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Meet 2021 Excellence in Research and/or Education Award Winner, Dr Kylie McCullough

3 Dec 2021

Hear from Dr Kylie McCullough, lecturer at Edith Cowan University in Perth, on her early experiences in Kakadu, how they shaped her research interests, and how research into remote area nursing is tackling workforce issues head on — including on an international level.

The 2021 Excel­lence in Research and/​or Edu­ca­tion Award is spon­sored by Flinders Uni­ver­si­ty – Rur­al and Remote Health (CRH)

Dr McCul­lough is a lec­tur­er based at Edith Cow­an Uni­ver­si­ty in Perth, who has pub­lished sev­en aca­d­e­m­ic arti­cles and count­ing on remote health. In 2018, she com­plet­ed her PhD the­sis, which estab­lished a frame­work of remote area nurs­ing practice.

For McCul­lough, it all start­ed when she grad­u­at­ed as a Reg­is­tered Nurse in 1995, lived in New Zealand for a few years, and then arrived in Kakadu Nation­al Park look­ing for a nurs­ing position.

I lit­er­al­ly just turned up, not know­ing any­thing, went to the clin­ic and said, Can I have a job?’” she explains. 

The answer was, Well, no, you don’t know what you’re doing here. But you can work as med­ical recep­tion­ist for a few months.’

Dur­ing that time, I read the CARPA man­u­al con­tin­u­ous­ly at my desk, attend­ed every train­ing oppor­tu­ni­ty, and spent more time in the clin­ic rooms and hang­ing round with oth­er staff than answer­ing the phone.

I was for­tu­nate because I end­ed up in a clin­ic where there was a real­ly sta­ble, expe­ri­enced team of nurs­es and mid­wives and even a cou­ple of GPs. When a vacan­cy did come up, they agreed as a team they’d be pre­pared to men­tor me and put in what­ev­er sup­port they need­ed to get me up to speed. I feel eter­nal­ly grateful.”

Dr McCul­lough went on to spend three and a half years work­ing in the clin­ic, attain­ing the posi­tion of clin­i­cal man­ag­er. She says she learned so much and not just clin­i­cal stuff, but about myself, my own capac­i­ty to deal with the unknown – because that is a char­ac­ter­is­tic of remote area nursing.”

Inspired by first­hand experience

After mov­ing to Perth and becom­ing a moth­er, Dr McCul­lough began look­ing for a research project.

My men­tor at the time asked: What was your biggest con­cern when you were out bush?’” she says. I said per­son­al safe­ty. In the com­mu­ni­ty there had been a num­ber of vio­lent inci­dents and I felt unsafe and some­what trau­ma­tised, know­ing it was hap­pen­ing out in the com­mu­ni­ty, even if not hap­pen­ing direct­ly to me.”

That was the inspi­ra­tion for her first pub­li­ca­tions and since then, she has tran­si­tioned onto oth­er top­ics informed by her own expe­ri­ences and the expe­ri­ences of the RANs she reg­u­lar­ly talks with.

I felt that when I was work­ing out bush that most peo­ple didn’t have any idea what RANs actu­al­ly do,” she says. They couldn’t com­pre­hend the lev­el of respon­si­bil­i­ty, the com­plex­i­ty of the deci­sion mak­ing, the impor­tance of build­ing rela­tion­ship with com­mu­ni­ties, and the whole idea of liv­ing in a com­mu­ni­ty that you’re actu­al­ly work­ing with as well.”

Com­mu­ni­ties, employ­ers, oth­er nurs­es and Aus­tralians at large real­ly need to under stand, val­ue and recog­nise the con­tri­bu­tion nurs­es are mak­ing to the health and well­be­ing of com­mu­ni­ties, and the advanced prac­tice nature of what they’re doing.”

If we knew that, we would sup­port peo­ple more and pro­vide bet­ter incen­tives for going out bush. Our com­mu­ni­ties would val­ue nurs­es a bit more – and that’d make a dif­fer­ence to remote health.”

Research find­ings bear­ing out sub­jec­tive experience

Dr McCul­lough says that if remote area nurs­es read her 2018 the­sis, titled The deliv­ery of Pri­ma­ry Health Care in remote com­mu­ni­ties: A Ground­ed The­o­ry study of the per­spec­tive of nurs­es, they would hope­ful­ly feel a sense of recognition.

What I was try­ing to do was present a mod­el or frame­work for oth­er peo­ple to under­stand what it is that RANs do,” Dr McCul­lough says.
Hope­ful­ly RANs would read that work and say, oh, yeah, that’s what I do’. And peo­ple who are not RANs will hope­ful­ly say, oh, wow, there’s actu­al­ly a lot to what they do.’”

If you pub­lish some­thing that’s evi­dence based then it can be dis­sem­i­nat­ed and used in a much more con­struc­tive way than a sto­ry, because there’s this rigour around the way it’s col­lect­ed and presented.”

Dr McCul­lough says, build­ing upon the frame­work estab­lished through her PhD, she now has six oth­er research projects going, and five PHD stu­dents mak­ing con­tri­bu­tions to the rur­al and remote research body of knowledge.

McCullough’s research pro­gram is now most­ly explor­ing the idea of how we can mea­sure the qual­i­ty and safe­ty of nurs­ing prac­tice in rur­al and remote areas, she says.

The impor­tance of par­tic­i­pat­ing in research

Dr McCul­lough appre­ci­ates the obsta­cles to RANs par­tic­i­pat­ing in research, but says that when they do par­tic­i­pate, they make a huge difference.

They’re under a lot of pres­sure, with a lot of work and things to do,” she says. But when they par­tic­i­pate in research, answer sur­veys, or agree to be inter­viewed for research pur­pos­es, they’re actu­al­ly con­tribut­ing to change. 

We need the evi­dence that’s com­ing from the peo­ple who are out there at the coal­face doing the work.

Yes, they’re just one per­son com­plet­ing that sur­vey, but when every­one does it, then we have some strong evi­dence and that makes it eas­i­er to argue the case for RANs. Peo­ple pay atten­tion to jour­nal arti­cles and research find­ings; peo­ple all over the world. In Cana­da in par­tic­u­lar, they ref­er­ence our work on what RANs are doing in Aus­tralia – so it has a glob­al impact.”

Do you know some­one whose achieve­ments deserve to be cel­e­brat­ed? Nom­i­nate them for a CRANAplus Award when appli­ca­tions open.

Par­tic­i­pate in Dr McCul­lough’s short sur­vey on pri­ma­ry health care in the remote set­ting and go into the run­ning to win one of five $100 gift vouch­ers donat­ed by CRANAplus.