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Clinical skills pushed to the limits
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.”