The Nursing Workforce in Very Remote Australia

15 Oct 2010

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.