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Turning up at the coal face

1 Jun 2021

Each edition of the magazine, we talk to a Fellow of CRANAplus, people who work tirelessly in their roles in rural and remote health and who we have recognised for their efforts. This month we recognise the work of Nurse Practitioner Sharon Weymouth, currently based in Timber Creek in the NT and travelling in a wide circle from there to remote NT.

I’m not an aca­d­e­m­ic and have not earned my stripes through con­tribut­ing to ground-break­ing research. My pro­fes­sion­al career is not note­wor­thy, I have nev­er been a senior man­ag­er or in any posi­tion of influ­ence or impor­tance. But I have not been afraid to speak up or write or con­tribute to sub­mis­sions for change. I would say my approach is small real­is­tic bites.

What I can say is that I turn up at the coal face every day — and have done so for over 40 years: work­ing along­side like-mind­ed peo­ple, always think­ing I can help, I can sup­port, so that togeth­er we can improve the lives of peo­ple in the Bush and the peo­ple who care for them.

I see the inequal­i­ty that exists and it moti­vates me to want bet­ter for the Bush and I am lucky enough to have a part­ner along for the ride.”

For Sharon, who became a Fel­low in 2010, the things that are bet­ter for the bush” revolve around the pro­vi­sion of high-qual­i­ty pri­ma­ry health care.

Sharon is an advo­cate for strength­en­ing the remote work­force both in health cen­tres and the com­mu­ni­ty and enabling the con­sumers who use the ser­vices. Over the years, this has involved recruit­ing and assist­ing with the train­ing of local health and com­mu­ni­ty work­ers and sup­port­ing com­mu­ni­ty groups such as strong women’s pro­grams, ear­ly inter­ven­tion pro­grams for chil­dren and aged care. She has been involved in train­ing and sup­port­ing remote area nurs­es so they not only sur­vive but enjoy the expe­ri­ence so they can give the best ser­vice they can. Encour­ag­ing the shift towards Abo­rig­i­nal com­mu­ni­ty-con­trolled Health organ­i­sa­tions (ACCHOs) has been an impor­tant priority.

I have been nurs­ing for over 40 years now and only a hand­ful of those years have been in an urban set­ting – and that was while train­ing — so I guess you could say I love the Bush, the peo­ple, the land and the spir­it,” says Sharon.

Cur­rent­ly Sharon and her hus­band Phil, who trained as a Reg­is­tered Nurse while they were based in East Arn­hem, work togeth­er as the mobile remote team for Kather­ine West Health Board. They cov­er around 40,000 km a year, vis­it­ing cat­tle sta­tions and some small Indige­nous com­mu­ni­ties with­out a clinic.

I was already sold on the val­ue of pri­ma­ry health care so this job has been anoth­er great oppor­tu­ni­ty to prac­tise what we preach and to broad­en my scope of prac­tise in this area,” says Sharon. When peo­ple live in such iso­lat­ed areas, its impor­tant for them to have reg­u­lar health checks but access is not so easy. So along we come, set­ting up under the shade of a tree, or in a spare room offer­ing proac­tive screen­ing and assis­tance with man­age­ment of chron­ic con­di­tions and pre-exist­ing con­di­tions. This job allows us to use every pri­ma­ry health care skill set across the lifes­pan. This includes my first love, child health, women’s and mater­nal health also sex­u­al health, men’s health, chron­ic dis­ease man­age­ment, tobac­co and alco­hol assess­ment and coun­selling; assess­ing nutri­tion and hydra­tion, immu­ni­sa­tion, skin spot checks and oth­er skin relat­ed prob­lem; psy­cho­log­i­cal and men­tal health sup­port, plus a bit of acute care as the need arises.

All aspects of our work is impor­tant but I think mental/​emo­tion­al health sup­port is one of our main roles. Liv­ing remote can come with a unique set of stress­es for every­one. Dur­ing our well-per­son checks we pro­vide a human con­tact that is pri­vate, safe, an oppor­tu­ni­ty to get things spo­ken that may be wor­ry­ing them, and we sit around the din­ner table with staff and we nor­malise talk­ing about men­tal health ask­ing them ques­tions about how they are travelling.”

Sharon and Phil work close­ly with all mem­bers of the extend­ed Kather­ine West staff and vis­it­ing spe­cial­ist teams. If needs are iden­ti­fied, you then have the capac­i­ty to phone a friend to get appro­pri­ate help from the net­work of health pro­fes­sion­als. Last year the COVID-19 restric­tions saw sta­tion peo­ple even more iso­lat­ed than usu­al and it was a busy and reward­ing year as we picked up many of the ser­vices that peo­ple would nor­mal­ly vis­it their GP for.”

Sharon has been present for a lot of change in remote health over the years. The good and the bad,’ she says.

Child sur­vival from acute ill­ness has improved. But dis­eases that are pre­ventable like rheumat­ic heart dis­ease, that should not still be there.

I thought I knew poor, what poor peo­ple had to put up with, but to live with peo­ple who are liv­ing in absolute pover­ty with­out their basic human rights being met bring home the spi­ral of con­se­quences that comes with that. A big thing for me deal­ing with main­ly women in my ear­ly years in remote was the lev­el of fam­i­ly vio­lence and how nor­malised that was. It was both con­fronting and sad­den­ing. I gained a great respect for the women in Indige­nous com­mu­ni­ties how they could car­ry on. Their spir­it always amazed me. 

The inter­ven­tion broke my heart. How that was rolled out and the big spoon of dis­re­spect that came with it. But despite that set back I have seen some pos­i­tive changes, which should be our focus. Phil and I are both proud to work for an Indige­nous health board: they get the pri­or­i­ties right and there are less delays due to bureau­cra­cy. It’s great to work in an organ­i­sa­tion that places health pro­mo­tion and pre­ven­tive health mea­sures in such high esteem. 

There were lim­it­ed Indige­nous resources when Sharon start­ed work­ing in remote com­mu­ni­ties about 20 years ago, so she start­ed pro­duc­ing appro­pri­ate mate­ri­als. She recalls a Paul Hogan-style response from a group of Indige­nous women pre­sent­ed with a perky pair of pink breasts to talk about check­ing for breast lumps . One woman lift­ed up her top,” says Sharon, and said they’re not breasts, these are breasts’. Now, the ACCHOs ensure resources are approved by the local Indige­nous people.

Work­ing in com­mu­ni­ties is a roller coast­er,” says Sharon. You work with some of the most amaz­ing mix­ture of peo­ple and the oppor­tu­ni­ties are end­less in the most beau­ti­ful landscape. 

I wish I could say I felt sup­port­ed as a remote area nurse but to be hon­est most of the time I did not. Over the years I saw some amaz­ing nurs­es who were com­mit­ted to doing a good job in often extreme cir­cum­stance leave remote burnt out and dam­aged. The turnover of staff in com­mu­ni­ties was high and there was lit­tle empa­thy for those that were deemed to be show­ing weak­ness. I had a con­ver­sa­tion with a man­ag­er once who said remote nurs­es are dis­pos­able items — there’s always fresh fod­der look­ing for a remote adven­ture.” I hope it’s not like that now.” 

What’s next for us?” Sharon mus­es. Not quite ready for retire­ment. I am think­ing some sort of teach­ing, of health work­ers or nurs­es new to remote.

Both of us absolute­ly believe that that is one of best ways to help remote com­mu­ni­ties and the peo­ple that live in them.”