The Nursing Workforce in Very Remote Australia
The nursing workforce in very remote Australia is the mainstay of health services to some of the most disadvantaged communities in Australia. Research led by the Centre for Remote Health has highlighted the ageing of this workforce; the lack of suitably qualified midwives and child health nurses; the lack of formal preparation for remote nursing generally; and the ongoing problem of single nurse posts on remote areas.
The Remote Area Nursing (RAN) workforce is ageing and ageing at a faster rate fast, with 40.2% over 50 compared to 33% nationally. There is a national shortage of nurses and it can be anticipated that there will be an increasing shortage of registered nurses in very remote Australia over the next 10 years. Remote area nurses RANs work more than two days on average per week more than registered nurses nationally and miss significantly fewer hours for physical or mental health concerns. This is probably due to the difficulty in taking sick leave where there is no replacement.
There is a maldistribution of midwives throughout Australia, with most working in cities and regional areas. However, the large apparent reduction in nurses with midwifery qualifications — 65% in 1995 to 29% in 2008 — in very remote Australia is alarming. There has also been an apparent reduction in nurses with child health qualifications, from 18% in 1995 to 11% in 2008. There is a need to increase the number of nurses with midwifery and child health qualifications in very remote Australia.
While the educational opportunities for nurses in very remote Australia have improved over the last 10 years, there is still only a small percentage (5%) of nurses in very remote Australia prepared specifically for their role. There is a need for greater effort in meeting the educational needs of RANs, which include public health, cultural safety, primary health care, community development and management, emergency and extended clinical skills.
CRANAplus and the Australian Nursing Federation do not support the employment of remote area nurses in single nurse posts due to increased stressors such as professional isolation, fatigue, safety, quality and exploitation. The relatively low number of Northern Territory Department of Health and Families single nurse clinics the reflects the current policy of phasing out these clinics. QLD, WA and ACCHOs non-government health services have yet to establish a similar policy.