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Supporting farmers in remote Gippsland, Victoria

30 Aug 2021

The Victorian Government announced funding for a Bush Nursing Pilot project this June. We catch up with Sarah Carr from Dargo Bush Nursing Centre to find out how the project is being implemented and why it's so important.

Our cen­tre is prob­a­bly one of the most remote in Vic­to­ria,” said Sarah Carr, Nurs­ing Man­ag­er, who over­sees a team of three oth­er RANs at the Depart­ment of Health fund­ed centre.

Our nurs­es all live in the Briago­long area, near Strat­ford, near Sale. It takes about an hour to get to work. There’s a house linked to the cen­tre. You can stay up here; it’s almost like a mini-FIFO.

We’re trained as Remote Area Nurs­es. We respond by pager to any emer­gen­cies that hap­pen in the Dar­go area. We are the first respon­ders. It’s about an hour’s wait for an ambu­lance by road and about 45 min­utes for an emer­gency flight.

In one shift, you could get an emer­gency call-out for an ambu­lance and be treat­ing pneu­moth­o­rax and decom­press­ing the chest,” Sarah con­tin­ues. You can then come back to the cen­tre and be doing the admin, then in walks wound care. Then you might have a lady want­i­ng a pre­na­tal assess­ment, then a pal­lia­tive care patient, then you’ve got a meet­ing. When you come back there’s a kid with gas­tro or a men­tal health patient.”

The cen­tre has over 230 patients on its books and cov­ers a wide geo­graph­i­cal area. Due to resourc­ing, it has often only had one nurse ros­tered on per shift, mak­ing it a chal­lenge for nurs­es to reach the out­ly­ing community.

For a home vis­it to, say, Crooked Riv­er, it can take one and a half hours just to get there – mak­ing for a four to five hour round trip,” Sarah said. You can’t close a cen­tre for that long.”

At the same time, farm­ers in out­er Dar­go have demon­strat­ed low lev­els of engage­ment with health care providers. The dis­tance presents an obsta­cle, par­tic­u­lar­ly when con­sid­ered in light of the stress caused by drought, bush­fire and COVID-19.

In ear­ly June, Vic­to­ri­an Min­is­ter for Agri­cul­ture Mary-Anne Thomas announced $350,000 for the Bush Nurs­ing pilot project’, an ini­tia­tive that aims to equip farm­ing com­mu­ni­ties with the infor­ma­tion, tools and resources to improve health out­comes and build resilience. The funds come out of the state government’s $20-mil­lion Smarter, Safer Farms initiative.

The pilot focus­es on sup­port­ing farm­ers who are geo­graph­i­cal­ly hard­er to reach, with fund­ing going to six Bush Nurs­ing Cen­tres in Gipp­s­land includ­ing the Dar­go Bush Nurs­ing Cen­tre, plus sim­i­lar cen­tres in Ensay, Gelan­tipy, Swifts Creek, Buchan and Cann Valley.

The great news is that with the fund­ing we have been able to employ a nurse to work one day a week along­side anoth­er nurse. That nurse will pri­mar­i­ly run the project one day a week.”

For a long time we have done screen­ing and health pro­mo­tion… but we have usu­al­ly had to focus on peo­ple com­ing to the cen­tre to do that.”

Now, instead of hav­ing to close the cen­tre to do home vis­its, and leave the cen­tre unmanned, we’re going to have anoth­er nurse here to do the home vis­its. It’s a great resource to have!”

In July, Sarah explained that there had been a real­ly pos­i­tive” ini­tial com­mu­ni­ty response.

She went on to say that the Dar­go cen­tre planned to approach 30 to 40 farm­ers who haven’t accessed health­care in the last 12 to 24 months.

Many of the can­di­dates are to be with­in the vul­ner­a­ble 65+ age group and male, because his­tor­i­cal­ly men have engaged less with health­care than women in Dargo.

We’ll be doing home vis­its on the road, mak­ing a time that’s con­ve­nient for par­tic­i­pants. If it’s hay sea­son or it’s busy on the farm, we’ll work in with what they’re doing.”

We’ll ini­tial­ly ask how they’re going and what’s been hap­pen­ing. And we will do a lot of health screen­ing dur­ing vis­its. We’ll be

look­ing at stan­dard things like blood pres­sure, weight/​height, and glu­cose lev­els; but also bow­el screen­ing with test­ing-at-home kits and cho­les­terol checks using a point-of-care cho­les­terol check­ing machine we are going to purchase.”

Basi­cal­ly it will be an all-sys­tems check. And if any­thing is flagged, we’ll be part of the refer­ral process as well. We’ll help organ­ise GP spe­cial­ist appoint­ments, write let­ters, fol­low up with health pro­fes­sion­als and liaise on behalf of the patient.”

We are hop­ing that if the pilot project is suc­cess­ful, we could look at get­ting addi­tion­al fund­ing through the next few years – which would be absolute­ly amazing.”

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