For Ter­rie ​‘Tess’ Ivan­hoe, this year’s Auro­ra Award win­ner and the Remote and Iso­lat­ed Health Pro­fes­sion­al of the Year, com­mu­ni­ty access to high-qual­i­ty care is everything.

In her role as Nurse Prac­ti­tion­er on the Chron­ic Dis­ease Pro­gram at Nganam­pa Health Coun­cil in north-west South Australia’s APY Lands, she facil­i­tates vis­it­ing spe­cial­ists and doc tors to deliv­er chron­ic dis­ease ser­vices in a coor­di­nat­ed manner.

Over the last 11 years, she’s been busy ensur­ing clients can access high qual­i­ty care ​“where they feel com­fort­able” and ​“in a much time­li­er manner”. 

A teller of sto­ries, Ms Ivan­hoe under­lines the val­ue of local care through sev­er­al anecdotes.

“I remem­ber, a patient had under­gone an Echo in Alice Springs,” she tells CRANAplus. ​“They wouldn’t sit still, wouldn’t wait, got up and left. When the patient came to us, he sat down, and we did the test eas­i­ly and got a great pic­ture. [This often hap­pens when] old men are in their own coun­try, in their own clin­ic, with some­body they know stand­ing there hold­ing their hand.”

Recall­ing anoth­er exam­ple, Tess says: ​“We had a lady who had can­cer of lung, a sim­ple cough. The res­pi­ra­to­ry physi­cian said: ​‘I’m wor­ried about her Tess. I think we need to get her to have high-res CT down in Ade­laide’. We got her down to Ade­laide in Jan­u­ary, and at the end of the month she had a lobec­to­my that saved her life.

“When she came in for her next vis­it in Feb­ru­ary, she was well and fit. That would not have hap­pened if she’d had to trav­el back­wards and for­wards. If we didn’t dis­cov­er that can­cer while it was still in one lobe, we could have had catastrophe.”

A late tran­si­tion to remote

On top of her work on the Chron­ic Dis­ease Pro­gram, Ms Ivan­hoe has co-led Nganampa’s COVID-19 Pan demi c Response across their six large clin­ics and is present­ly involved in research into hepat­ic can­cer, as well as projects on child­hood obe­si­ty and dia­betes mellitus.

Through­out the years, she has also men­tored many upcom­ing pro­fes­sion­als, impart­ing the lessons she’s learned since enter­ing remote prac­tice 20 years ago.

“I had been a pret­ty high-tech acute care nurse in emer­gency. I’d run an emer­gency depart­ment for about 10 years,” she says. ​“But I decid­ed that when I was 50, I was going to go casu­al and cruise around. I found myself in Ern­abel­la in Cen­tral Aus­tralia. When the agency asked me to go there, I thought it was just down the road. I didn’t realise it was in Cen­tral Aus­tralia; that I’d have to get on a lit­tle plane to get there.

“When I arrived, I realised a whole new world. I’ve nev­er looked back real­ly. I loved it from the minute I got there. But I did realise that even though I thought I was a sharp­shoot­er, I didn’t know any­thing about this environment.

“I remem­ber feel­ing, why has no one ever told me about this? That Anan gu peo­ple live in Cen­tral Aus­tralia, talk their own lan­guages, have their own beau­ti­ful cul­ture – I wasn’t taught that in school. I was taught that Cap­tain Cook con­quered Aus­tralia,” she says, dis­ap­point­ed with her child­hood edu­ca­tion. ​“I come from that era.”

“It was a very over­whelm­ing moment when I first came out here to see that,” she says. ​“I realised I didn’t know any­thing about car­ing for Indige­nous Aus­tralians. That’s why I had to go back. I enrolled in the Mas­ters of Remote Health and lat­er con­vert­ed to Nurse Prac­ti­tion­er at the Cen­tre for Remote Health to learn more about what I didn’t know, and lat­er, I was invit­ed to go back and teach [at CRH].”

Con­trast with the mainstream

“When I first start­ed this job peo­ple said ​‘You’ll nev­er get a job in main­stream again. What are you going to do out there, run­ning around?’” Tess con­fides. ​“Well, I’m going to wing it, I said. If it doesn’t work, it’ll just be bad luck. I’ll sort it out.”

“I think now I am a bet­ter nurse, per­son­al­ly and pro­fes­sion­al­ly, than I was in main­stream. Because what I think I’ve learned, and what the Anan­gu peo­ple have taught me, is to see things from the client’s side. We don’t do that enough in the main stream.

Remote area prac­tice teach­es you to seek to under­stand first.”

When asked how impor­tant it is to know the com­mu­ni­ty you work with­in, Tess said: ​“It’s over­whelm­ing­ly vital. You couldn’t do this job prop­er­ly if you didn’t.

“Say­ing that,” she con­tin­ues, ​“I don’t need to be everybody’s best friend. Peo­ple don’t need that. They’ve got their own fam­i­lies, their own best friend. What they need is some­one who’s authen­tic, that believes in them, who’s an advo­cate for them, and who’s here to do a pro­fes­sion­al job for them and respect them.”

Hum­ble about her achievements

Ms Ivan­hoe is inclined to play down her achieve­ments, telling CRANAplus ​“I’m a basic kind of nurse.”

Her col­leagues would sug­gest she was much more than that, prais­ing her ​“prodi­gious capac­i­ty for work” and ​“bound­less ener­gy and enthu­si­asm”. They say she’s a ​“great ambas­sador for remote area nurs­ing”, ​“a con­stant inspi­ra­tion for nurs­ing and mid­wifery staff”, ​“a per­son of deep integri­ty” and a ​“dri­ver of change and con­tin­u­ous improve­ment” who has been ​“instru­men­tal in devel­op­ing and main­tain­ing our chron­ic dis­ease programme.”

“I’ve been very lucky that peo­ple accept me as their mal­pa (helper friend),” Tess says. ​“To me my proud­est thing is to have pro­vid­ed first-rate care to the best of my abil­i­ty to Anan­gu peo­ple in a pro­fes­sion­al way.”

“When you look at the peo­ple like Sabi­na [Knight] and Sue [Lenthall] and oth­er lead­ers and pio­neers of remote health, they did it hard… I’m not sure I’ve led the pro­fes­sion in that way, but I think I can advo­cate for the position.

“I advo­cate for RANs to be spe­cial­ists in their area. It is a spe­cial­i­ty. It isn’t a place to sit on your lau­rels with no pro­fes­sion­al devel­op­ment. You need to pro­vide first-rate care to the peo­ple who are the most mar­gin­alised in the country.”

Tess believes the CRANAplus Awards and sim­i­lar ini­tia­tives are a help­ful com­po­nent of this advocacy.

“Any thing that pro motes remote area nurs­ing as a spe­cial­i­ty and as a pro­fes­sion is real­ly impor­tant,” she says. ​“These awards bring the pro­fes­sion to the fore front – not just in the remote area set ting, but the whole of Aus­tralia. If one oth­er nurse decides they want to be a remote area nurse because of our sto­ries, then I think that’s real­ly important.”