First taste of Remote Nursing: From ICU to Ali Curung

4 Jul 2017

Self-exposed quin­tes­sen­tial city slick­er’ Char­lotte Sum­skas, a Crit­i­cal Care Reg­is­tered Nurse, recent­ly went bush for a remote clin­i­cal place­ment. These are her thoughts, penned in the midst of her jam-packed experience.

This two-week place­ment is the first time in my career I’ve ven­tured out­side the Inten­sive Care facil­i­ties with­in an inner-city ter­tiary pub­lic hos­pi­tal. So far, it’s been many things… eye open­ing, tir­ing, con­fronting and chal­leng­ing — but most of all a very pos­i­tive, excit­ing and hum­bling experience. 

I’ve had a long buried pas­sion of Rural/​Remote nurs­ing. So here I am. I signed up for the TRAN course last year know­ing absolute­ly noth­ing about Remote Nurs­ing… and I just loved it! I am now half way through the Post­grad Cer­tifi­cate in Remote Health Prac­tice- and this two-week clin­i­cal place­ment is my first ever time work­ing remote. 

I find the job of a Remote Area Nurse (RAN) very daunt­ing. The vast and com­plex role, and the respon­si­bil­i­ty has felt almost over­whelm­ing at times. Com­ing from ICU, where there are very senior and expe­ri­enced doc­tors and staff around every cor­ner at all times, I sud­den­ly felt very exposed and liable. But I also felt excit­ed. My nurs­ing scope of prac­tice just sud­den­ly opened up… because I couldn’t just get the doc­tor to review some­thing or sim­ply call the spe­cial­ist or just hand­ball to some­one else. Because there real­ly wasn’t any­one else. It was just us. A small group of nurs­es all work­ing inde­pen­dent­ly, but togeth­er at the same time. It’s wonderful. 

I haven’t felt as lone­ly as I thought I might, I also don’t have as much free time as I thought I would: with shifts run­ning over time and call outs after hours, life is pret­ty jam packed. My down time is filled with study­ing, read­ing, walk­ing, reflec­tion, cook­ing and hav­ing mean­ing­ful con­ver­sa­tions with my loved ones. It’s actu­al­ly real­ly love­ly to be away and total­ly on my own for the first time ever. 

A RAN is not only a nurse, but a para­medic, GP, phar­ma­cist, coun­sel­lor, friend, vet, clean­er and much, much more. The care ranges from ante­na­tal through to elder­ly patients and pal­lia­tive care. On my first solo shift, I had an ante­na­tal check, baby vac­ci­na­tions, com­plex wound dress­ings, many chron­ic dis­ease issues, acute pain, skin infec­tions and child health checks. The RAN real­ly does have to be a jack of all trades. 

I have found some days con­fronting. Espe­cial­ly when it comes to the chil­dren. The amount of skin infec­tions and head lice and sores with­in the com­mu­ni­ty is quite astound­ing. I hat­ed hav­ing to give IM injec­tions to lit­tle kids and caus­ing them pain for a prob­lem that is so eas­i­ly pre­ventable. I tried to remain non-judg­men­tal and instead just attempt­ed to edu­cate and empha­sise the impor­tance of wash­ing and clean­li­ness as much as I could, hop­ing I would at least get through to some­one and make even the small­est difference. 

I assist­ed with one road evac­u­a­tion and one air evac­u­a­tion — and it was very impres­sive. Wit­ness­ing how things hap­pen out here, how the logis­tics are worked out when fly­ing some­one out and how much thought has to go into these events. But it oper­at­ed like a well-oiled machine. Every­one knew their role and just worked togeth­er. The air evac­u­a­tion was espe­cial­ly mem­o­rable – some­thing about being in the absolute mid­dle of nowhere, in the dead of the night, stand­ing on a red dust airstrip and watch­ing the patient being whisked off for the spe­cial­ist treat­ments that she need­ed. That point was when I realised just how spe­cial it is to be a RAN. It is these ded­i­cat­ed peo­ple, work­ing around the clock, in the country’s most remote loca­tions that are the rea­son these com­mu­ni­ties have the access to the health­care that they do. And it was a pret­ty nice feel­ing to be a part of it. 

I learnt an enor­mous amount dur­ing my two week at Ali Curung. By far the most impor­tant thing I learnt has been: that after eight years of nursing…I still have so much more to learn!