“When you’re place-based, or in a long-term FIFO role, you are pro­vid­ing care for peo­ple who are also your com­mu­ni­ty,” Katie says. 

“They may be the local barista at your favourite cof­fee shop, kids at the local school or grand­par­ents of some­one you know. 

“In an urban set­ting, you often only have brief inter­ac­tions with peo­ple who you don’t see in your dai­ly world.

“In a rur­al and remote set­ting, you see the out­comes of the care you pro­vide in the lives of the peo­ple around you. 

“The per­son­al ben­e­fit [of this] is the emo­tion­al sat­is­fac­tion and joy when you wit­ness pos­i­tive out­comes,” Katie says, going on to pro­vide an exam­ple from her own career. In a remote West­ern Aus­tralian com­mu­ni­ty where Katie used to work, she had the oppor­tu­ni­ty to sup­port com­mu­ni­ty mem­bers – some of whom first inter­act­ed with non-Indige­nous peo­ple in the late 1970s and 1980s when they were already in their 20s or 30s – to remain on their Coun­try for their end-of-life journey. 

“I now work in remote Tas­ma­nia in a pri­ma­ry health care role, that at times also involves enabling fam­i­lies to pro­vide end-of-life care for loved ones at home, in the places they are con­nect­ed to,” Katie says.

“It’s sad because they’re peo­ple you know, mem­bers of your com­mu­ni­ty, but joy­ful in that you are help­ing them achieve some­thing they real­ly desire.” 

While wit­ness­ing a suc­cess­ful out­come can con­firm you in your approach, see­ing the impact of health care that didn’t have the desired result pro­vides strong exter­nal feed­back that indi­cates where you may need to improve or extend your practice. 

Deep com­mu­ni­ty con­nec­tions also max­imise your abil­i­ty to deliv­er health­care and inspire you to advo­cate – which is one rea­son why Katie prefers place-based mod­els of care to short-term place­ment models. 

“It takes time to devel­op the trust required for ther­a­peu­tic rela­tion­ships,” she says. 

As a res­i­dent in a remote com­mu­ni­ty, Katie says: ​“When I think about myself as a health care con­sumer, I’m real­ly picky and choosy about who I share my health sto­ries to, so I have empa­thy for peo­ple liv­ing in areas with a high turnover of health­care staff… It’s that thing of hav­ing to tell the same health sto­ry to dif­fer­ent people. 

“The work you can do with peo­ple, par­tic­u­lar­ly around the chal­leng­ing changes to lifestyle that are required to pre­vent chron­ic con­di­tions, or under­stand­ing com­plex sup­port and advo­ca­cy needs – that only real­ly occurs when you’ve estab­lished a long-term ther­a­peu­tic relationship.” 

As she has learnt about health­care needs and bar­ri­ers in the com­mu­ni­ties she has served, Katie has felt dri­ven to improve the sta­tus quo. She has helped to improve fund­ing arrange­ments for health ser­vice deliv­ery in numer­ous com­mu­ni­ties and set­tings through the use of rel­e­vant data, polit­i­cal advo­ca­cy, and work­ing with fund­ing bodies. 

Katie has recent­ly com­plet­ed research exam­in­ing the impact of med­i­cines and poi­sons leg­is­la­tion on health ser­vice deliv­ery in remote Aus­tralia, which con­tributed to leg­isla­tive reform enabling RNs work­ing in remote areas of WA to legal­ly sup­ply med­i­cines for chron­ic conditions.

She is cur­rent­ly advo­cat­ing for sus­tain­able mod­els of pri­ma­ry health care pro­vi­sion on the East Coast of Tas­ma­nia, while also sit­ting on the CRANAplus Nurs­ing and Mid­wifery Round­table to ensure CRANAplus is aware of local health­care challenges. 

“Ini­tial­ly as a health­care advo­cate I prob­a­bly bum­bled my way along, until I learnt strate­gies that can suc­cess­ful­ly be used to advo­cate for change,” Katie says. 

“It was being brave, say­ing that… even though I might not know exact­ly the right way to start speak­ing up, I’m going to have a go. 

“The oppor­tu­ni­ty may not have arisen in urban set­tings, because there are so many oth­er peo­ple around – the sys­tems are big­ger, the pro­fes­sion­al white noise loud­er – that your voice may not be heard, or the need for you to be an advo­cate may not even exist. 

“In remote areas, where you may be the only health pro­fes­sion­al who is con­sis­tent­ly present, who has that deep under­stand­ing of local bar­ri­ers and chal­lenges, the dri­ve to be brave and use your voice is very strong. 

“I would put the chal­lenge out to [short-term work­ers] to con­sid­er the dif­fer­ence they could make if they chose to return to the same place, con­tin­u­al­ly,” Katie says in closing. 

“We can only fix the things that are wrong with the sys­tems in which we work if we stay in a place and tack­le the chal­lenges our­selves… If we say okay, I can see these things are bro­ken – how am I going to be part of the solution? 

“If you stick with it and see one pos­i­tive out­come, then anoth­er, and then realise you are part of pos­i­tive change in the sys­tem that’s result­ing in improved health care deliv­ery – how reward­ing is that?!”