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Tess Ivanhoe, Nurse Practitioner on the Chronic Disease Program at Nganampa Health Council, discusses how localised care can change health outcomes, the importance of understanding the community you work within, and her late transition to remote care.
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.”
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].”
“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.”
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.”
Know someone who deserves to win the Aurora Award in 2022? Nominate them using our Award Nominations page.
Want to read more about Tess? Read the ANMJ article on the 2021 Aurora Award Winner.