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Clinical skills pushed to the limits

9 Jul 2015

For Angela Ramsay and Ely Taylor, two students from Canberra whose clinical nursing experience to date was bound to hospitals, “going remote” was both eye-opening and refreshing.

The Ura­pun­t­ja Health Ser­vice (UHS) in Utopia, a hot and dusty dri­ve of about 280 kilo­me­tres north-east of Alice Springs, was the des­ti­na­tion for Angela and Ely on their recent clin­i­cal nurs­ing placement.

Arriv­ing in Alice Springs bright-eyed and bushy-tailed”, accord­ing to Angela, the pair were greet­ed by Char­lie, bun­dled into the 4WD along with their belong­ings and text­books, and dri­ven the three and a half hours to Utopia, where they were set­tled in their very own lit­tle place, com­plete with every­thing they need­ed for their two-week stint.

Angela described the start of their first day: At 9am we were met at the clin­ic (a very short walk from our abode) by the most wel­com­ing, enthu­si­as­tic team of health staff we could have hoped for. As a stu­dent you often feel a lit­tle bur­den­some know­ing that you are prob­a­bly dou­bling the work­load. But the nurs­es, doc­tors, abo­rig­i­nal health work­ers, liai­son staff and admin sup­port were total­ly approach­able, patient and seemed keen to help us learn.

Our very first task was to check the indus­tri­al tool­box that would be loaded into the back of one of the 4WDs. This tool­box was full of med­ica­tions, diag­nos­tic equip­ment, pathol­o­gy kits, man­u­als and oth­er lit­tle things that come in handy when you are out in a com­mu­ni­ty – like vit­a­min Cs to give out to kids.

Ely and I tried to absorb every piece of knowl­edge and wis­dom we could (which left us qui­et and hun­gry by the evening!).”

Set up in the 1970s on the decen­tralised com­mu­ni­ty mod­el, UHS is a com­mu­ni­ty con­trolled Abo­rig­i­nal Med­ical Ser­vice. The UHS oper­a­tion cov­ers almost 4000 kilo­me­tres, and serves 15 out­sta­tions. Each com­mu­ni­ty gets vis­it­ed once a week by a team of health pro­fes­sion­als, when immu­ni­sa­tions, health checks, med­ica­tion reviews and gen­er­al com­plaints are seen to. The ser­vice is focused on keep­ing Abo­rig­i­nal peo­ple on their land and pro­vid­ing pri­ma­ry health.Abundant in Abo­rig­i­nal cul­ture and tra­di­tion, the Alyawarr and Anmat­jerre peo­ple boast a slight­ly improved health sta­tus in com­par­i­son to the nation­al aver­age for Abo­rig­i­nal people.

Ely out­lines their dai­ly expe­ri­ence: Mon­day to Thurs­day we would go out over the dirt roads to the com­mu­ni­ties with the nurs­es and some­times a doc­tor or an Abo­rig­i­nal Health Work­er. It was such beau­ti­ful coun­try with wild flow­ers and desert shrubs con­trast­ing bril­liant­ly with the bright red soil. They had a lot of rain last sea­son so the desert was bloom­ing and full of life

When we arrived at an out­sta­tion, we would set up a lit­tle clin­ic out the back of the 4WD. It was quite well equipped with med­ica­tion box­es, tables, chairs, com­put­ers and sup­plies. Peo­ple would come to get a health check, get their med­ica­tions and any­thing else they need­ed. I was total­ly blown away by this dif­fer­ent take on health­care. It was com­mu­ni­ty and patient cen­tered, and the nurs­es all had their own ways of con­nect­ing with their clients. It was great to see the mix of skills and life expe­ri­ence that brings peo­ple to this kind of nursing.

Each day wound up at about 5:30pm when Bru­tus, the CEO’s dog, would walk the pair home. We sat on our patio and watched the sun go down whilst we debriefed about what the day had giv­en us, both some­what over­whelmed but ready to take on more the next day,” says Angela. This was a very dif­fer­ent world to the wards at the hos­pi­tals in Canberra

Towards the end of our adven­ture we were sor­ry to be leav­ing and wished we could have stayed a lit­tle longer. Although we still would have made it to Utopia, with­out the Under­grad­u­ate Remote Place­ment Schol­ar­ship that CRANAplus award­ed us with, it would have been much more of a chal­lenge. It took a great weight off our shoul­ders and we were able to ful­ly embrace what we were experiencing.

Accord­ing to Ely, being out in the desert real­ly empha­sised what a diverse and reward­ing pro­fes­sion nurs­ing is. We were able to see how anoth­er cul­ture lived – their way of life and how health and ill­ness impact­ed on the com­mu­ni­ty,” she says. It was a real priv­i­lege to see and be involved in. All the staff at Ura­pun­t­ja pro­mot­ed a holis­tic approach to health­care, which encour­aged local heal­ing reme­dies, such as bush med­i­cine, cou­pled with the west­ern bio­med­ical approach.

The biggest chal­lenge that I found was the lan­guage bar­ri­er – I wasn’t expect­ing it to be so vast. I was impressed and inspired by how the health pro­fes­sion­als were able to give com­pre­hen­sive and qual­i­ty care despite the lan­guage dif­fi­cul­ties. They used basic words and ges­tures to explain what was hap­pen­ing to their bod­ies and to com­mu­ni­cate what med­ical inter­ven­tion need­ed to happen.

This expe­ri­ence has changed my view on health­care deliv­ery in Aus­tralia. It has rein­forced how vital holis­tic care is and how nurs­es can influ­ence the lives of so many peo­ple across the coun­try. I was very lucky to have a sneak peek at what it is like to be a remote area nurse and it has def­i­nite­ly inspired me to explore this wide coun­try with my nurs­ing skills. Thank you CRANAplus for mak­ing it pos­si­ble! For a sec­ond year stu­dent nurse I don’t think you can get a more cul­tur­al­ly invig­o­rat­ing clin­i­cal place­ment than going remote. Every sense is awak­ened and your clin­i­cal skills are pushed to new limits.”