northern Territory, working with indigenous health organisations.

Warakurna
Warakurna community in the Ngaanyatjarra Lands, about four hours west of Uluru just over the Western Australia border

Sunrise Health Service Aboriginal Corporation (SHSAC) is a primary health care service for both Indigenous and non-Indigenous people in the Jawoyn and Roper River regions of the Northern Territory and provides small clinics in several remore areas. In the Tri-State area , Phillips was working with the Ngaanyatjarra Independent Aboriginal Health Service in WA.

Suzanne&snake
A remote nurse has to be prepared for anything! Suzanne Phillips holding a harmless local snake at Warakurna

Remote employers encourge their nurses to gain extra skills and qualifications. Some give extra study leave, and access to university courses or in-house courses. At Ngaanyatjarra, there was an-house lecture every three months from a visiting expert on topics such as sexual health or woundcare, The Centre for Remote Health in Alice Springs provides online courses for remote health workers. Professional organisations such as the RCNA are also very supportive, and send the lates nursing journals, so remote workers can keep up to date and not feel professionally isolated.

Phillips is currently studying a Masters in Nurse Education through the School of Nursing and Midwifery, UTS, Sydney, and sits for her exam in the prescribing course later this year. She intends to continue working in remote nursing for “at least another five years.”

Suzanne Phillips
Suzanne Phillips: all nurses should try remote nursing at least once, to see if they are suited to it

Indigenous health

In all these positions Phillips is working with local community staff in a cross-cultural manner. In the aboriginal health clinics, many of her patients speak no English at all, and health staff, who have English as a second or third language, do the interpreting for her.

Why did she choose to focus on indigenous health, here in Australia and in New Zealand? ” I like the approach to cultural issues – the emphasis on training people in preventative measures, and working with the community to help improve their health.”

There are language difficulties and cultural issues that must be observed, such who can see/speak to whom. For example: son-in-law and mother-in-law must not see each, and this has implications for who can come to the clinic, or who can be taken in the van to the nearest hospital. Some times a health worker is alo a forbidden relative and cannot treat that particular person or be in the clinic that day. Phillips says similar non-communication relationships apply with the Maori-Pacif Islander communities she serves in South Westland.

“I always have a local health worker to speak the language, as well as to explain to me the complexities of the culture, so I would always ask the health worker to advise who I should see next.” Unfortunately women are not allowed to nurse men, so “men’s health doesn’t fare so well – we have to wait for a visiting male nurse.”

Phillips says all nurses should try remote nursing at least once, to see if they are suited to it. The position calls for a sense of community, and the ability to work with others while treating evryone equally, bearing in mind that a small community is a web of connections and relationships.

Would she recommend remote nursing?
“Yes, if that’s what interests someone. Lots wouldn’t want to do it – there’s only a select few it suits. You need to be assertive and independent and have a broad experience, and that’s why it generally suits older nurses.”

As well as the strong sense of idependence, Phillips says remote nurses need to have a clear idea of the situation they are in. “You need to think about looking after yourself in the remote context – how you will look after your physical and mental health, and your relationships. “

The extra leave available – including study leave, remote nurses can expect up to 12 weeks’ leave a year – certainly helps, as does a generally higher rate of pay than in most areas of nursing.

Phillips says she would certainly encourage young nurses who try a remote position for the adventure of it, to “stay in and learn from the experienced nurses out there.” Like all nurses, the average age is creeping up — to about 47 — and she is concerned about a loss of skills when these older nurses retire.
“When I first went out I worked in clinics with experienced nurses, one of whom retired recently at 67. It would be good to have some younger ones come and learn from the experienced ones while they are still there.”

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