“At the time of that dis­as­ter, I was con­sid­ered a senior, work­ing in triage and resus­ci­ta­tion at the hos­pi­tal where I was work­ing,” says Catherine.

“It got me think­ing, we have con­certs here. What if some­thing like that hap­pened on my watch? What would I be required to do? What can I expect?

“I start­ed to read arti­cles about dis­as­ter pre­pared­ness and respons­es. And I realised that this was big­ger than me and the facil­i­ty I was work­ing in.”

Cather­ine is now half way through her PhD research to explore the expe­ri­ences of rur­al and remote nurs­es in Aus­tralia who have assist­ed in disasters.

Which was not simple. 

“Rur­al and remote nurs­es in Aus­tralia are often involved in dis­as­ter response, fac­ing unique chal­lenges in their dai­ly prac­tice because of geo­graph­i­cal iso­la­tion and reduced resources,” says Catherine.

“But their expe­ri­ences have been large­ly unre­port­ed. I knew there had to be oth­er rur­al and remote nurs­es in Aus­tralia who would like access to local research to inform their practice.”

Cather­ine looked at thou­sands of arti­cles, from coun­tries like Brazil, Japan, Cana­da, the US and Thai­land. Not one arti­cle in Aus­tralia fit­ted the cri­te­ria. And so Cather­ine relied on over­seas mate­r­i­al for the first stage of her research, Expe­ri­ences of rur­al and remote nurs­es dur­ing and fol­low­ing dis­as­ters: a scop­ing review.

Eight over­seas arti­cles met the inclu­sion cri­te­ria for the review which iden­ti­fied four major themes: dis­as­ter roles, pre-dis­as­ter prepa­ra­tions, psy­cho­log­i­cal and emo­tion­al states, and com­mu­ni­ty involve­ment and relationships.

“We learned about nurs­es’ ini­tial involve­ment, which was imme­di­ate­ly before the dis­as­ter,” Cathe­rien says.

“They did things such as gath­er­ing essen­tial equip­ment and First Aid mate­ri­als; con­tact­ed oth­er indi­vid­u­als, inform­ing them of what was hap­pen­ing; checked out safe ground and evac­u­at­ed peo­ple, gen­er­al­ly prepar­ing for the impend­ing disaster.”

The arti­cles then described the psy­cho­log­i­cal and emo­tion­al states, the feel­ings of pow­er­less­less or unease when they couldn’t leave the hos­pi­tal, because the demand for their skills was too high, and con­cerns that they didn’t have the right or essen­tial equipment.

“The arti­cles did show spe­cif­ic areas where the nurs­es, because they were in rur­al and remote areas, had exist­ing rela­tion­ships with the com­mu­ni­ty and, because of that, they felt able to step up,” says Catherine.

“They felt they could assist the com­mu­ni­ty mem­bers because of those con­nec­tions. For exam­ple, ​‘they knew this per­son has high blood pres­sure,’ ​‘They’d met this per­son before and could facil­i­tate eas­i­er pre­scrip­tion of their med­ica­tion due to this inti­mate knowl­edge of the com­mu­ni­ty members’.”

“The scop­ing review showed that the nurs­es had exten­sive roles when respond­ing to the dis­as­ter. Assess­ing, triag­ing, pro­vid­ing treat­ment and psy­cho­log­i­cal sup­port, skills in net­work­ing and col­lab­o­rat­ing with oth­er health agen­cies; they were required to coor­di­nate peo­ple and to respond effectively.

“What has been clear to me are the attrib­ut­es that nurs­es bring to their role in dis­as­ter sit­u­a­tions, attrib­ut­es that you don’t learn. They are innate,” says Catherine.

“And what couldn’t be answered in the scop­ing review was how these attrib­ut­es are influ­enced by the rur­al and remote con­text in which these nurs­es are sit­u­at­ed and the rela­tion­ships they have with their com­mu­ni­ty. Is this some­thing that is spe­cif­ic to rur­al and remote nurses?”

Cather­ine recog­nised that fur­ther research is need­ed to bet­ter under­stand this phe­nom­e­na and to address knowl­edge gaps in exist­ing lit­er­a­ture, specif­i­cal­ly regard­ing Aus­tralia. She’s set out to fill those miss­ing spaces.

In the process, she has been inspired by the sto­ries from Aus­tralian nurs­es who have faced dis­as­ter in their work­ing lives, sto­ries that will become part of her thesis.

“I’ve been over­whelmed by the sto­ries that these nurs­es have shared with me,” she says. ​“Their com­mit­ment and ded­i­ca­tion to pro­vide care for the com­mu­ni­ty, some­times even being affect­ed by the dis­as­ter them­selves, help­ing out wher­ev­er and how­ev­er they can — they are just tru­ly amaz­ing clin­i­cians and human beings.”

In the next stage of her research, Cather­ine will analyse the respons­es from the nurs­es she has inter­viewed – to bet­ter under­stand and explain their expe­ri­ences in dis­as­ter sit­u­a­tions in rur­al and remote areas.

Ulti­mate­ly, her aim is to pro­vide Aus­tralia-spe­cif­ic infor­ma­tion and sup­port for nurs­es through­out the coun­try, should that ​“what if” ques­tion ever become a real­i­ty for them.