Going into work as a school nurse in a remote com­mu­ni­ty, my goal was to pro­vide qual­i­ty holis­tic care to the stu­dents and school staff. When I first went to work in the com­mu­ni­ty, I did not know what to expect and felt unpre­pared for the poten­tial chal­lenges that lay ahead.

I had heard a lot about the term ​‘cul­ture shock’ and won­dered what that even looked like. Well, I can tell you ​‘cul­ture shock’ is real!

I had lived and worked in Dar­win in the past so I thought ​“How dif­fer­ent can work­ing in a remote com­mu­ni­ty be?” Noth­ing pre­pared me for the iso­la­tion, lack of resources and health chal­lenges that I was pre­sent­ed with. I found it extreme­ly con­fronting and at times, heartbreaking.

I knew very lit­tle about Rheumat­ic Heart Dis­ease before this time. I ques­tioned myself con­stant­ly, ​“What is it you want to achieve out here, Julie?”

The health issues that the com­mu­ni­ty faced were huge. I found myself each day patch­ing up wounds; treat­ing infect­ed sca­bies, strep throat, impeti­go, burns, and oti­tis media; liais­ing with allied health pro­fes­sion­als who vis­it­ed month­ly if we were lucky; organ­is­ing Hear­ing Health vis­its; cre­at­ing care plans for the chil­dren who had asth­ma, dia­betes or who were growth fal­ter­ing; admin­is­ter­ing Rital­in and admin­is­ter­ing LA bicillin to the RHD kids. These were just a few of the list of duties that I found myself doing.

One of the high­lights (and there were many) was hav­ing the oppor­tu­ni­ty to go into the class­rooms and edu­cate stu­dents and local staff on the many health issues the com­mu­ni­ty faced. I found this extreme­ly reward­ing and hoped that by edu­cat­ing the stu­dents and local staff that would have a ​‘rip­ple’ effect in the community.

I was also very for­tu­nate to have a good boss (prin­ci­pal) at the time who fund­ed any pro­fes­sion­al devel­op­ment that I felt I need­ed fur­ther edu­ca­tion on.

I was also extreme­ly grate­ful to be cho­sen to par­tic­i­pate in the Recar­dia Pro­gram that was run by Men­zies and I spent a week in Dar­win and then Man­ingri­da learn­ing how to do echocar­dio­grams to look for mitral valve regur­gi­ta­tion in the detec­tion of RHD.

Although, there were many high­lights and adven­tures (such as hav­ing the priv­i­lege of going out on Coun­try with won­der­ful fam­i­lies that I had formed con­nec­tions with) I felt as if I was drown­ing in the nev­er-end­ing sea of peo­ple that would come through my lit­tle clin­ic door.

It’s easy to say ​‘del­e­gate’ but being the only school nurse with a school pop­u­la­tion of 600 and often you were nurse to the stu­dents’ fam­i­ly mem­bers as well, not to men­tion the school staff who would vis­it dur­ing their school lunch or recess breaks which was also your break times. Then, there were the school staff who’d ring you after hours for med­ical advice or request you to come and see their dog.

You learnt very quick­ly to upskill and you became every­thing to every­one. You cer­tain­ly learn to adapt to your envi­ron­ment and become inven­tive very quickly.

I cer­tain­ly could not have done any of this suc­cess­ful­ly with­out the help of the Abo­rig­i­nal Health Worker.

Abo­rig­i­nal Health Work­ers are a wealth of local knowl­edge and often know where every­body lives, which child belonged to which fam­i­ly, and which hous­es to avoid if they have ​‘cheeky dogs’, or if there is ​‘sor­ry busi­ness’ going on.

I found that you learned very quick­ly that to sur­vive out here you need­ed to devel­op rela­tion­ships and earn the trust of the local peo­ple: with­out that, you don’t have a chance.

I learnt so much from the local peo­ple, resilience being one. I have so much respect for the grand­moth­ers who with­out com­plaint often take on the role of look­ing after their grand­chil­dren and keep­ing their fam­i­lies togeth­er and safe whilst often neglect­ing their own needs.

After four years in the remote com­mu­ni­ty, I decid­ed that I need­ed to be clos­er to fam­i­ly and in all hon­esty I was exhaust­ed, men­tal­ly, emo­tion­al­ly and phys­i­cal­ly. I believe I had com­pas­sion fatigue and had become desen­si­tised to liv­ing and work­ing in chal­leng­ing circumstances. 

I can cer­tain­ly say I have nev­er expe­ri­enced so much joy, sad­ness, despair, hope­less­ness and grat­i­tude in the one place. I encour­age any­one who has ever thought of doing remote nurs­ing to go and do it. You won’t regret it. It is life-changing!