“While work­ing in emer­gency in west­ern Syd­ney, I’d see patients come through who would have ben­e­fit­ed from stronger pri­ma­ry health care,” says Cather­ine. ​“We’d see peo­ple, for exam­ple, come in with COPD (chron­ic obstruc­tive pul­monary dis­ease) every fortnight.

“Maybe if they had stronger sup­port with pre­ven­ta­tive mea­sures, dis­ease man­age­ment at a com­mu­ni­ty lev­el, with infor­ma­tion on how to take their med­i­cines, more edu­ca­tion on the impor­tance of vaccinations.

“I’d speak to patients, see­ing these missed oppor­tu­ni­ties, but you don’t have time to focus on these things in ED.”

Cather­ine, who grew up in west­ern Syd­ney and stud­ied nurs­ing in Wag­ga Wag­ga, has worked at mul­ti­ple met­ro­pol­i­tan Syd­ney hos­pi­tals as well as for the NHS in the UK, before under­tak­ing a Mas­ter of Pub­lic Health and Trop­i­cal Med­i­cine, where the impor­tance of pri­ma­ry health care came to the fore.

“I cer­tain­ly learned that a stronger pri­ma­ry health­care sys­tem would be of ben­e­fit to all Aus­tralians,” says Cather­ine, who start­ed look­ing at her options for a change in direction.

“I start­ed to look at rur­al and remote, know­ing that there is a gap in those areas in the pro­vi­sion of health care,” she says. ​“Pri­ma­ry health is a spe­cial­ist area and pri­ma­ry health­care nurs­es in rur­al and remote areas are spe­cial­ist generalists.”

“Hav­ing a var­ied back­ground is a strength, but my back­ground doesn’t make me an expert pri­ma­ry health­care nurse. There are many agen­cies send­ing nurs­es into those loca­tions, but I felt I need­ed more sup­port. I want­ed to make sure I was prepared.”

It was then that Cather­ine learned about an NT Health ini­tia­tive which aims to sup­port reg­is­tered nurs­es with a min­i­mum of three years post grad­u­ate expe­ri­ence. ​“Through the Top End Pub­lic and Pri­ma­ry Health Care Tran­si­tion to Remote Health Nurse Pro­gram, I knew I would get a year’s train­ing and edu­ca­tion­al sup­port to do cours­es, help­ing me gain rel­e­vant skills, expe­ri­ence and knowl­edge with a spe­cif­ic focus on remote area nurs­ing. It was just what I want­ed and needed.”

And so in Feb­ru­ary this year, Cather­ine arrived in Wad­eye, about 420 km south west of Dar­win, one of the largest remote com­mu­ni­ties in the Ter­ri­to­ry with a fluc­tu­at­ing pop­u­la­tion of around 2,500 people.

“I found Wad­eye to be a very wel­com­ing com­mu­ni­ty and it’s a very col­lab­o­ra­tive health prac­tice. It’s a chal­leng­ing envi­ron­ment, being geo­graph­i­cal­ly iso­lat­ed and lack­ing many of the phys­i­cal resources I was used to in Syd­ney. A patient starts a new med­i­cine, for exam­ple, and you can’t just send them to the phar­ma­cy. The med­i­cine they need may not be avail­able and you have to wait some days for it to be deliv­ered. Spe­cial­ist sup­port is not on hand either – it may be hours away by plane.

“Some days are chal­leng­ing and I am very mind­ful of the need for self-care. It would be very dif­fi­cult to take on this kind of role if you aren’t open to new experiences.”

Part of the NT tran­si­tion pro­gram are com­po­nents of cul­tur­al aware­ness. ​“I did a two-week ori­en­ta­tion pro­gram and a week of cul­tur­al train­ing which was real­ly valu­able,” says Cather­ine. ​“I found it helped me to reframe how we deliv­er health care.

“It empha­sis­es that we are now in a com­mu­ni­ty with a dif­fer­ent cul­ture, dif­fer­ent social struc­tures, a dif­fer­ent lan­guage – like going to work in a dif­fer­ent country.

Cho­sen for the 2024 CRANAplus Ear­ly to Remote Prac­tice Award, her nom­i­na­tion states: Cather­ine is a nurse tran­si­tion­ing from acute met­ro­pol­i­tan care to remote prac­tice and in her first remote expe­ri­ence has demon­strat­ed a com­mit­ment to col­lab­o­rat­ing with col­leagues and oth­er ser­vices to sup­port the com­mu­ni­ty and deliv­er evi­dence-based care. 

She has broad­ened her prac­tice includ­ing pri­ma­ry health care and demon­strat­ed open­ness to learn­ing and devel­op­ing as a cul­tur­al­ly safe clin­i­cian and devel­op­ing rap­port with the com­mu­ni­ty. Cather­ine exem­pli­fies CRANAplus val­ues of Excel­lence, Respect and Inclusiveness.

“Dai­ly, I need to be mind­ful that the health care and ser­vice I deliv­er is meet­ing the needs of the com­mu­ni­ty and what they want and need; not my per­cep­tions of what they need,” says Cather­ine. ​“Doing this makes me more thought­ful –one size does not fit all.

“I’ve been doing CRANAplus cours­es, so far com­plet­ing the REC and the MEC cours­es. They were fan­tas­tic, always geared to refram­ing clin­i­cal skills for the rur­al and remote context.

“I have asked a mil­lion ques­tions and will ask a mil­lion more.”

And, come next Feb­ru­ary, Cather­ine knows she will con­fi­dent­ly be ready to apply for any remote or rur­al posi­tion as a junior remote area nurse.