As a CRANAplus Nurs­ing and Mid­wifery Round­table mem­ber, Sam proud­ly shares her sto­ry – from the grat­i­fy­ing human con­nec­tions to the real­i­ties of work­ing in region­al and remote health care – and what changes she’d like to see in the future.

Can you tell us about your jour­ney to becom­ing a nurse?

My pas­sion for rur­al and remote health care began dur­ing my time as an aged care work­er in Broome, where I found ful­fil­ment in build­ing con­nec­tions with res­i­dents and enjoy­ing my place­ments in bush clin­ics over acute hos­pi­tal settings.

In 2014, I start­ed my career at Der­by Abo­rig­i­nal Health Ser­vice (DAHS), focus­ing on Indige­nous health, and lat­er worked (for a short time) as the sole nurse in a small clin­ic at Pan­danus Park, which solid­i­fied my com­mit­ment to rur­al health care. I now work at Oak Val­ley Health Ser­vices, locat­ed 1,200 kilo­me­tres north­west of Adelaide.

How did you end up at Oak Valley?

I met my part­ner in Der­by dur­ing my sec­ond year post-uni­ver­si­ty, which led us to move to Ger­ald­ton, where I spent a year work­ing at the region­al hos­pi­tal. From there, we relo­cat­ed to his home­town of Ceduna in South Aus­tralia, where I worked at Ceduna Hos­pi­tal for four and a half years. Dur­ing that time, I com­plet­ed a Grad­u­ate Cer­tifi­cate in Emer­gency Care and gained expe­ri­ence as a dial­y­sis nurse.

Many of my patients were Indige­nous, and I enjoyed hear­ing their sto­ries about the places they grew up and missed dear­ly. I even­tu­al­ly sought a new direc­tion in my nurs­ing career, want­i­ng to step away from acute and emer­gency care.

After men­tion­ing my inter­est in a local GP clin­ic, one of my NUMs con­nect­ed me with the Gen­er­al Man­ag­er of Mar­alin­ga Tjarut­ja Abo­rig­i­nal Cor­po­ra­tion, lead­ing to an oppor­tu­ni­ty at Oak Val­ley Health Service.

What does a typ­i­cal day look like? 

A typ­i­cal day at Oak Val­ley? It’s any­thing but typ­i­cal! We’re locat­ed in between the Anan­gu Com­mu­ni­ties of Yala­ta Com­mu­ni­ty (Eyre High­way) and Tjun­tjun­t­jara Com­mu­ni­ty in West­ern Aus­tralia. The Anan­gu peo­ple fre­quent­ly move between these com­mu­ni­ties, mean­ing the pop­u­la­tion can fluc­tu­ate dra­mat­i­cal­ly – from around 30 in the after­noon to over 50 by the next morning. 

Our tasks include con­duct­ing health checks and med­ica­tion rounds dur­ing school vis­its (around 18 kids), dis­pens­ing Web­ster packs for reg­u­lars, pro­vid­ing emer­gency care, and liais­ing with the Roy­al Fly­ing Doc­tor Ser­vice (RFDS) when nec­es­sary. We also over­see aged care, which resem­bles assist­ed liv­ing more than tra­di­tion­al aged care. Dur­ing sig­nif­i­cant cul­tur­al events, we can host up to 11 aged care clients and 10 – 15 clients stay­ing with fam­i­ly mem­bers, and com­mu­ni­ty num­bers can climb to over 300.

How does work­ing in a remote com­mu­ni­ty dif­fer from work­ing in a larg­er hos­pi­tal?

Work­ing in pri­ma­ry health has a dif­fer­ent rhythm com­pared to an acute hos­pi­tal set­ting. While it’s still busy, the pace is slow­er, allow­ing more time for inter­ac­tion and con­nec­tion with patients. Trust is not giv­en auto­mat­i­cal­ly; it must be earned through con­sis­tent, com­pas­sion­ate care. In a tiny com­mu­ni­ty like Oak Val­ley, we often find our­selves iso­lat­ed from larg­er towns (Ceduna is 500 km away).

How­ev­er, in emer­gen­cies, the com­mu­ni­ty ral­lies togeth­er, pro­vid­ing food, airstrip checks, and trans­porta­tion for clin­ic staff and RFDS crews.

What unique chal­lenges do you face in pro­vid­ing care in a remote set­ting, and how do you over­come them?

Our com­mu­ni­ty is high­ly mobile, which com­pli­cates con­sis­tent care, espe­cial­ly when patients may be away for extend­ed periods.

It can also be chal­leng­ing to obtain med­ica­tion and health sum­maries from oth­er small health ser­vices for vis­i­tors. We have addressed these chal­lenges by fos­ter­ing strong part­ner­ships with per­ma­nent staff in neigh­bour­ing clin­ics.

We’ve built a robust net­work for men­tal health patients who need month­ly depo nee­dles, ensur­ing they receive time­ly care through collaboration.

What’s the most sat­is­fy­ing aspect of your role?

Being recog­nised by com­mu­ni­ty mem­bers from my pre­vi­ous role in Ceduna has been grat­i­fy­ing. I love spend­ing time with chil­dren and their moth­ers; while bathing the kids, I engage in con­ver­sa­tions about health issues and upcom­ing immunisations.

Over my two and a half years here, I’ve had the priv­i­lege of watch­ing babies grow into tod­dlers and chil­dren grow into teenagers who leave for school in Adelaide.

What sur­prised you about work­ing in rur­al and remote health care? 

Tran­si­tion­ing from Ger­ald­ton to Ceduna, I was struck by the diverse roles rur­al nurs­es must fill. In a larg­er hos­pi­tal, a ward nurse focus­es on a spe­cif­ic set of patients with defined treat­ment plans. In Ceduna, nurs­es are phle­botomists, emer­gency respon­ders, ward nurs­es, x‑ray tech­ni­cians, and more. While this can be pres­sur­ing, it’s also empow­er­ing. At Oak Val­ley, I appre­ci­ate the auton­o­my of remote clin­ic work, sup­port­ed by the Cen­tral Aus­tralian Rur­al Prac­ti­tion­ers Asso­ci­a­tion (CARPA) Man­u­als and a reli­able team ready to assist. 

Can you describe a par­tic­u­lar­ly reward­ing expe­ri­ence you’ve had with a patient or fam­i­ly in this community? 

Due to cul­tur­al sen­si­tiv­i­ties, I can­not delve into specifics. How­ev­er, advo­cat­ing for pal­lia­tive patients to return to their com­mu­ni­ty has been pro­found­ly reward­ing. Col­lab­o­rat­ing with our health team and the com­mu­ni­ty to pro­vide pal­lia­tive care dur­ing the final days and hours of life was an honour. 

What keeps you moti­vat­ed and pas­sion­ate about your work in a remote setting? 

The peo­ple tru­ly moti­vate me. Our health team – com­pris­ing the man­ag­er, an admin staff mem­ber, and myself – works cohe­sive­ly. We trust each oth­er and get the job done togeth­er. Com­mu­ni­ty mem­bers know they can rely on us, and some­times they drop by just for a cup of tea, which reflects the strong con­nec­tions we’ve built with the Anan­gu people. 

What tips would you give nurs­es inter­est­ed in explor­ing a career in rur­al and remote locations? 

Absolute­ly give it a try! Start with short­er place­ments clos­er to home to gain con­fi­dence before branch­ing out. Nurs­ing is incred­i­bly var­ied, offer­ing numer­ous paths to explore.

When work­ing with Indige­nous com­mu­ni­ties, remem­ber to lis­ten more than you speak. Observe how expe­ri­enced staff inter­act with patients; every com­mu­ni­ty has unique customs. 

Build­ing trust often starts with under­stand­ing fam­i­ly rela­tion­ships and cul­tur­al back­grounds before address­ing med­ical issues. Over the years, many non-Indige­nous indi­vid­u­als have come and gone, so it’s essen­tial to make peo­ple feel heard. 

Why did you decide to apply to become a CRANAplus Round­table member? 

I was encour­aged to apply due to the lack of rep­re­sen­ta­tion from remote South Aus­tralia. Ini­tial­ly, I hadn’t con­sid­ered it, but I now feel I have enough expe­ri­ence to con­tribute mean­ing­ful­ly. CRANAplus has been an excel­lent resource for edu­ca­tion and sup­port through the Bush Sup­port Line, and I believe it’s time to give back.

What strate­gies do you use to edu­cate patients about their health, espe­cial­ly in a com­mu­ni­ty with lim­it­ed resources? 

We receive valu­able sup­port from organ­i­sa­tions such as the South Aus­tralian West Coast ACCHO Net­work (SAW­CAN) and the Abo­rig­i­nal Health Coun­cil of South Aus­tralia (AHC­SA), which pro­vide cul­tur­al­ly appro­pri­ate resources that are easy for com­mu­ni­ty mem­bers to understand. 

I strive to keep my edu­ca­tion­al efforts con­cise, plant­i­ng the seed for fur­ther dis­cus­sions lat­er. It’s impor­tant to avoid sound­ing preachy while shar­ing information. 

What changes or improve­ments would you like to see in health care deliv­ery in remote communities? 

Stream­lined fund­ing and report­ing process­es would great­ly ben­e­fit health care delivery.

In our small clin­ic, I’ve seen how my man­ag­er spends count­less hours on fund­ing reports. 

Each fund­ing source requires dif­fer­ent proof of appro­pri­ate use of funds, lead­ing to com­plex and time-con­sum­ing report­ing processes.